N.A.S.S Dingwall Branch Information Page

Link to full Index

Codeine and Aspirin-Codeine Combinations

Paracetamol with codeine should be investigated in the Drug File under paracetamol and codeine.
Codeine is usually given alone (Paveral) when the patient should not be taking paracetamol or aspirin.
Often used as the active ingredient in cold/cough medications to suppress cough. Examples of (BRITISH) UK Trade name products: (Benylin with Codeine) (Dimotane Co) (Phensedyl Linctus) (Pulmo Barley). Example of (AMERICAN) US Trade name products: (Robitussin-AC)

INDICATION

A narcotic medication used to relieve pain. Codeine is also effective as a cough suppressant.

SIDE EFFECTS

Sedation, decreased senses, euphoria, dizziness, seizures, decreased blood pressure, decreased heart rate, nausea, vomiting, constipation, dry mouth, urinary retention (cannot void), intestinal obstruction, flushing, itching, respiratory depression (slowing of breathing), and addiction.

INTERACTIONS and PRECAUTIONS

Use with tricyclic antidepressants, antihistamines, sedatives, muscle relaxants, other narcotic analgesics or alcohol can increase sedation.

USUAL DOSE

Adult and adolescent: 1-2 tablets every four hours as needed and tolerated Paediatrics: dosage not established.

Overdose of Drugs

There were 3800 fatal accidental poisonings that occurred in the UK in 1992 of which 4.8% were children under the age of six years. When all drug categories are combined, medicines are clearly the biggest group of agents responsible for childhood poisonings.

Narcotic Medications

This would include a wide variety of medicinal and "streetdrugs" such as:
Heroin, morphine, pethidine, codeine, oxycodone, oxymorphone,
Dextropropoxyphene, nalbuphine, hydromorphone, methadone, butorphanol, fentanyl, hydrocodone, (Demerol) (Darvon) (Darvocet) (Vicodin) (Nubain) (Tylenol #3) (Percocet) (Percodan) (Wygesic) (Lortab) (Lorcet) (Phenaphen #3) (Anexia) (Roxicet) (Tylox) (Talwin Compound) (Dilaudid) (Dolene) (Doraphen) (Doxaphene) (Stadol) (Duragesic)

FIRST AID:

DO NOT administer ipecac. See a doctor at once. This group of medications can cause severe respiratory depression.

RELATIVE TOXICITY:

Toxic levels of the medications are extremely variable. Patients with a history for regular use of an agent, versus the "first time" use or ingestion can have vastly different reactions. Narcotics are often mixed with other medications (e.g. paracetamol, aspirin, etc.); therefore, it is very important to evaluate the relative toxicity of these medications as well. Anything in excess of the recommended dosage should be considered toxic.

TOXIC EFFECTS:

Pinpoint pupils, blurred vision, dizziness, sleepiness, incoordination, nausea, low blood pressure, seizures, respiratory depression, coma, and death may occur.

RECOMMENDATIONS:

Administer ipecac following the guidelines above, and seek emergency medical treatment immediately.

REMEMBER:

Take the remaining pills and the original pill bottle to the hospital for complete analysis.

Link to full Index