are health risks for children who are given codeine for coughs
year, the U.S. Food and Drug Administration (FDA) convened an
advisory panel to consider the use of codeine specifically for
suppression of cough and found little evidence of
benefit," says Dr. Randall Flick, director of Mayo Clinic
Childrenís Center. The American Academy of Pediatrics agrees
in a clinical report published in the September 2016 issue of
who was a member of the FDA panel, adds, "The report went
significantly farther and recommended that labeling of codeine
use be eliminated for all indications and that codeine be
removed from the list of medications for over the counter use.
Over the past few years, several deaths have been associated
with the use of codeine in children, typically, but not
always, after tonsillectomy. In order to provide pain relief,
codeine must be converted by the body into morphine.
on genetics, some people convert none of the codeine dose to
morphine, while others convert a large amount very rapidly. As
a consequence, some children receive no benefit and continue
to have unrelieved pain. Perhaps more importantly, those that
convert a large amount of codeine to morphine, called
ultra-rapid metabolizers, are placed at risk for overdose,
despite having received the recommended dose."
to Flick, alternative pain medications include other opioids
that do not share the same genetically based problems as
codeine and non-opioid pain medicines such as ibuprofen,
acetaminophen or other similar medicines. "The issue of
codeine use in children must also be part of any conversation
regarding the use of opioids Ö because, despite warnings, it
remains among the most prescribed opioids for children."
concludes with this reminder: "Parents should avoid using
over-the-counter, codeine-containing products such as cough
medicines. They should discuss alternatives with their doctor
when prescribed codeine for pain or cough."