If you are:
FDB Only When Necessary: INSUFFICIENT DATA AVAILABLE; NEONATE RISK OF SEIZURES;AVOID DURING 3RD TRIMESTER
Only When Necessary: NEONATAL WITHDRAWAL/RESP.DEPRESS. W/CHRONIC OR HIGH DOSE; SMALL TERATOGENIC RISK
Precaution: CNS/RESPIRATORY DEPRESSION,APNEA POSSIBLE;CAUTION W/ FAST CYP2D6 METABOLIZER
No Known Risk: LOW LEVELS EXCRETED WITH LOW RISK FOR ADVERSE EFFECTS IN INFANT
Precaution: INSUFFICIENT DATA AVAILABLE; MAY CAUSE SEDATION AND INHIBIT LACTATION
An adult over 60:
management or monitoring precaution: Neuro/Psych-Anticholinergic effects may cause sedation, worsen cognitive impairment and increase fall risk. Non-sedating antihistamine preferred. Gastrointestinal-May cause or worsen pre-existing constipation. Genitourinary-Best avoided in patients with urinary retention from any cause.
management or monitoring precaution: Pulmonary-Life threatening respiratory depression is more likely to occur with high doses, SR products, cachexia, or debilitation due to altered pharmacokinetics with poor fat stores, muscle wasting, or altered clearance. Monitor closely at initiation and with dose titration. Neuro/Psych-Risk for increased confusion and delirium. May increase fall risk. Avoid treatment with 3 or more CNS active drugs. Gastrointestinal-Constipation risk. Urogenital-Urinary retention risk.
management or monitoring precaution: Hepatic-Elderly are more susceptible to hepatotoxicity. Strict adherence to a maximum daily dose of 3000mg is advised.
Giving Cotabflu tablet to a child under 12:
management or monitoring precaution: Use weight based dosing in children less than 12 years.
Severe Precaution: Not recommended in children under 6 years unless clinician consultation.
Contraindication: Possible paradoxical CNS excitation. Seizure risk in newborns.
Contraindication: Contraindicated for pain management post tonsillectomy and adenoidectomy. Risk of respiratory depression increased in CYP2D6 ultra-rapid metabolizers. Children are at increased risk of CNS and respiratory depression. Efficacy and safety for use as an antitussive has not been demonstrated in children.
Severe Precaution: Contraindicated for pain management post-surgical tonsillectomy and or adenoidectomy. Respiratory depression and death reported in CYP2D6 ultra-rapid metabolizer patients post tonsillectomy or adenoidectomy. Specific CYP2D6 genotypes convert codeine into morphine more rapidly and achieve higher levels of morphine even with standard dosing. Slow or difficult breathing risk in patients with asthma or other underlying breathing problem.
Severe Precaution: Risk of CNS and respiratory depression increased in CYP 2D6 ultra rapid metabolizers. Slow or difficult breathing risk in patients with asthma and other underlying breathing problems. Contraindicated post tonsillectomy and adenoidectomy. Health Canada advises avoid for all indications age < 12 years.