If you are:
Only When Necessary: NEONATAL WITHDRAWAL/RESP.DEPRESS. W/CHRONIC OR HIGH DOSE; SMALL TERATOGENIC RISK
Only When Necessary: EVIDENCE FOR MALFORMATIONS; CAN REDUCE UTERINE BLOOD FLOW CAUSING FETAL HYPOXIA
Only When Necessary:
Absolute Contraindication: 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: ORAL BIOAVAILABILITY LOW; INFANT EXPOSURE MAY BE MINIMAL
Precaution: INSUFFICIENT DATA AVAILABLE
An adult over 60:
management or monitoring precaution: Cardiovascular-Elderly are more sensitive to tachycardia and hypertensive effects. May exacerbate symptomatic coronary insufficiency. Genitourinary-May cause urinary retention. Neuro/Psych-May worsen cognitive impairment in some elderly with dementia. Insomnia risk.
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 PE-codeine-acetaminophen-guaif tablet to a child under 12:
management or monitoring precaution: Use weight based dosing in children less than 12 years.
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. Avoid in patient with obesity, obstructive sleep apnea, asthma or other underlying breathing problem.
management or monitoring precaution: Consult clinician for use in pediatrics age < 12 years.
Contraindication: Increased risk of CNS and respiratory depression. Contraindicated post-surgical tonsillectomy or adenoidectomy. Respiratory depression and death reported in CYP2D6 ultra-rapid metabolizer patients post tonsillectomy or adenoidectomy. Risk increases with obesity, asthma, obstructive sleep apnea or other underlying lung or breathing problem.
Contraindication: Risk of CNS excitation. Do not use age <6 years without clinician consult.