If you are:
Only When Necessary: NEONATAL WITHDRAWAL/RESP.DEPRESS. W/CHRONIC OR HIGH DOSE; SMALL TERATOGENIC RISK
Only When Necessary: FDA C W/COMBO PROD; POSS RISK OF GASTROSCHISIS/SIA WITH 1ST TRIMESTER EXPOSURE
Only When Necessary:
Precaution: CNS/RESPIRATORY DEPRESSION,APNEA POSSIBLE;CAUTION W/ FAST CYP2D6 METABOLIZER
Precaution: MAY DECREASE MILK SUPPLY, AND CAUSE IRRITABILITY
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.
Giving Zodryl DEC 50 to a child under 12:
Severe Precaution: No established efficacy for cough and cold products age < 6 years. Do not use unless directed by clinician consultation.
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.
Contraindication: High risk of adverse CNS effects. Not recommended for use age < 6 years.