If you are:
FDB Only When Necessary: NO FDA CATEGORY; INCR RISK OF RETROLENTAL FIBROPLASIA SEEN WITH SIMILAR DRUG
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
Precaution: USE IS NOT RECOMMENDED; MAY CAUSE UNUSUAL EXCITEMENT OR IRRITABILITY
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.
Giving codeine-pyrilamine Liquid to a child under 12:
Contraindication: Do not use in pediatrics <6 years of age unless 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: Possible CNS excitation and seizure risk in newborns.