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    Acetaminophen-Codeine

    precautions

    What should I know regarding pregnancy, nursing and administering Acetaminophen-Codeine to children or the elderly?

    If you are:

    Pregnant:

    Only When Necessary: NEONATAL WITHDRAWAL/RESP.DEPRESS. W/CHRONIC OR HIGH DOSE; SMALL TERATOGENIC RISK

    Nursing:

    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

    An adult over 60:

    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 acetaminophen-codeine to a child under 12:

    management or monitoring precaution: Use weight based dosing in children less than 12 years.

    Severe Precaution: Contraindicated post-surgical tonsillectomy or adenoidectomy age < 18 years. Contraindicated for any indication age < 12 years per Health Canada. 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 high levels of morphine. Increased risk of CNS and respiratory depression especially with asthma or other underlying breathing problem.

    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.

    Selected from data included with permission and copyrighted by First Databank, Inc. This copyrighted material has been downloaded from a licensed data provider and is not for distribution, expect as may be authorized by the applicable terms of use.

    CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.

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