Calls for codeine caution
October 5, 2011
PEOPLE should take care with
codeine, according to Dr Joel Iedema
of the Royal Brisbane and Women’s
Hospital, who added fuel to the
growing debate over withdrawing
the drug from the market.
The comments, published in this
month’s Australian Prescriber, come
in the wake of recent trials which
found that whilst it is only a
moderately effective painkiller,
codeine’s efficacy and safety can be
difficult to predict in individual
patients.
Speaking about the trials, Iedema
said codeine’s effectiveness was
“disappointing”.
He also questioned the value of
prescription and low dose OTC
combination drugs sold in Australia
which include codeine and other
pain killers such as paracetamol.
“To relieve pain, codeine has to
be converted to morphine once in
the body,” the report said
“However, the rate at which this
happens varies between individuals
and some people will have little
pain relief,” it added.
According to Iedema, in many
instances where a codeine
combination medicine is used,
treatment with paracetamol or an
NSAID may be just as effective.
For patients where there is a need
for stronger pain relief, Iedma
argues for the use of a low dose of
the active metabolite morphine,
saying it would provide a more
predictable response than codeine.
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