Consider activated charcoal if an adult presents within one hour of ingestion of more than 350 mg or if more than 2.5 mg/kg (adults and children) has been ingested.
Codeine should not be used during breastfeeding (see section 4.3).
At normal therapeutic doses codeine and its active metabolite may be present in breast milk at very low doses and is unlikely to adversely affect the breast fed infant.
These patients convert codeine into morphine rapidly resulting in higher than expected serum morphine levels. Possible CNS excitation or depression (hypertension or hypotension) can occur when opioid analgesics are given with antidepressants such as moclobemide (a reversible MAO-A inhibitor).
The sedative effects of codeine can possibly be increased when given with tricyclic antidepressants, with anxiolytics or hypnotics, or with sedating antihistamines.
A reduced dose is recommended in elderly or debilitated patients, in hepatic and renal impairment (but avoid if severe), in hypothyroidism, and in adrenocortical insufficiency.
Repeated use of opioid analgesics is associated with the development of psychological and physical dependence; although this is rarely a problem with therapeutic use, caution is advised if prescribing for patients with a history of drug dependence or in acute alcoholism.This medicine can impair cognitive function and can affect a patient's ability to drive safely.This class of medicine is in the list of drugs included in regulations under 5a of the Road Traffic Act 1988.Hypotension and tachycardia are possible but unlikely.This should include general symptomatic and supportive measures including a clear airway and monitoring of vital signs until stable.Antipsychotic medicines can enhance hypotensive and sedative effects when opioid analgesics are given with antipsychotics.