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The American Academy of Pediatrics has strengthened its warnings about prescribing codeine for children because of reports of deaths and risks for dangerous side effects including breathing problems.  The academy’s advice, published in a report Monday in its medical journal, Pediatrics, mirrors warnings from the Food and Drug Administration about using codeine for kids’ coughs or pain.

Despite previous warnings from the AAP and the FDA, the drug is still available in some over-the-counter cough medicines in many states.  Researchers have found that about one in five kids under age six continue to be given over-the-counter cough and cold medicine, despite a Health Canada-mandated warning against use of the products in young children.

Codeine is an opioid drug that’s been counted on for decades as a prescription pain medication. Codeine has often been prescribed for pain relief after tonsillectomies but the FDA has advised against this use. The Academy report cites an FDA review that found 21 codeine-related deaths in children younger than 12 and 64 cases of severe breathing problems over five decades.  A previous Academy report highlighted codeine’s risks and lack of benefit in treating coughs.  The new report is more comprehensive, adding concerns about using codeine for pain along with information on deaths.

American doctors are warning parents to stop relying on codeine to tame their kids’ cough and pain symptoms.  The doctors representing the AAP say there are too many worrisome side effects for kids tied to the commonly prescribed medication.  You’re better off using acetaminophen or ibuprofen and other simple remedies.

The report says that better education of parents and doctors is needed, along with additional research on risks and benefits of codeine and non-opioid painkillers for children.

One Comment

  1. Gravatar for John Steed

    So, over a 50 year period, 24 deaths are "linked" to codeine, 21 of those deaths on children less than 12 years old. I'll have to suspect that most, or all of those deaths were overdoses from children getting into the medicine cabinets. Sounds like codeine is one of the safest drugs to hit the market for such a safety record over a 50 year period. Then the article tries to justify this action by pointing out that the drug is handled metabolically different by different people. Just what drug is not handled differently by different people, either by absorption, break down, affect, size or age of the individual, or excretion?

    On reading the researchers article, greater than 800,000 children had been treated with codeine in just a 5 year period, and of the anecdotal cases mentioned, all were for treatment after surgery, and one was for a child dosed at higher than recommended levels. This all points to a drug of high efficacy and safety, that has potential for misuse (as do all drugs).

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