Codeine isn’t safe for children and shouldn’t be used to ease pain or relieve coughs, a leading US pediatricians group warns.
Codeine has been prescribed for decades for both purposes, despite mounting evidence that it doesn’t always work and sometimes causes serious or potentially fatal side effects, doctors said in a statement from the American Academy of Pediatrics.
“We firmly believe that there is never a reason to use codeine,” said the lead author of the statement, Dr. Joseph Tobias of Ohio State University and Nationwide Children’s Hospital in Columbus, in email to Reuters Health.
Codeine has been linked to life-threatening or fatal respiratory problems in children for more than a decade, Tobias and colleagues note in the statement published in the journal Pediatrics.
A recent review by the US Food and Drug Administration (FDA) of potentially dangerous side effects in kids using codeine identified 64 cases of severe slowed breathing rates and 24 deaths related to the drug, including 21 deaths in kids under 12.
Respiratory issues often developed after children had surgery to remove their adenoids and tonsils, a procedure done to address obstructed breathing during sleep or treat acute or chronic tonsillitis.
Generally, the life-threatening events and deaths associated with codeine were found in relatively young kids who received a combination of acetaminophen and codeine after surgery. Some children with undiagnosed nighttime breathing problems may also have respiratory problems after taking codeine, and obesity may increase the risk of this occurring.
As doctors weigh the risks of prescribing codeine to children, they also need to consider the instances when there’s not enough evidence that the drug works, according to the AAP statement.
There’s little proof codeine is effective for kids’ coughs, and mounting evidence suggests that some children may not respond to treatment for pain.
Despite mounting safety concerns and questions about whether codeine works, the drug is still widely prescribed and available without a prescription over-the-counter in 28 states and the District of Columbia.
