From the Guidelines
Codeine-containing cough medicines are not recommended for children due to the potential for serious side effects, including respiratory distress.
Cough Medicines with Codeine
- The FDA has issued warnings and guidelines regarding the limited use of codeine in children, including a restriction on its use for children younger than 18 years who underwent tonsillectomy and adenoidectomy due to respiratory concerns 1.
- Codeine is contraindicated to treat pain or cough in children younger than 12 years, and its use is warned against in adolescents aged between 12 and 18 years who are obese or have conditions that increase the risk of serious breathing problems 1.
- The CHEST guidelines suggest avoiding the use of codeine-containing medications for children with acute cough due to the potential for serious side effects, including respiratory distress 1.
Alternatives to Codeine-Containing Cough Medicines
- Honey may offer more relief for cough symptoms than no treatment, diphenhydramine, or placebo, but it is not better than dextromethorphan 1.
- Dextromethorphan is an alternative to codeine, but preparations containing anti-histamine and dextromethorphan were associated with adverse events 1.
From the FDA Drug Label
Drug Facts Active Ingredients Purpose (in each teaspoonful (5 mL)) Codeine Phosphate USP 10 mg ................... Antitussive Guaifenesin USP 100 mg ........................... Expectorant The cough medicine that contains codeine is codeine (PO), which has Codeine Phosphate USP 10 mg as an active ingredient with an Antitussive purpose 2.
From the Research
Cough Medicines Containing Codeine
- Codeine is a commonly used antitussive in clinical practice, often combined with other medicines for the effective short-term symptomatic relief of dry or nonproductive cough 3
- However, there is a lack of evidence to support the use of over-the-counter cough and cold medications containing codeine for the treatment of acute cough in children 4, 5
- Some studies have shown that codeine is no more effective than placebo in suppressing cough caused by upper respiratory disorders or chronic obstructive pulmonary disease 6
- A recent study found that codeine was effective in reducing cough severity in patients with chronic cough, but may induce side effects such as drowsiness, constipation, and headaches 7
Specific Medications
- There is no specific list of cough medicines containing codeine provided in the available evidence
- However, it is mentioned that codeine is widely available in over-the-counter preparations for the common cold/cough 5
- Codeine is often used in combination with other medicines, but the specific combinations are not detailed in the provided evidence
Safety and Efficacy
- The use of codeine in children is not recommended due to the lack of sufficient evidence to support its efficacy and the known risks associated with its use, such as respiratory suppression and opioid toxicity 4, 5
- Codeine may have efficacy in suppressing cough in specific situations, but caution is needed to limit its use only when and as long as it is clinically necessary 3
- The safety and efficacy of codeine in patients with chronic cough have been investigated in a recent study, which found that codeine was effective but may induce side effects 7