What is the minimum amount of codeine (opioid analgesic) required to cause an overdose?

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From the FDA Drug Label

Directions do not exceed 6 doses in 24 hours. Adults and children 12 years of age and over: 2 tsp (10 mL) every 4 hours, or as directed by a doctor. Children 6 to under 12 years of age: 1 tsp (5 mL) every 4 hours, or as directed by a doctor. Children under 6 years of age: Consult a doctor. Drug Facts Active Ingredients Purpose (in each teaspoonful (5 mL)) Codeine Phosphate USP 10 mg ................... Antitussive

The FDA drug label does not answer the question.

From the Research

Introduction to Codeine Overdose

Codeine is an opioid analgesic commonly used for pain relief. However, its use can lead to overdose, especially when combined with other substances or taken in excessive amounts.

Factors Influencing Codeine Overdose

The risk of codeine overdose is influenced by several factors, including:

  • Individual tolerance to opioids
  • Presence of other substances, such as paracetamol or doxylamine
  • Genetic variations in the CYP2D6 enzyme, which metabolizes codeine to morphine 1
  • Dose and duration of codeine use

Minimum Amount of Codeine Required for Overdose

The minimum amount of codeine required to cause an overdose is not well-established, as it depends on various individual factors. However, studies suggest that codeine overdoses are rarely associated with severe respiratory depression, even at high doses 2.

Treatment and Management of Codeine Overdose

Treatment for codeine overdose typically involves:

  • Administration of naloxone to reverse opioid effects
  • Supportive care, such as mechanical ventilation and cardiac monitoring
  • Management of underlying medical conditions, such as hepatotoxicity or respiratory depression

Dosing Information

The typical dose of codeine for pain relief is 30-60 mg, taken orally every 4-6 hours as needed 3. However, higher doses may be required for severe pain, and individual tolerance to codeine can vary significantly.

Caveats and Considerations

When prescribing or dispensing codeine, healthcare providers should be aware of the potential risks of overdose and dependence. Codeine should be used with caution, especially in combination with other substances, and patients should be closely monitored for signs of overdose or adverse effects 4.

Conclusion

In conclusion, the minimum amount of codeine required to cause an overdose is not well-established, but it is clear that codeine can be dangerous when taken in excessive amounts or combined with other substances. Healthcare providers should exercise caution when prescribing or dispensing codeine and closely monitor patients for signs of overdose or adverse effects.

References

Research

Lack of respiratory depression in paracetamol-codeine combination overdoses.

British journal of clinical pharmacology, 2017

Research

Single dose oral codeine, as a single agent, for acute postoperative pain in adults.

The Cochrane database of systematic reviews, 2010

Research

Should Codeine Still be Considered a WHO Essential Medicine?

Journal of pharmacy & pharmaceutical sciences : a publication of the Canadian Society for Pharmaceutical Sciences, Societe canadienne des sciences pharmaceutiques, 2021

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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