Codeine phosphate

CLINICAL USE

Analgesic Antidiarrhoeal Cough suppressant

DOSE IN NORMAL RENAL FUNCTION

30–60 mg up to every 4 hours

PHARMACOKINETICS

Molecular weight &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :406.4

%Protein binding &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :7

%Excreted unchanged in urine &nbsp &nbsp : 0

Volume of distribution (L/kg) &nbsp &nbsp &nbsp :3–4

half-life – normal/ESRD (hrs)&nbsp &nbsp &nbsp :2.5–4/13

DOSE IN RENAL IMPAIRMENT

GFR (mL/MIN)

20 to 50 &nbsp &nbsp : Dose as in normal renal function

10 to 20 &nbsp &nbsp : 30 mg up to every 4 hours. Increase if tolerated

<10 &nbsp &nbsp &nbsp &nbsp &nbsp : 30 mg up to every 6 hours. Increase if tolerated

DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

CAPD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp:Unlikely to be dialysed. Dose as in GFR <10 mL/min

HD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :Not dialysed. Dose as in GFR <10 mL/min

HDF/high flux &nbsp :Unknown dialysability. Dose as in GFR <10 mL/min

CAV/VVHD &nbsp &nbsp &nbsp:Not dialysed. Dose as in GFR=10–20 mL/min

IMPORTANT DRUG INTERACTIONS

Potentially hazardous interactions with other drugsNone known

ADMINISTRATION

Reconstition

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Route

Oral, IV, IM, SC

Rate of Administration

IV bolus

Comments

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OTHER INFORMATION

Increased risk of drowsiness due to increased cerebral sensitivity in patients with renal failureIncreased risk of constipation – caution in patients on peritoneal dialysis

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