Codeine phosphate.JPG

Codeine phosphate

CLINICAL USE

Analgesic Antidiarrhoeal Cough suppressant

DOSE IN NORMAL RENAL FUNCTION

30–60 mg up to every 4 hours

PHARMACOKINETICS

  • Molecular weight                           :406.4
  • %Protein binding                           :7
  • %Excreted unchanged in urine     : 0
  • Volume of distribution (L/kg)       :3–4
  • half-life – normal/ESRD (hrs)      :2.5–4/13

    DOSE IN RENAL IMPAIRMENT

    GFR (mL/MIN)

  • 20 to 50     : Dose as in normal renal function
  • 10 to 20     : 30 mg up to every 4 hours. Increase if tolerated
  • <10           : 30 mg up to every 6 hours. Increase if tolerated

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

  • CAPD                :Unlikely to be dialysed. Dose as in GFR <10 mL/min
  • HD                     :Not dialysed. Dose as in GFR <10 mL/min
  • HDF/high flux   :Unknown dialysability. Dose as in GFR <10 mL/min
  • CAV/VVHD      :Not dialysed. Dose as in GFR=10–20 mL/min

    IMPORTANT DRUG INTERACTIONS

    Potentially hazardous interactions with other drugsNone known

    ADMINISTRATION

    Reconstition

    Route

    Oral, IV, IM, SC

    Rate of Administration

    IV bolus

    Comments

    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