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In elderly or debilitated patients, in severe impairment of renal or hepatic function. This preparation may cause drowsiness. If affected, do not drive or operate machinery. Avoid alcohol.
Codeine may be habit forming when used over long periods or in high doses and may cause psychological dependence, physical dependence and tolerance.
Codeine is contraindicated for all children younger than 12 years of age.
Codeine should only be used to treat acute moderate pain in children above 12 years of age, and only if it cannot be relieved by other painkillers such as paracetamol or ibuprofen.
Codeine is contraindicated for post-operative management in children younger than 18 years of age following tonsillectomy and/or adenoidectomy.
Avoid the use of codeine in adolescents 12 to 18 years of age who have other risk factors that may increase their sensitivity to the respiratory depressant effects of codeine unless the benefits outweigh the risks. Risk factors include conditions associated with hypoventilation, such as postoperative status, obstructive sleep apnea, obesity, severe pulmonary disease, neuromuscular disease, and concomitant use of other medications that cause respiratory depression.
Codeine should not be used in people of any age who are known to be ultra-rapid metabolisers. Because of the potential for serious adverse reactions, including excess sedation, respiratory depression, and death in a breastfed infant, breastfeeding is not recommended during treatment with codeine.
