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Safety warning over giving codeine tablets to under-18s

The European Medicines Agency says codeine, which is converted to morphine in the body, can pose problems for kids.

Image: Nomad_Soul via Shutterstock

THE EUROPEAN UNION’S medicines advisory body has issued a public health warning, advising parents not to administer codeine tablets to children under the age of 12.

The European Medicines Agency (EMA)’s recommendation may lead to an EU-wide legal review to regulate the use of the painkilling drug if it is intended for use by children.

The EMA’s risk assessment committee undertook a review of how the drug is used, after reports of children who died or developed a serious adverse reaction after taking codeine for pain relief.

The drug is sometimes given to children after having their tonsils removed, or after surgery on the adenoid glands to treat sleep apnoea.

It has now recommended giving codeine to children above 12 only in cases where other painkillers like paracetamol or ibuprofen have failed to relieve their pain.

It says codeine should not be used at all for under-18s who have undergone adenoid or tonsil surgery.

The threat from codeine comes in the way that the body converts it to morphine as a way of treating pain.

The physical build of children means this may happen faster than expected – leading to high level of morphine in the blood stream, which can then cause respiratory depression.

The EMA has also recommended that codeine should not be taken by breast-feeding mothers, as it can be passed to a child through breast milk, and that the drug should also be avoided by people who are known to be ‘ultra-rapid metabolisers’.

The agency said that while the adult body’s reaction to codeine was the subject of extensive research, little investigation had been undertaken into how it is handled by a juvenile body.

It said there was limited data on how effective the drug was at offering pain relief for juveniles – and it was possible that, for young people, codeine may not be any more effective than a more routine painkiller like paracetamol.

The sale of codeine has been restricted in Ireland since 2010, and can now only be sold over-the-counter under the personal supervision of a pharmacist and with the ‘appropriate counselling’.

Read: Pharmacists express concern over addiction to pain relief

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Gavan Reilly

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