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Pediatric Dentistry Pharmacology

Codeine or other opioids: Which to use to relieve pain in pediatric patients?

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This summary is based on the Rapid Response Report developed by the Canadian Agency for Drugs and Technologies in Health: Codeine Compared with Other Opioids for Pain Relief in Pediatric Patients: Comparative Clinical Effectiveness, Safety, and Guidelines

Full Report (PDF)

Research Questions

  1. What is the evidence for the clinical effectiveness of codeine compared with other opioids for pain relief in pediatric patients?
  2. What is the evidence for the safety of codeine compared with other opioids when administered to pediatric patients?
  3. What are the evidence-based guidelines regarding the use of codeine compared with other opioids for pain relief in pediatric patients?

Key Messages

Two non-randomized studies were identified regarding the use of codeine compared with other opioids for pain relief in pediatric patients. No evidence-based guidelines were identified regarding the use of codeine compared with other opioids for pain relief in pediatric patients.

 

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2 Comments

  1. Don Siltanen July 16, 2013

    Codeine use is contraindicated in children due to the potential for toxicity , morphine is a safer choice if Opiods are required for pain relief. The Clinical pharmacy department at your local hospital would be the place to call for questions regarding dosage and monitoring . They deal with these type of issues regularly and have a wealth of experience for you to draw on.

    Reply
  2. MIchael Saso July 17, 2013

    This is a great question given HEalth Canada’s recent Black Box warning re codeine use and children under 12. Unfortunately the response gives no clinical direction on what to do.
    For pain relief for children under 12, would other opioids pose the same risk or (even greater )as codeine? Would a drug that was not a prodrug be safer? Is the risk only increased in children with OSA? What if any non opioids are adequate choices?

    Reply

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