Codeine is a substance that is found in opium naturally. It is used for medical purposes in different ways, as a pain reliever, as a sedative, or as a cough suppressant. Therefore, it is useful to relieve moderate pain considering that, although it is said that it does not have the same level of risk of causing dependence as other similar substances used for this purpose, such as morphine, it can also be addictive. However, its most widespread use is as a treatment to reduce cough , along with other medications, since codeine relieves symptoms but does not treat the cause, and can be administered in capsules or as a liquid solution.
Until recently, it was a common treatment also in children, especially to treat catarrhal processes and the unproductive cough associated with them. However, this medicine has been restricted to those under twelve years of age and women who are breastfeeding , although its use is not recommended in people under 18 years of age , especially if they suffer from respiratory problems.
This turn in the use of codeine occurred in 2013, after the case of several children who had suffered serious and even fatal poisonings, during the treatment of codeine as an analgesic . Most used it after tonsil removal to relieve pain. According to the review carried out by the European Pharmacovigilance Risk Assessment Committee (PRAC), these cases occurred because codeine is metabolized as morphine for the most part . This process can affect children to a greater extent, although some people, even adults who metabolize it more quickly, can also be affected by morphine intoxication.
According to the Pharmacoepidemiological Research Database in Primary Care (BIFAP), codeine in our country is used mainly as an antitussive, but later studies confirmed that these dangers may also exist even when codeine is used for this purpose . Given the restrictions of the Spanish Agency for Medicines and Health Products (AEMPS) in their use in minors and in breastfeeding women, some medicines for pediatric use that are marketed, for example, under the name of Codeisan, Histaverin or Toseina.
Codeisan, like the two other proposed examples, is a syrup used for the treatment of moderate pain and cough without secretions in people over 12 years of age. The leaflet itself warns that it is not recommended for use in children and adolescents if they suffer from respiratory or heart problems.
Tosein is an effective cough suppressant used in both acute and chronic respiratory conditions. The leaflet warns, among other dangers, the risk of addiction to the drug if taken for a very long time.
Histaverin is also recommended for cases of dry and unproductive cough. In this case, it warns of the precaution to be taken when administering it to the elderly and weakened patients or those with respiratory diseases, not to mention minors or nursing women.
In any case, as recommended by the Spanish Agency for Medicines and Health Products (AEMPS), special care must be taken with these medicines and any other that has codeine as a component in minors and in lactating women.