Take caution with codeine

People should be careful when taking codeine as trials have shown that it is only moderately effective as a painkiller, and it has a range of common side effects, according to Dr Joel Iedema of the Royal Brisbane and Women's Hospital.

Writing in the October edition of Australian Prescriber, Dr Iedema says that the effectiveness of codeine in trials is disappointing.

Generally perceived as safe and effective, codeine is widely available as a painkiller in both prescription and over-the-counter medicines in Australia. It is often sold combined with other painkillers such as paracetamol. Dr Iedema questions the value of these combination products.

The use of codeine as a painkiller is complicated because its effectiveness and safety is difficult to predict. To relieve pain, codeine has to be converted to morphine once in the body. However, the rate at which this happens varies between individuals and some people will have little pain relief.

Dr Iedema highlights that while the side effects of codeine are usually mild and can include nausea, vomiting, constipation, drowsiness and dizziness, there have been reports of serious, sometimes fatal, side effects. In particular, children and the elderly can be very susceptible to the side effects of codeine.

Some people get addicted to medicines containing codeine, even if these medicines can be bought in a pharmacy.

"People should take care with codeine," says Dr Iedema. "Simple painkillers such as paracetamol give more predictable pain relief."

Individuals should be medicinewise and ask the right questions when talking to their doctor or pharmacist about a prescribed or recommended medicine.

Five questions you should always ask before taking a medicine:

• What is the medicine for?
• What is the active ingredient?
• How do I use or take this medicine correctly?
• What are the possible side effects and what can I do about them?
• What should or shouldn't I do while taking this medicine?

For information over the phone about your medicines, call Medicines Line (1300 MEDICINES or 1300 633 424).

To read the full article and others, visit www.australianprescriber.com.