Hold codeine out of the reach of kids. Codeine is a controlled substance because it may be misused or lead to dependence. Keep codeine inside a safe area to protect it from theft. It is illegal to provide or give absent this medicine.
The prescriber ought to determine the volume of tablets for each dose, and also the maximum amount of tablets for each 24 hours, based on the above dosage direction. This facts should be conveyed in the prescription.
Instruct patients to discontinue acetaminophen and codeine phosphate tablets quickly and search for medical treatment if they practical experience these symptoms. Usually do not prescribe acetaminophen and codeine phosphate tablets for patients with acetaminophen allergy (see Safety measures, Information for Patients/Caregivers).
Consistently Examine these patients for signs of hypotension just after initiating or titrating the dosage of acetaminophen and codeine phosphate tablets. In patients with circulatory shock acetaminophen and codeine phosphate tablets might cause vasodilatation that can even more decrease cardiac output and blood pressure. Stay away from using acetaminophen and codeine with circulatory shock.
Observational reports have demonstrated that concomitant utilization of opioid analgesics and benzodiazepines boosts the chance of drug-linked mortality compared to use of opioid analgesics by yourself.
Propulsive peristaltic waves in the colon are lowered, while tone might be improved to The purpose of spasm, leading to constipation. Other opioid-induced effects may well contain a reduction in biliary and pancreatic secretions, spasm of sphincter of Oddi, and transient elevations in serum amylase.
The causal purpose of opioids inside the clinical syndrome of hypogonadism is mysterious because the various medical, Bodily, Way of living, and psychological stressors that could impact gonadal hormone levels have not been adequately controlled for in scientific tests conducted to date (see ADVERSE REACTIONS).
Neonatal Opioid Withdrawal Syndrome Tell woman patients of reproductive potential that utilization of acetaminophen and codeine phosphate tablets for an prolonged period of time throughout pregnancy may result in neonatal opioid withdrawal syndrome, here which may be life-threatening Otherwise regarded and treated (see PRECAUTIONS, Pregnancy).
Your healthcare supplier might check with you to definitely have naloxone, a medicine used to reverse the effects of codeine, readily available in the event of an unexpected emergency. Make positive you and also a caregiver understand how to use naloxone. In case you have any questions, speak with your healthcare company or pharmacist.
Moreover, a small number of codeine is converted to morphine from the body. The precise mechanism of action of codeine isn't identified; on the other hand, like morphine, codeine binds to receptors from the brain (opioid receptors) that are crucial for transmitting the sensation of pain all through the body and brain.
Because the length of opioid reversal is anticipated being under the duration of action of codeine in acetaminophen and codeine phosphate tablets, meticulously monitor the affected person right until spontaneous respiration is reliably reestablished. When the reaction to an opioid antagonist is suboptimal or only brief in character, administer supplemental antagonist as directed from the products’s prescribing data. In an individual bodily dependent on opioids, administration in the recommended standard dosage in the antagonist will precipitate an acute withdrawal syndrome.
Interactions with Benzodiazepines and Other CNS Depressants Notify patients and caregivers that potentially deadly additive effects could happen if acetaminophen and codeine phosphate tablets are used with benzodiazepines or other CNS depressants, including alcohol, rather than to implement these drugs concomitantly unless supervised by a healthcare provider (see WARNINGS and Safety measures, Drug Interactions).
Physical dependence is often a condition that develops due to a physiological adaptation in response to repeated drug use, manifested by withdrawal signals and symptoms right after abrupt discontinuation or a substantial dose reduction of a drug.
Advise patients to hunt medical consideration when they knowledge a constellation of these symptoms (see WARNINGS).