A European review has found limited evidence that codeine is effective for treating cough and cold symptoms in children.
Healthcare professionals are reminded that codeine-containing medicines used for cough and cold are:
- contraindicated in children under 12 years of age
- not recommended for adolescents (12 to 18 years of age) who have problems with breathing.
In addition, codeine must not be used in patients of any age known to be CYP2D6 ultra-rapid metabolisers or in breastfeeding mothers.
The new guidance follows the 2013 Pharmacovigilance Risk Assessment Committee review of codeine for pain relief in children, which resulted in several recommendations, including:
- use restricted to those aged over 12 years with acute moderate pain that cannot be relieved by other analgesics eg ibuprofen or paracetamol
- use contraindicated in children under 18 years undergoing tonsillectomy or adenoidectomy to treat obstructive sleep apnoea.