Codeine Intoxication in the Neonate

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Codeine intoxication in the neonate.

Although opiates can provide patients with relief from pain and the discomfort of cough, the routine prescription of these drugs for infants demands caution and concern. Infants, particularly neonates, are not merely small adults requiring smaller dosages, but rather uniquely different patients. Neonates present with an immature physiology and biochemistry with respect to drug metabolism. We re...

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Safety of codeine during breastfeeding: fatal morphine poisoning in the breastfed neonate of a mother prescribed codeine.

QUESTION Recently a newborn died from morphine poisoning when his mother used codeine while breastfeeding. Many patients receive codeine for postlabour pain. Is it safe to prescribe codeine for nursing mothers? ANSWER When a mother is an ultrarapid metabolizer of cytochrome P450 2D6, she produces much more morphine when taking codeine than most people do. In this situation, newborns might be ...

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Risk to the breast-fed neonate from codeine treatment to the mother: a quantitative mechanistic modeling study.

Administering codeine to breast-feeding mothers had been considered safe until the recent death of a breast-fed neonate whose mother had been prescribed codeine. We investigated the risk of opioid poisoning to breast-fed neonates using coupled physiologically based pharmacokinetic models for the mother and child. Neonatal morphine plasma concentrations were simulated for various combinations of...

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Analgesia in the neonate

1 Ridley H. Drugs of choice: a report on the drug formularies used in NHS hospitals. London: Social Audit 1986. 2 Crooks J. Drug epidemniology and clinical pharmicology: their contribution to patient care. BrJ Clin Pharmnacol 1983;16:351-7. 3 Collier J, Foster J. Management of a restricted drugs policy in hospital: the first five years' experience. Lancet 1985;i:331-3. 4 Swallow RD, Remington H...

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ژورنال

عنوان ژورنال: PEDIATRICS

سال: 1999

ISSN: 0031-4005,1098-4275

DOI: 10.1542/peds.104.6.e75