Understanding the Metabolism of Codeine is Important for the Clinician and the Forensic Pathologist Introduction

Recently, an advisory committee to the FDA has recommended codeine be contraindicated for pain and cough management in children and adolescents due to concerns for respiratory depression and death. This FDA warning was also extended to prescriptions of codeine to nursing mothers. In Europe, codeine is contraindicated in children under age 12 for cold or cough, and the European Medicines Agency recommends against using the drug in those age 12 to 18 years-of-age who have breathing difficulties. We need to explore the foundation for the necessity of this recommendation.