The U.S. Food and Drug Administration (FDA) has issued a drug safety communication concerning three children who died and one child who experienced a life-threatening case of respiratory depression after taking codeine.
The events followed surgery to treat obstructive sleep apnea syndrome by removing the tonsils (tonsillectomy) and/or adenoids (adenoidectomy).
The children received doses of codeine that were within the typical dose range. Healthcare professionals and parents should be aware of the risks of using codeine in children who have had their tonsils and/or adenoids removed to treat obstructive sleep apnea syndrome.
Some people metabolize codeine much faster and more completely than others and are known as ultrarapid metabolizers, the agency noted. They are likely to have higher-than-normal levels of morphine in their blood after taking codeine, which can lead to overdose and death. The three children who died after taking codeine exhibited evidence of being ultrarapid metabolizers.
When prescribing codeine-containing drugs, healthcare providers should use the lowest effective dose for the shortest time on an as-needed basis, according to the FDA.
