8.6 Hepatic Impairment No formal studies have been conducted in patients with hepatic impairment so the pharmacokinetics of codeine in this patient population are unknown. Start these patients with a lower than normal dosage of codeine sulfate tablets or with longer dosing intervals and titrate slowly...
An event is serious (FDA MedWatch definition) when the patient outcome is: death life-threatening hospitalisation disability congenital anomaly requires intervention to prevent permanent impairment or damage Drug overdose A 65-year-old woman developed liver failure, encephalopathy, coagulopathy and renal ...
Some people may also experience impairment in thinking and judgment. You should avoid or limit the use of alcohol while being treated with chlorpheniramine. Do not use more than the recommended dose of chlorpheniramine, and avoid activities requiring mental alertness such as driving or operating ...
Codeine is metabolized in the liver by three different pathways: glucuronidation to codeine 6-glucuronide (the principal route), N-demethylation to norcodeine (10% to 20%) and O-demethylation to morphine (5% to 15%). Five to 15% of codeine is excreted unchanged in urine (Williams et al....
Codeine can impair thinking and physical abilities required for driving or operating machinery. Alcoholand othersedativessuch asalprazolam(Xanax) can produce further brain impairment and even confusion when combined with codeine. Therefore, alcohol and other sedatives should not be used when taking codei...
Hepatitis or severe hepatic/renal impairment Cautions Acetaminophen has been associated with cases of acute liver failure, at times resulting in liver transplantation and death; risk increases in individuals with underlying liver disease, alcohol ingestion, and/or use of more than 1 acetaminophen-contain...
Renal impairment. The renal clearance of codeine and its metabolites is significantly reduced in patients with end-stage re- nal disease on regular haemodialysis therapy. One such elderly patient developed tonic-clonic seizures 7 days after starting oral codeine phosphate 30 mg 4 times daily; no ...
. In newborn and young infants, the rate of morphine elimination is slower because of immature kidney and liver functions (Bhat et al., 1990; Osborne, Joel, Grebenik, Trew, & Slevin, 1993). The average elimination half-life of codeine in children and adults is 2–4h. Neonates and ...
In patients with severe hepatic or renal disease, effects of therapy should be monitored with serial liver and/or renal function tests. Carcinogenesis, Mutagenesis, Impairment of Fertility No adequate studies have been conducted in animals to determine whether acetaminophen and codeine have a potential...
Long-term administration of NSAIDs has resulted in renal papillarynecrosisand another renal injury; correct volume status in dehydrated or hypovolemic patients before initiating therapy; monitor renal function in patients with renal or hepatic impairment,heart failure, dehydration, orhypovolemiaduring thera...