Codeine sulphate

Codeine Sulphate is an opioid analgesic used primarily for its antitussive (cough suppressant) and analgesic (pain relieving) properties. It is derived from the opium poppy, making it a naturally occurring alkaloid. Codeine works by binding to the mu-opioid receptors in the brain, which results in a reduction of pain and suppression of cough. It is often prescribed for the relief of mild to moderate pain and to alleviate coughing associated with conditions like the common cold and bronchitis.

Pharmacology

Codeine is metabolized in the liver, primarily by the enzyme CYP2D6, into morphine, which is the active metabolite responsible for most of codeine's analgesic effects. However, the efficacy and safety of codeine can vary significantly among individuals due to genetic variations in the CYP2D6 enzyme. Some individuals metabolize codeine much faster than average, leading to higher concentrations of morphine in the blood, which can increase the risk of opioid toxicity. Conversely, poor metabolizers may find codeine less effective for pain relief and cough suppression.

Medical Uses

Codeine Sulphate is indicated for the relief of mild to moderate pain and as a cough suppressant. It is often combined with other analgesics like acetaminophen or NSAIDs (non-steroidal anti-inflammatory drugs) to enhance pain relief. In some formulations, it is also combined with antihistamines or decongestants to provide symptomatic relief for cold and flu.

Side Effects

Common side effects of codeine include drowsiness, constipation, nausea, and vomiting. More severe side effects may include respiratory depression, especially in individuals who are ultra-rapid metabolizers of codeine. Due to its potential for abuse and dependence, codeine is classified as a controlled substance in many countries.

Contraindications

Codeine should not be used in individuals with respiratory depression, acute asthma, or in those with a known hypersensitivity to opioids. It is also contraindicated in children under 12 years of age for the treatment of cough and cold symptoms due to the risk of serious and life-threatening breathing problems.

Regulation

The regulation of codeine varies by country. In some regions, codeine preparations are available over the counter in low doses, often in combination with other medications. In other areas, codeine is strictly regulated and available only by prescription.