Pain: 15-60 mg 4 hrly. Max: 360 mg/day.
Cough suppressant: 15-30 mg 3-4 times daily.
Acute diarrhoea: 15-60 mg 3-4 times daily. Syr 1-2 5 mL every 4-6 hr.
Pain: 30-60 mg 4 hrly. Max: 240 mg/day.
Codeine is the commonest weak opioid; if pain relief is not achieved on the ceiling dose (max dose 240mg per day), move to strong opioids.
Codeine is often combined with step 1 analgesics (paracetamol, ibuprofen, diclofenac); give laxatives to avoid constipation unless patient has diarrhoea.
Adverse drug reactions
: dependence, nausea, vomiting, constipation, drowsiness, confusion, difficulty in micturition, ureteric or biliary spasms, urinary retention, dry mouth, dizziness, sweating, facial flushing, headache, vertigo, palpitations, postural hypotension, vertigo, restlessness, mood changes, decreased libido or potency, hallucination, miosis, raised intracranial pressure, muscle rigidity, visual disturbances.
Adapted CIMS Drug Information System. Internet. Accessed on January 10, 2016.