THE widely used painkiller codeine doesn't work in some people and can be fatal in others, so its use should be halted, say researchers at the University of British Columbia in Vancouver, Canada.
Codeine works by being metabolised to morphine in the body, but the extent of that metabolism depends on a person's genetic make-up, so the amount of morphine produced varies.
In an editorial published in the Canadian Medical Association Journal this week, Stuart MacLeod and Noni MacDonald say the problem is especially relevant for infants, citing examples of two children who died after being given codeine following a tonsillectomy, and two studies that show non-fatal toxicity to infants being breastfed by mothers taking codeine.
The Hospital for Sick Children in Toronto, Canada, has stopped using codeine. The authors are calling for others to follow suit.
The UK Medicines and Healthcare Products Regulatory Agency currently has no plans to stop codeine being sold over the counter. "As only 1 to 2 per cent of the population has an enhanced metabolism most patients could continue to take codeine," says Florence Palmer of the MHRA.
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