The TGA has recently put out regulatory warnings on the use of codeine in children, with the recommendations outlined below. The full article can be accessed here.
After reviewing Australian and international data, the TGA recommends the following:
1. Use of codeine in children younger than 12 years of age for any indication should be contraindicated.
2. Use of codeine in children aged 12-18 years should be contraindicated post adenotonsillectomy for obstructive sleep apnoea.
3. Existing warnings contraindicating codeine use by breastfeeding mothers should be made consistent across all codeine-containing products, and warnings should be added to advise against using codeine if known to be an ultra-rapid metaboliser.
4. Health professionals, patients and caregivers should be educated regarding the variability of codeine efficacy, the possibility of ultra-rapid metabolism-related morphine overdose and the signs of such, including respiratory depression.