Page 31 - PBA Medicine list - edition 5_SW_Neat
P. 31

By Sara Assaad

               Generic Name: Paracetamol/Codeine phosophate hemihydrate

               Brand names: APO-Paracetamol/Codeine 500/30

               Side effects/precautions:
               Cardiac,  hepatic,  renal  impairment;  viral  hepatitis,  hepatic  disease  (monitor  LFTs);  aspirin,  NSAID
               hypersensitivity; recent alcohol intake cessation; low glutathione reserves; Gilbert’s syndrome; acute
               abdominal conditions; severe IBD (incr toxic megacolon risk with repeat dosing); chronic constipation;
               analgesic  intolerance;  recent  GI,  urinary  tract  surgery;  urethral  stricture,  stenosis;  prostate
               hypertrophy; high dose; prolonged use (monitor FBC, renal, hepatic function; disc gradually); drug,
               alcohol abuse history; convulsive disorder history; CNS depression; head injury, brain tumour, incr ICP;
               impaired consciousness; bronchial asthma; decr respiratory reserve eg emphysema, kyphoscoliosis,
               hypoxia, hypercapnia, severe obesity, cor pulmonale, COPD; chronic ulcerative colitis; gallbladder
               condition; MS; hypothyroidism; adrenocortical insufficiency eg Addison's disease; shock; myxoedema;
               acute  alcohol  intoxication;  delirium  tremens;  cholecystectomy;  poor  CYP2D6  metabolisers;  North
               African, Ethiopian Arab populations (higher prevalence of CYP2D6 ultrarapid metabolisers); elderly;
               debility; pregnancy (avoid in 3rd trimester, labour).

               Interactions:

               RIMAs;  salicylates,  NSAIDs  incl  diflunisal;  CNS  depressants  eg  general  anaesthetics,  tranquillisers,
               sedatives,  hypnotics,  other  opioid  analgesics;  benzodiazepines;  anticholinergics;  hepatic  enzyme
               inducers  eg  alcohol,  barbiturates,  antiepileptics;  hepatotoxics;  coumarins  (monitor  coagulation);
               chloramphenicol;  antihypertensives;  antiperistaltic  antidiarrhoeals  eg  kaolin,  pectin,  loperamide;
               metoclopramide; neuromuscular blockers; colestyramine (within 1 hr); chelating resin; rifampicin;
               zidovudine; domperidone; morphinic agonist (eg buprenorphine), antagonist (eg naltrexone); TCAs;
               lab tests: plasma amylase/ lipase, gastric emptying studies; uric acid/ BGL

               Reasons for interactions:
               Not provided
























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