[pharout]

I know this is somewhat an indirect response to the original question, but I would be hardpressed to find an accepted guideline that includes codeine for pain relief. If this is chosen, you are setting your patients up for ongoing, unrelieved pain. Codeine (in any strength) is an excellent antitussive, but poor in pain relief with an analgesic ceiling of approximately 65mg. It has basically been found to be no more effective than paracetamol or an nsaid. However with that being said, I think in the US, we are quite aggressive in treating pain versus Europe. I do not think opioids are used as much as a standard of practice in Europe (based on what I've read). Clinically speaking, if I offered a patient codeine (or here codeine+acetaminophen), most of them would simply not take it.