Codeine induced nausea

[sfp20]

As a community pharmacist, what can you do to help the patient with nausea side from changing the painkiller?

Thanks

[johnep]

Try Stugeron (cinnazarine) or Buccastem (Prochlorperazine?) (Sorry about the spelling). Not licensed of course, but the form of these anti-emetics available OTC.
Ideally you should ask your Dr.
johnep

[Nik]

Options are always going to be limited. Could consider first whether dose reduction may work or use lower strength codeine prep. Main action of opioids in inducing nausea/vomiting is through the chemoreceptor trigger zone (CTZ) which contains opioid receptors. However it is also rich in dopamine D2 and 5-HT3 receptors, so these anti-emetics should work well, eg domperidone, prochlorperazine (which has the advantage of alternative routes). Cyclizine and/or prochlorperazine are often favourites in hospital.

[johnep]

Not likely to be able to buy Cyclizine in a community pharmacy.
johnep

[Raju]

Not likely to be able to buy Cyclizine in a community pharmacy.
johnep

Why not? I occasionally sell it when appropriate.

On another note - a small pack of domperidone 0mg tablets is licensed OTC, and I believe that the license includes nausea and vomiting of up to 48hours.

[johnep]

There are many cyclizine addicts. most pharmacies where I worked, kept in the CD cupbd.
johnep

[sNASA]

There are many cyclizine addicts. most pharmacies where I worked, kept in the CD cupbd.
johnep

Ooo, interesting. Never heard of that one bring kept in the cupboard.