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  • codeine lictus for pain

    I know this forum is mainly the domain of the hospital pharmacists but so sorry to intrude, but I was wondering at the feasabilty of codeine linctus use in pain.

    as everyone knows (hopefully) codeine phosphate tablets are licensed for use in pain management, and they come normally in the form of tablets, which are classed as POM. Codeine linctus on the other hand is a P medicine, and it contains 5mg codeine phosphate per 5ml. (strongest codeine tablets ive seen are 30mg). now the two ingredients are the same but no where in the literature for codeine linctus ive seen it being recommended for pain and even the bottle only mentions it as anti-tuissive.

    I understand the dangers of additions to the linctus, but i dont understand the apparent absence of this information, or is it something im missing, i would underatnd if the codeine salt form in the linctus was different but even thats the same, so anyone can enlighten me on this please?
    We are the music makers, We are the dreamers of dreams and God damn we are that good

  • #2
    Re: codeine lictus for pain

    A reference for codeine linctus and pain is at the following address that references the Analgesic Ladder :

    http://www.formulary.cht.nhs.uk/pdf,...%20Edition.pdf

    - as you can see the linctus is also available as a 25mg/5ml strength that is used for pain relief.

    Hope this helps a little

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    • #3
      Re: codeine lictus for pain

      If I ever have to convert anyone's tablets to liquids because of swallowing problems etc, I replace codeine tablets with the linctus as the drug is the same.
      Band6 is a Band 6 no longer.. now 7/8a

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      • #4
        Re: codeine lictus for pain

        Originally posted by Band6 View Post
        If I ever have to convert anyone's tablets to liquids because of swallowing problems etc, I replace codeine tablets with the linctus as the drug is the same.
        What base do you use to grind the crushed tablets into? Keltrol? Syrup BP?

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        • #5
          Re: codeine lictus for pain

          I simply dispense a bottle of codeine lintus labelled for the patient to take/nurses to give to the same dose as per the drug chart. Of course I amend the drug chart to reflect the new form. You do have to be a bit careful when it comes to NG/PEG/JEG/NJ tubes - crushing tablets isn't always best as sometimes bits get stuck! I can call on a specialist manufacturing facility within the hospital to make up a liquid if we've got a formula.
          Band6 is a Band 6 no longer.. now 7/8a

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          • #6
            Re: codeine lictus for pain

            my enquiry was more about the codeine linctus bp 5mg/5ml. im sure the 25mg/5ml is licensed for pain but i dont find anything in literature to suggest the lower strenght form can be used in pain (or for diarrhoea)
            We are the music makers, We are the dreamers of dreams and God damn we are that good

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            • #7
              Re: codeine lictus for pain

              Originally posted by SolomonQ View Post
              my enquiry was more about the codeine linctus bp 5mg/5ml. im sure the 25mg/5ml is licensed for pain but i dont find anything in literature to suggest the lower strenght form can be used in pain (or for diarrhoea)
              i'm sure you mean codeing linctus 15mg/5ml

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              • #8
                Re: codeine lictus for pain

                have u actually checked the bottle, im on about the P medcine normally used for coughs, which isnt as strong as 15mg/5ml, normally hard to find because alot of people abuse it and pharmacies keep it outta site
                We are the music makers, We are the dreamers of dreams and God damn we are that good

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                • #9
                  Re: codeine lictus for pain

                  I had a prescription for codeine 25mg/5ml 5-10ml up to TDS for chest pain due to a chesty cough!!!

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                  • #10
                    Re: codeine lictus for pain

                    that sounds right but wouldnt the codeine linctus stop the phlegm from being brought up if the lictus stoped the cough causing other adverse breathing problems because of this!!!
                    We are the music makers, We are the dreamers of dreams and God damn we are that good

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                    • #11
                      Re: codeine lictus for pain

                      No--codeine only acts as a placebo cough suppressant.

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                      • #12
                        Re: codeine lictus for pain

                        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.

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                        • #13
                          Re: codeine lictus for pain

                          Originally posted by lamzee View Post
                          No--codeine only acts as a placebo cough suppressant.
                          Through my own use I'd have to disagree on this point. I'd say codeine is an excellent cough suppressant and does indeed stop mucous from being expelled from the lungs, along with all the consequences that go along with that.

                          I don't use it very often, but if I have a bad dry cough I'd say it works a treat. I don't see why it can't be used for diarrhoea as well.
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                          • #14
                            Re: codeine lictus for pain

                            I work in hospital and as far as I'm concerned codeine works as an anti-tussive, painkiller, causes constipation and can be addictive. Maybe a one-off dose won't do anything, but definitely if taken on a regular basis it will cause all of the above. I wouldn't recommend codeine for a chesty cough as the cough mechanism is there to expel mucous from the lungs caused by the infection. The reason why the linctus you sell won't mention pain relief is because we're not legally allowed to sell codeine on its own for pain relief, the linctus is licensed for anti-tussive purposes only. The codeine in linctus is the same as that in tablets, and I see what you mean that in order to take pain killer doses of codeine (15-60mg) in the linctus form (5mg/5ml) you might end up taking too much of the other excipients, although I don't know what they are, and maybe it's OK. Codeine linctus 25mg/5ml is licensed for pain relief, but that is POM. You can buy soluble co-codamol tabs ofcourse.
                            Last edited by lrpolo; 2, May 2008, 08:35 PM.

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                            • #15
                              Re: codeine lictus for pain

                              Piss off...immediately.
                              Don't Stop Believing

                              http://youtube.com/watch?v=rnT7nYbCSvM

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