To prescribe codeine or not to prescribe codeine?

Marc L. Fleming, Matthew A. Wanat

Research output: Contribution to journalReview articlepeer-review

12 Scopus citations


A recently published study in Pediatrics by Kaiser et al. (2014; Epub April 21, DOI: 10.1542/peds.2013-3171) reported that on average, over the past decade, children aged 3 to 17 were prescribed approximately 700,000 prescriptions for codeine-containing products each year in association with emergency department (ED) visits. Although, guidelines from the American Academy of Pediatrics issued warnings in 1997 and reaffirmed their concerns regarding the safety and effectiveness of codeine in 2006, it is still often prescribed for pain and cough associated with upper respiratory infection. With the impending rescheduling of hydrocodone combination products to Schedule II, physicians and mid-level prescribers may be compelled to prescribe codeine-containing products (e.g., with acetaminophen) due to reduced administrative burden and limits on Schedule II prescriptive authority for nurse practitioners and physician assistants in some states. This commentary expounds on the safety and effectiveness concerns of codeine, with a primary focus on patients in the ED setting.

Original languageEnglish
Pages (from-to)251-254
Number of pages4
JournalJournal of Pain and Palliative Care Pharmacotherapy
Issue number3
StatePublished - Sep 2014


  • Codeine
  • Emergency department
  • Hydrocodone
  • Pain management
  • Safety
  • Schedule


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