pediatric, hospital, medical errors, kids with leukemia, codeine

Doctors used to prescribe codeine to kids who’d undergone a tonsillectomy or appendectomy. They believed that this narcotic was less potent and hence not as risky as more powerful opioids.

However, the FDA has determined that this opioid is not safe for children. It can even be deadly. The agency has warned doctors not to prescribe this drug to children for any reason. It requires a black box on the prescribing label to this effect.

Have Doctors Stopped Prescribing Codeine?

After this caution was issued, most doctors did stop prescribing this pain reliever. But a review of the records of more than 300,000 children between 2010 and 2015 showed that surgeons were still prescribing codeine for about 5 percent of children after a tonsillectomy and adenoidectomy  (Chua, Shrime & Conti, Pediatrics, Nov, 2017).

According to the FDA, doctors should prescribe ibuprofen or acetaminophen for children following this type of surgery. If pain is unexpectedly severe and a child really needs an opioid analgesic, they might offer hydrocodone or oxycodone instead.

Some youngsters could not metabolize codeine readily. As a result, the drug built up to dangerously high levels in their bloodstreams. Oxycodone and hydrocodone are not metabolized through the same pathway, so they don’t pose the same risk.

Of course, such opioids carry their own hazards. Doctors should choose non-narcotic pain relievers for youngsters whenever possible.

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