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Should Your Child Be Prescribed Codeine?

From the Show: Healthy Children
Summary: Hundreds of thousands of kids are prescribed codeine each year, but is that really necessary? What might be at risk?
Air Date: 4/23/14
Duration: 10
Host: Melanie Cole, MS
Guest Bio: Kathleen A. Neville, MD
Kathleen Neville, M.D., M.S., is board certified in pediatrics, pediatric hematology/oncology and clinical pharmacology and received her Master of Science degree in Clinical Research from Indiana University. She has significant clinical trials expertise (e.g., study design, execution, data analysis) and translational research experience (e.g., PG/PK/PD and development of non-invasive PD surrogate endpoints).  Dr. Neville has also been appointed to serve on the pediatric subcommittee of the FDA’s Oncologic Drugs Advisory Committee and the FDA's Committee on Clinical Pharmacology.  She also currently serves as Chair for the American Academy of Pediatrics Committee on Drugs and as Chair for the NICHD funded Pediatric Trials multi-center trial to evaluate the pharmacokinetics and relative bio-availability of a liquid formulation of hydroxyurea. Dr. Neville’s research interests relate to the early phase (Phase I/II) study of medications in children, characterizing the determinants of variability in drug disposition and response, and development of pediatric appropriate formulations.
Should Your Child Be Prescribed Codeine?
Although significant concerns have been raised about the safety and benefits of codeine-containing medications for children, there's been only a slight decline in hospital emergency department prescriptions for the drugs over the past decade, according to a new study.

"There's been growing evidence that codeine is metabolized very differently in different children, with a small portion of them being at risk for potentially fatal side effects," says pediatrician Sunitha Kaiser, an assistant clinical professor at the University of California-San Francisco, and lead author of the study published online in the journal Pediatrics.

One in three children "metabolize it in a way that they get no effect at all" when it's taken to relieve pain or to shorten or reduce the severity of cough and cold, says Kaiser. "The expense and time of going to get it may not even be worthwhile for a large proportion of children," she says.

That evidence aside, the new study shows that "hundreds of thousands of kids are still being prescribed codeine every year," most often for coughs and colds and to treat injury pain, Kaiser says.

Has your child been prescribed codeine? Are you concerned?

Dr. Kathleen A. Neville shares why some ERs are still writing prescriptions for codeine, why this medication may not be recommended for children and themedications that are a safe and effective alternative.
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