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Serious morbidity associated with misuse of over‐the‐counter codeine–ibuprofen analgesics: a series of 27 cases
Author(s) -
Frei Matthew Y,
Nielsen Suzanne,
Dobbin Malcolm D H,
Tobin Claire L
Publication year - 2010
Publication title -
medical journal of australia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 131
eISSN - 1326-5377
pISSN - 0025-729X
DOI - 10.5694/j.1326-5377.2010.tb03911.x
Subject(s) - codeine , medicine , ibuprofen , methadone , analgesic , opioid , buprenorphine , (+) naloxone , over the counter , anesthesia , morphine , pharmacology , medical prescription , receptor
Objective: To investigate morbidity related to misuse of over‐the‐counter (OTC) codeine–ibuprofen analgesics. Design and setting: Prospective case series collected from Victorian hospital‐based addiction medicine specialists between May 2005 and December 2008. Main outcome measures: Morbidity associated with codeine–ibuprofen misuse. Results: Twenty‐seven patients with serious morbidity were included, mainly with gastrointestinal haemorrhage and opioid dependence. The patients were taking mean daily doses of 435–602 mg of codeine phosphate and 6800–9400 mg ibuprofen. Most patients had no previous history of substance use disorder. The main treatment was opioid substitution treatment with buprenorphine–naloxone or methadone. Conclusions: Although codeine can be considered a relatively weak opioid analgesic, it is nevertheless addictive, and the significant morbidity and specific patient characteristics associated with overuse of codeine–ibuprofen analgesics support further awareness, investigation and monitoring of OTC codeine–ibuprofen analgesic use.