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Departllent of Pharmacy What analgesics can be given to a patient allergic to codeine? Pr:actico For a patient with a true allergy to codeine, the risk of cross-reactiMty with another opioid can be reduced if an analgesic from a different About Us chemical class is used. Chemically, there are three classes of opioid analgesics:phenanthrenes, phenylpiperidine, and phenylheptanones. Pcople Morphine and its related opioids, including codeine, are in the phenanthrene class. The mixed agonist-antagonist agents (buprenorphine, nalbuphine, butorphanol, pentazocine, and dezocine) Potential Partncls h ips are also included in the phenanthrenes. Use of anyof these agents in a patientwith a true allergy to codeine may result in an allergic reaction. Meperidine and its related congeners are Thc ILxPrcss phenylpiperidines, while methadone and propoxlphene are phenylheptanones. Selecting agents from a different chem ical class s hould m inim ize the risk of cross-sensitivity. However, I{csidenc:y Prograni it is importantto note that use of an opioid from a different chemical class does not eliminate the risk of an allergic reaction. For patients with severe or life-threatening reactions, nonnarcotic Frccluently Askecl Questbns analgesics, such as nonsteroidal anti-inllammatoryagents or acetaminophen, should be Contact t..ls considered.
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References
Bau m ann T. Analges s ic election when the patient is allergic to codeine. Clin pharm 1 991 :1 0:65g. Hebel sK. Drug Facts and comparisons. st. Louis:Facts and comparisons.2000
Koo P. Pain. In:Young YE, Koda-Kimble MA editors. Applied Therapeutics:the clinical use of drugs. Vancouver (WA): Applied Therapeutics.
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http://wv\iv/.ui c.edu/pharmacy/serVces/di/faq /codei ne.php