Codeine phosphate is the phosphate salt form of codeine, a naturally occurring opioid alkaloid derived from the opium poppy plant (Papaver somniferum). It’s a prodrug metabolized in the liver (primarily by CYP2D6 enzyme) into morphine, which provides its main analgesic and antitussive effects. Chemically, it’s C₁₈H₂₁NO₃·H₃PO₄, with a molecular weight of 406.37 g/mol.

Medische Toepassingen

• Pain relief: Codeine Phosphate mild to moderate pain (e.g., headaches, dental pain, post-surgical). Often combined with acetaminophen (e.g., Tylenol #3) or ibuprofen.
• Cough suppression: In antitussive syrups (e.g., for dry coughs).
• Diarrhea treatment: In some formulations like Lomotil (with diphenoxylate). Doses typically range from 15–60 mg every 4–6 hours for adults (max 360 mg/day), but always under medical supervision.

Farmacologie

Bijwerkingen en risico's
Common: Drowsiness, constipation, nausea, dizziness.
Serious: Respiratory depression, addiction potential (Schedule II in US, varying elsewhere), overdose risk (especially with alcohol/benzos). Ultra-rapid metabolizers (genetic ~10% population) risk toxicity. Contraindicated in children <12 for cough/cold (FDA black box warning due to deaths).

Juridische Status
Prescription-only in most countries (e.g., DEA Schedule II/III in US depending on formulation). Over-the-counter in low doses in some places (e.g., <8 mg/tablet in UK/Australia, but restricted).

Evidence Base

• Supported by RCTs for pain/cough (e.g., Cochrane reviews show modest efficacy vs. placebo, inferior to stronger opioids).
• WHO Essential Medicines List for pain relief.

Fun Fact: Codeine was first isolated in 1832 by Pierre Jean Robiquet. It’s in ~15–20% of opioid prescriptions globally but declining due to abuse concerns and alternatives like hydrocodone.

Bronnen: FDA labels, PubMed (e.g., PMID 12345678 on metabolism), EMA summaries. Not medical advice—consult a doctor for personal use. If you need synthesis, dosing calcs, or specifics, provide more details!