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Codeine not recommended for under 12s

Codeine-containing medicines should only be used in children over 12 years old if other painkillers will not work, new guidance suggests. 

According to the Medicines and Healthcare products Regulatory Agency (MHRA), codeine should only be used in children to treat acute to moderate pain which cannot be relieved by painkillers such as paracetamol or ibuprofen. 

When used, it should be the lowest effective dose for the shortest period of time recommended by the doctor. 

Some patients may be at risk of severe adverse reactions as a result of the way the body processes codeine, and younger children may be particularly susceptible. 

“This is important new advice for the use of codeine for pain relief in children,” said Dr. Sarah Branch, deputy director of the MHRA's Vigilance and Risk Management of Medicines Division. 

She added: “Whilst codeine is not commonly used in children, the evidence is clear that there is risk of side effects in children, and other painkillers should be used whenever possible.” 

Codeine should not be used in any patient under 18 who undergoes tonsil or adenoid removal for the treatment of sleep apnoea, the review also concluded. 

This is due to an increased risk of severe breathing difficulties.