Codeína
Codeine
Codeine phosphate, Codeine sulfate
También conocido como: Tylenol with Codeine · Empirin with Codeine · Pardale-V · Co-codamol (human combination) · Codeine phosphate hemihydrate · Codeini phosphas hemihydricus · Codeinii phosphas · Codeinum · Methylmorphine · Codeine sulfate
Revisado por el equipo veterinario de VetSheetActualizado 5 abr 2026Referencia veterinaria basada en la evidencia
Evidencia posológica v13 auditada
Evidencia estructurada para el cálculoAntitussive (extra-label)
Requiere verificación veterinaria
- q6-12h
NA
Contexto clínico obligatorio (2)
- ■ This medicine may be given with food or on an empty stomach.
- Store codeine sulfate tablets in light-resistant, well-closed containers at room temperature 15°C to 30°C (59°F-86°F).
Las dosis son una referencia clínica para profesionales veterinarios autorizados. Confirme siempre con el prospecto actual y cada paciente individual.
Resumen
La codeína es un agonista opiáceo derivado del fenantreno utilizado en medicina veterinaria principalmente como antitusígeno (supresor de la tos) y analgésico leve. Ocasionalmente también se utiliza como agente antidiarreico.
- Analgesia: Se utiliza para el dolor leve a moderado, a menudo cuando los AINE son ineficaces o están contraindicados.
- Antitusígeno: Altamente eficaz para suprimir la tos no productiva (p. ej., colapso traqueal, bronquitis crónica).
- Antidiarreico: Disminuye la motilidad gastrointestinal.
Perla clínica: Aunque se utiliza ampliamente en medicina humana, el uso de codeína en perros es controvertido. Los perros absorben muy mal la codeína oral y carecen de las vías enzimáticas robustas para convertirla en su metabolito activo (morfina). Por lo tanto, su eficacia analgésica en perros es muy variable y generalmente se considera inferior a otros opioides como la buprenorfina o la metadona.
Mecanismo de acción
Codeine acts as a weak agonist at mu (μ) opioid receptors.
- Analgesia: Binds to μ-receptors in the central nervous system → inhibits the release of excitatory neurotransmitters (such as Substance P) in ascending pain pathways → alters the perception of and response to pain.
- Antitussive: Causes direct depression of the medullary cough center in the brainstem.
- Antidiarrheal: Binds to enteric μ-receptors → decreases gastrointestinal motility and increases sphincter tone.
- Metabolism Note: In humans, codeine is a prodrug metabolized by the enzyme CYP2D6 → morphine. Dogs lack significant CYP2D6-equivalent activity, relying mostly on codeine-6-glucuronide for any analgesic effect, which explains its limited efficacy in this species.
Seguridad y advertencias
Contraindicaciones
- Hypersensitivity to narcotic analgesics
- Patients receiving monoamine oxidase inhibitors (MAOIs) like amitraz or selegiline
- Diarrhea caused by toxic ingestion (until toxin is eliminated)
- Repeated use in severe inflammatory bowel disease
- Scorpion stings (Centruroides sculpturatus and C. gertschi) as it may potentiate venom
- Combination products containing acetaminophen are STRICTLY CONTRAINDICATED in cats
- Hypersensitivity to opioids
- Severe respiratory depression or asthma
- Cats (especially if using combination products containing paracetamol)
Efectos adversos
- Sedation (most common)
- Constipation
- Anorexia
- Vomiting
- Ileus
- Biliary and pancreatic duct spasms
- Respiratory depression (at high doses)
- Cats: CNS stimulation, hyperexcitability, tremors, seizures
- Nausea
Precauciones
Use with caution in patients with hypothyroidism, severe renal insufficiency, Addison's disease, and in geriatric or severely debilitated patients.
Use with caution in patients with head injuries or increased intracranial pressure, and in those with acute abdominal conditions (e.g., colic) as it may obscure the diagnosis.
Use with extreme caution in patients suffering from respiratory disease or acute respiratory dysfunction (e.g., pulmonary edema secondary to smoke inhalation).
Warning: Opiates can increase plasma amylase and lipase values up to 24 hours following administration due to increased biliary tract pressure.
Interacciones farmacológicas
May increase the chances of constipation developing
May potentiate CNS depressant effects
May cause increased CNS or respiratory depression
May inhibit the transformation of codeine to morphine in the liver, decreasing its efficacy
Additive CNS and respiratory depression
Increased risk of serotonin syndrome
Additive CNS and respiratory depression
May cause severe, unpredictable reactions (serotonin syndrome or severe respiratory depression)
Monitorización
- Efficacy (pain relief, reduction in coughing, or resolution of diarrhea)
- Adverse effects (sedation, respiratory rate, GI signs)
- Respiratory rate and depth
- Level of sedation
- Pain score or coughing frequency
- Bowel movements (monitor for constipation)
Farmacocinética
Vida media
Absorción
Very limited evidence of oral absorption in dogs. In humans, codeine salts are rapidly absorbed orally, with oral administration being about 2/3 as effective as parenteral. Onset of action is usually within 30 minutes.
Distribución
Crosses the placenta and enters maternal milk.
Metabolismo
Metabolized in the liver.
Eliminación
Excreted into the urine.
Sobredosis
Opiate overdosage may produce profound respiratory and/or CNS depression. Other effects can include cardiovascular collapse, hypothermia, and skeletal muscle hypotonia.
- Decontamination: Oral ingestions should be removed using standard gut removal protocols. Inducing vomiting should be attempted with caution due to rapid changes in CNS status.
- Antidote: Naloxone is the agent of choice for treating respiratory depression. In massive overdoses, naloxone doses may need to be repeated, as its effects may diminish before subtoxic levels of codeine are attained.
- Supportive Care: Mechanical respiratory support should be considered in cases of severe respiratory depression. Contact an animal poison control center for further guidance.
Productos disponibles
Formulaciones
- Tablets
- Oral solution/elixir
- Parenteral injection
- Combination products (with acetaminophen, aspirin, or guaifenesin)
- 3 mg/5 ml paediatric linctus
- 3 mg/ml linctus
- 5 mg/ml syrup
- 15 mg tablet
- 30 mg tablet
- 60 mg tablet
Veterinario
- Pardale-V tablets (Combination: Paracetamol 400 mg + Codeine phosphate 9 mg)
Etiquetado para humanos
- Codeine Phosphate Solution: 15 mg/5 mL
- Codeine Sulfate Tablets: 15 mg, 30 mg & 60 mg
- Codeine Phosphate Parenteral Injection: 15 mg/mL & 30 mg/mL
- Codeine Phosphate Antitussives with expectorants (e.g., with guaifenesin)
- Codeine Phosphate with Acetaminophen tablets (Tylenol® with Codeine #1, #2, #3, #4)
- Codeine Phosphate with Aspirin tablets (Empirin® with Codeine #2, #3, #4)
- Codeine linctus (3 mg/ml, 3 mg/5 ml)
- Codeine syrup (5 mg/ml)
- Codeine tablets (15 mg, 30 mg, 60 mg)
Estado regulador
Availability of veterinary specific products varies by member state.
Classified as POM-V or POM depending on the specific product (e.g., Pardale-V is POM-V).
Sin datos reguladores para: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
Almacenamiento y estabilidad
Codeine phosphate and sulfate tablets should be stored in light-resistant, well-closed containers at room temperature. Codeine phosphate injection should be stored at room temperature (avoid freezing) and protected from light. Do not use the injection if discolored or if it contains a precipitate.
Información para el cliente
- Mantener fuera del alcance de niños y mascotas: Esta es una sustancia controlada.
- TÓXICO PARA GATOS: Nunca administre ningún producto que contenga acetaminofén (p. ej., Tylenol® with Codeine) a gatos. Es rápidamente fatal.
- Efectos secundarios: Esté atento a somnolencia extrema, estreñimiento, falta de apetito o vómitos. Los gatos pueden volverse inusualmente hiperactivos, nerviosos o presentar temblores.
- Cuándo llamar al veterinario: Informe a su veterinario de inmediato si observa cambios significativos en el comportamiento, nivel de actividad o efectos gastrointestinales graves.
La referencia de medicamentos de VetSheet está destinada a profesionales veterinarios autorizados como ayuda para la toma de decisiones clínicas, no como sustituto del criterio profesional ni del prospecto actual del fabricante.