Codeine for Acute Extremity Pain

Key Messages

• No comparative evidence was found on the use of codeine, as a single ingredient, for acute extremity pain management.
• There are many types of codeine combinations drugs available, which makes a direct comparison difficult and increases the uncertainty of the results. Although the overall analysis is inconclusive, in many comparisons, codeine was no different than the comparator group in increasing patient satisfaction or in reducing pain scores, the need for additional analgesia, and the number of adverse events.
• Most of the evidence is from studies without a placebo arm; therefore, it is not possible to know how much of the pain reduction was unrelated to codeine.
• Most of the evidence is from studies in which patients received a single dose of a codeine combination drug and were observed for a very limited time, usually minutes to hours. This increases the uncertainty of the findings, and safety information needs to be interpreted with caution.