Components:
Medically reviewed by Kovalenko Svetlana Olegovna, PharmD. Last updated on 13.03.2022
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neuralgia
An indication is a term used for the list of condition or symptom or illness for which the medicine is prescribed or used by the patient. For example, acetaminophen or paracetamol is used for fever by the patient, or the doctor prescribes it for a headache or body pains. Now fever, headache and body pains are the indications of paracetamol. A patient should be aware of the indications of medications used for common conditions because they can be taken over the counter in the pharmacy meaning without prescription by the Physician.1.Management of poisoning due to anticholinesterase compounds including:
•Organophosphorus pesticides
•Chemical warfare nerve gases
2.Management of overdosage or poisoning of parasympathomimetics such as neostigmine
3.To antagonise the effects of cholinomimetic substances in the treatment of overdosage with parasympathomimetics such as bethanechol.
4.Treatment of poisoning with mushrooms that contain muscarine.
An indication is a term used for the list of condition or symptom or illness for which the medicine is prescribed or used by the patient. For example, acetaminophen or paracetamol is used for fever by the patient, or the doctor prescribes it for a headache or body pains. Now fever, headache and body pains are the indications of paracetamol. A patient should be aware of the indications of medications used for common conditions because they can be taken over the counter in the pharmacy meaning without prescription by the Physician.Codeine (Pecto 6 Paediatric) sulfate is an opioid analgesic indicated for the management of mild to moderately severe pain where the use of an opioid analgesic is appropriate.
An indication is a term used for the list of condition or symptom or illness for which the medicine is prescribed or used by the patient. For example, acetaminophen or paracetamol is used for fever by the patient, or the doctor prescribes it for a headache or body pains. Now fever, headache and body pains are the indications of paracetamol. A patient should be aware of the indications of medications used for common conditions because they can be taken over the counter in the pharmacy meaning without prescription by the Physician.respiratory-tract disorders
Belladonna (Pecto 6 Paediatric) is a naturally occurring mixture.
Belladonna (Pecto 6 Paediatric) produces many effects in the body, including relief from spasms of the gastrointestinal tract (stomach and intestines), the bladder, and the biliary tract. This is helpful in controlling conditions such as colitis, spastic bladder, diverticulitis, infant colic, renal and biliary colic, peptic ulcer, and irritable bowel syndrome.
Belladonna (Pecto 6 Paediatric) also reduces the secretions of many organs, thereby helping to control conditions such as excessive stomach acid production.
Belladonna (Pecto 6 Paediatric) is used to treat the rigidity, tremor, excessive salivation, and sweating caused by Parkinson's disease.
Belladonna (Pecto 6 Paediatric) also is used to treat motion sickness, nausea, vomiting, abdominal cramping associated with menstruation, and to reduce nighttime urination.
Belladonna (Pecto 6 Paediatric) may also be used for purposes other than those listed in this medication guide.
Codeine (Pecto 6 Paediatric) is an opioid pain medication. An opioid is sometimes called a narcotic.
Codeine (Pecto 6 Paediatric) is used to treat mild to moderately severe pain.
Codeine (Pecto 6 Paediatric) may also be used for purposes not listed in this medication guide.
Dosage Forms
Excipient information presented when available (limited, particularly for generics); consult specific product labeling.
Tablet,
Oral, as sulfate:
Generic: 15 mg, 30 mg, 60 mg
Dosing: Adult
Pain management (analgesic):
Injection [Canadian product]:
Opioid-naive patients: IM, SubQ: 30 to 60 mg every 4 to 6 hours as needed (use the lowest effective dose for the shortest period of time necessary)
Conversion from oral Codeine (Pecto 6 Paediatric) or another opioid: IM, SubQ: Refer to product labeling for dose conversions.
Oral: Note:
These are guidelines and do not represent the maximum doses that may be required in all patients. Doses should be titrated to pain relief/prevention.
Immediate release (tablet, oral solution [Canadian product]): Initial: 15 to 60 mg every 4 hours as needed; maximum total daily dose: 360 mg/day; patients with prior opioid exposure may require higher initial doses. Note: The American Pain Society recommends an initial dose of 30 to 60 mg for adults with moderate pain (American Pain Society 2016).
Controlled release: Codeine (Pecto 6 Paediatric) Contin [Canadian product]: Note: Titrate at intervals of ≥48 hours until adequate analgesia has been achieved. Daily doses >600 mg/day should not be used; patients requiring higher doses should be switched to an opioid approved for use in severe pain. In patients who receive both Codeine (Pecto 6 Paediatric) Contin and an immediate release or combination Codeine (Pecto 6 Paediatric) product for breakthrough pain, the rescue dose of immediate release Codeine (Pecto 6 Paediatric) product should be ≤12.5% of the total daily Codeine (Pecto 6 Paediatric) Contin dose.
Opioid-naive patients: Initial: 50 mg every 12 hours
Conversion from immediate release Codeine (Pecto 6 Paediatric) preparations: Immediate release Codeine (Pecto 6 Paediatric) preparations contain ~75% Codeine (Pecto 6 Paediatric) base. Therefore, patients who are switching from immediate release Codeine (Pecto 6 Paediatric) preparations may be transferred to a ~25% lower total daily dose of Codeine (Pecto 6 Paediatric) Contin, equally divided into 2 daily doses every 12 hours.
Conversion from a combination Codeine (Pecto 6 Paediatric) product (eg, Codeine (Pecto 6 Paediatric) with acetaminophen or aspirin): See table:
Conversion from another opioid analgesic: Using the patient's current opioid dose, calculate an equivalent daily dose of immediate release Codeine (Pecto 6 Paediatric). A ~25% lower dose of Codeine (Pecto 6 Paediatric) Contin should then be initiated, equally divided into 2 daily doses.
Discontinuation of therapy: When discontinuing chronic opioid therapy, the dose should be gradually tapered down. An optimal universal tapering schedule for all patients has not been established (CDC [Dowell 2016]). Proposed schedules range from slow (eg, 10% reductions per week) to rapid (eg, 25% to 50% reduction every few days) (CDC 2015). Tapering schedules should be individualized to minimize opioid withdrawal while considering patient-specific goals and concerns as well as the pharmacokinetics of the opioid being tapered. An even slower taper may be appropriate in patients who have been receiving opioids for a long duration (eg, years), particularly in the final stage of tapering, whereas more rapid tapers may be appropriate in patients experiencing severe adverse events (CDC [Dowell 2016]). Monitor carefully for signs/symptoms of withdrawal. If the patient displays withdrawal symptoms, consider slowing the taper schedule; alterations may include increasing the interval between dose reductions, decreasing amount of daily dose reduction, pausing the taper and restarting when the patient is ready, and/or coadministration of an alpha-2 agonist (eg, clonidine) to blunt withdrawal symptoms (Berna 2015; CDC [Dowell 2016]). Continue to offer nonopioid analgesics as needed for pain management during the taper; consider nonopioid adjunctive treatments for withdrawal symptoms (eg, GI complaints, muscle spasm) as needed (Berna 2015; Sevarino 2018).
Cough in select patients (off-label use):
Oral: Reported doses vary with a range of 7.5 to 120 mg/day as a single dose or in divided doses; however, evidence is of low quality (ACCP [Bolser 2006]; Smith 2010). Some experts recommend 30 to 60 mg 4 times daily in specific patient populations (eg, lung cancer) (ACCP [Molassiotis 2017]). Additional data may be necessary to further define the role of Codeine (Pecto 6 Paediatric) in this condition.
Diarrhea (persistent) (palliative care) (off-label use):
Oral: 15 to 30 mg every 4 hours as needed (von Gunten 2013). Additional data may be necessary to further define the role of Codeine (Pecto 6 Paediatric) in this condition.
Restless leg syndrome (off-label use):
Oral: Initial: 30 mg once daily at bedtime or during the night; may increase to 60 mg if needed; maximum dose: 180 mg in 2 to 3 divided doses. May be used alone or in combination with other medications used to treat RLS (Earley 2003; Sandyk 1987; Silbers 2013; Walters 2001).
Dosing: Geriatric
Refer to adult dosing. Use with caution and consider initiation at the low end of the dosing range; reduced initial dosages may be necessary.
Dosing: Pediatric
Note: Codeine (Pecto 6 Paediatric) 30 mg/5 mL oral solution has been discontinued in the US for more than 1 year. Doses should be titrated to appropriate analgesic effect; use the lowest effective dose for the shortest period of time:
Pain management; analgesia: Limited data available: Note: Use is contraindicated in pediatric patients <12 years of age and for postoperative management in pediatric patients 12 to 18 years of age who have undergone tonsillectomy and/or adenoidectomy. Avoid Codeine (Pecto 6 Paediatric) use in all pediatric patient populations in which it is contraindicated and in pediatric patients 12 to 18 years of age who have other risk factors that increase risk for respiratory depression associated with Codeine (Pecto 6 Paediatric) (eg, conditions associated with hypoventilation like postoperative status, obstructive sleep apnea, obesity, severe pulmonary disease, neuromuscular disease, use of other medications known to depress respiratory drive); in rare cases in which Codeine (Pecto 6 Paediatric)-containing product is the only option, consider genotype testing prior to use; use extra precaution; monitor closely for adverse effects. Codeine (Pecto 6 Paediatric) has been associated with reports of life-threatening or fatal respiratory depression in children and adolescents; multifactorial causes have been identified; of primary concern are unrecognized ultrarapid metabolizers of CYP2D6 who may have extensive conversion of Codeine (Pecto 6 Paediatric) (prodrug) to morphine and thus increased opioid-mediated effects. Avoid Codeine (Pecto 6 Paediatric) use in pediatric patient populations in which it is contraindicated; in rare cases in which Codeine (Pecto 6 Paediatric)-containing product is the only option, consider genotype testing prior to use; use extra precaution; monitor closely for adverse effects (AAP [Tobias 2016]; Dancel 2017; Gammal 2016; Goldschneider 2017; Poonai 2015).
Children and Adolescents:
Oral: 0.5 to 1 mg/kg/dose every 4 to 6 hours as needed; maximum single dose: 60 mg/dose (APS 2016)
Dosage Forms
Excipient information presented when available (limited, particularly for generics); consult specific product labeling.
Powder: 454 g
Dosing: Adult
Note: Sodium Benzoate (Pecto 6 Paediatric) is not commercially available as a ready-to-use product; however, some centers are still using compounded formulations when necessary. IV dosing is usually required for acute episodes; if IV administration is necessary, see the Sodium Phenylacetate and Sodium Benzoate (Pecto 6 Paediatric) monograph for information about a commercially available parenteral product.
Dosing: Pediatric
Note: Sodium Benzoate (Pecto 6 Paediatric) is not commercially available as a ready-to-use product; however, some centers are still using compounded formulations when necessary. IV dosing is usually required for acute episodes; if IV administration is necessary, see the Sodium Phenylacetate and Sodium Benzoate (Pecto 6 Paediatric) monograph for information about a commercially available parenteral product.
Urea cycle disorders, long-term therapy: Very limited data available: Dosage should be individualized based on patient response; consult metabolic specialist: Infants, Children, and Adolescents:
Oral: 250 to 500 mg/kg/day in 3 to 4 divided doses given with meals (Häberle 2012; Kliegman 2016, Maestri 1991; Maestri 1996).
See also:
What is the most important information I should know about Belladonna (Pecto 6 Paediatric)?
Pregnancy is no contraindication to therapy as the organophosphate poisoning represents a greater threat to the fetus than atropine.
See also:
What is the most important information I should know about Codeine (Pecto 6 Paediatric)?
Codeine (Pecto 6 Paediatric) Sulfate is contraindicated for postoperative pain management in children who have undergone tonsillectomy and/or adenoidectomy.
Codeine (Pecto 6 Paediatric) Sulfate is contraindicated in patients with known hypersensitivity to Codeine (Pecto 6 Paediatric) or any components of the product. Persons known to be hypersensitive to certain other opioids may exhibit cross-sensitivity to Codeine (Pecto 6 Paediatric).
Codeine (Pecto 6 Paediatric) Sulfate is contraindicated in patients with respiratory depression in the absence of resuscitative equipment.
Codeine (Pecto 6 Paediatric) Sulfate is contraindicated in patients with acute or severe bronchial asthma or hypercarbia.
Codeine (Pecto 6 Paediatric) Sulfate is contraindicated in any patient who has or is suspected of having paralytic ileus.
Use: Labeled Indications
Pain management: Management of mild- to moderately-severe pain
Limitations of use: Reserve Codeine (Pecto 6 Paediatric) for use in patients for whom alternative treatment options (eg, nonopioid analgesics, opioid combination products) are ineffective, not tolerated, or would be otherwise inadequate.
Off Label Uses
Cough in select patients
In a metaanalysis of trials evaluating the treatment of chronic cough, the use of Codeine (Pecto 6 Paediatric) demonstrated efficacy in patients with this condition.
There are specific as well as general uses of a drug or medicine. A medicine can be used to prevent a disease, treat a disease over a period or cure a disease. It can also be used to treat the particular symptom of the disease. The drug use depends on the form the patient takes it. It may be more useful in injection form or sometimes in tablet form. The drug can be used for a single troubling symptom or a life-threatening condition. While some medications can be stopped after few days, some drugs need to be continued for prolonged period to get the benefit from it.Use: Labeled Indications
Urea cycle disorders: Adjunctive therapy for the prevention and treatment of hyperammonemia due to suspected or proven urea cycle disorders
See also:
What other drugs will affect Belladonna (Pecto 6 Paediatric)?
The muscarinic actions of parasympathomimetic drugs such as carbachol, bethanecol and pilocarpine are blocked by atropine.
The action of anticholinesterase agents such as physostigmine, neostigmine, edrophonium, ambenonium and pyridostigmine can be antagonised at muscarinic receptor sites by atropine.
See also:
What other drugs will affect Codeine (Pecto 6 Paediatric)?
When this drug applied simultaneously with:
- drugs have a depressing effect on the central nervous system (including those with opioid analgesics, barbiturates, benzodiazepines, clonidine) it is possible an increase the action of Codeine (Pecto 6 Paediatric).
- derivatives of morphine it may increased the inhibitory action on the respiratory center; ibuprofen - analgesic effect is enhanced; carbamazepine - it may increased the analgesic effect is apparently due to increased formation of Codeine (Pecto 6 Paediatric) metabolite normorphine, which has a stronger effect.
- quinidine the analgesic effect of Codeine (Pecto 6 Paediatric) decreased or almost disappeared.
- Codeine (Pecto 6 Paediatric) increases the effect of ethanol on psychomotor function.
Probenecid: May increase the serum concentration of Sodium Benzoate (Pecto 6 Paediatric). Specifically, probenecid may inhibit the renal transport of the hippuric acid metabolite of Sodium Benzoate (Pecto 6 Paediatric). Monitor therapy
See also:
What are the possible side effects of Belladonna (Pecto 6 Paediatric)?
Atropine administration should be discontinued if over-atropinization is observed.
Possible hypersensitivity to cholinergic stimulation (tremors, rigidity) after prolonged atropine therapy may occur.
See also:
What are the possible side effects of Codeine (Pecto 6 Paediatric)?
Applies to Codeine (Pecto 6 Paediatric): oral solution, oral syrup, oral tablet, oral tablet extended release
In addition to its needed effects, some unwanted effects may be caused by Codeine (Pecto 6 Paediatric). In the event that any of these side effects do occur, they may require medical attention.
Major Side Effects
You should check with your doctor immediately if any of these side effects occur when taking Codeine (Pecto 6 Paediatric):
Incidence not known:
- Bloating
- blurred vision
- chills
- cold, clammy skin
- confusion
- constipation
- darkened urine
- difficult or troubled breathing
- dizziness
- dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
- fainting
- fast, irregular, pounding, or racing heartbeat or pulse
- fast, weak pulse
- feeling of warmth
- fever
- indigestion
- irregular, fast or slow, or shallow breathing
- lightheadedness
- loss of appetite
- nausea
- no blood pressure or pulse
- no breathing
- pains in the stomach, side, or abdomen, possibly radiating to the back
- pale or blue lips, fingernails, or skin
- redness of the face, neck, arms, and occasionally, upper chest
- shortness of breath
- stopping of the heart
- sweating
- unconsciousness
- unusual tiredness or weakness
- vomiting
- wheezing
- yellow eyes or skin
If any of the following symptoms of overdose occur while taking Codeine (Pecto 6 Paediatric), get emergency help immediately:
Symptoms of overdose:
- Bluish lips or skin
- change in consciousness
- chest pain or discomfort
- constricted, pinpoint, or small pupils (black part of the eye)
- decreased awareness or responsiveness
- extreme sleepiness or unusual drowsiness
- loss of consciousness
- no blood pressure or pulse
- severe sleepiness
- slow or irregular heartbeat
Minor Side Effects
Some of the side effects that can occur with Codeine (Pecto 6 Paediatric) may not need medical attention. As your body adjusts to the medicine during treatment these side effects may go away. Your health care professional may also be able to tell you about ways to reduce or prevent some of these side effects. If any of the following side effects continue, are bothersome or if you have any questions about them, check with your health care professional:
More common:
- Drowsiness
- relaxed and calm
- Abdominal or stomach pain or cramps
- blurred or loss of vision
- diarrhea
- disturbed color perception
- double vision
- dry mouth
- false or unusual sense of well-being
- fear or nervousness
- feeling of constant movement of self or surroundings
- halos around lights
- headache
- hives or welts
- itching skin
- night blindness
- overbright appearance of lights
- redness of the skin
- sensation of spinning
- shakiness
- skin rash
- sleeplessness
- trouble sleeping
- tunnel vision
- unable to sleep
- weight loss
Adverse Reactions
Frequency not defined. Adverse reactions are from multiple indications and dosing.
Cardiovascular: ECG abnormality (Sushma 1992)
Gastrointestinal: Anorexia (Wolff 1986), dyspepsia (Sushma 1992), epigastric distress (Sushma 1992), gastritis (Häberle 2012), mucositis (Häberle 2012), nausea (Sushma 1992), vomiting (Sushma 1992; Wolff 1986)
Endocrine & metabolic: Hypokalemia (Häberle 2012), increased serum sodium (Sushma 1992), metabolic acidosis (Häberle 2012)
Renal: Renal tubular disease (Wolff 1986)
An opioid analgesic related to morphine but with less potent analgesic properties and mild sedative effects. It also acts centrally to suppress cough. [PubChem]