Pediatric Codeine Formulary Restriction

Information for AHS Staff and Clinicians

The Drugs and Therapeutics Committee (DTC), in conjunction with the Pediatric Advisory Committee (PAC), has recently approved a formulary restriction on codeine restricting the use of these products to patients 18 years of age and older within AHS facilities.

The impetus for this restriction stems from several published cases of respiratory depression and death in children, when they were given codeine. Morphine is the alternative opioid being recommended to prescribers, as its effects are more predictable and reliable than codeine. In order to prescribe morphine for outpatients or discharged patients, a Triplicate Prescription form must be used.

The Stollery Children’s Hospital and the Alberta Children’s Hospital were the first two AHS sites to implement this formulary restriction in June 2013. After the successful implementation of the pediatric codeine formulary restrictions at these two major pediatric sites, all AHS sites are now expected to implement this change.

The following resource material provides background and further information on the Formulary Restriction: