Is Codeine safe for babies and kids?
Severe risk for kidsInfants are more vulnerable to Codeine than children or adults due to immature hepatic/renal clearance, higher intake-to-body-weight ratio, rapid organ development, and increased gastrointestinal absorption.
What is codeine?
The IUPAC name is 1,2-dimethoxy-12-methyl-[1,3]benzodioxolo[5,6-c]phenanthridin-12-ium.
Also known as: chelerythrine, 34316-15-9, Toddalin, cheleritrine.
- IUPAC name
- 1,2-dimethoxy-12-methyl-[1,3]benzodioxolo[5,6-c]phenanthridin-12-ium
- CAS number
- 76-57-3
- Molecular formula
- C21H18NO4+
- Molecular weight
- 348.4 g/mol
- SMILES
- COc1ccc2C[C@H]3N(C)CC[C@@]45[C@@H](Oc1c24)[C@H](O)C=C[C@@H]35
- PubChem CID
- 2703
Risk for babies
Severe riskInfants are more vulnerable to Codeine than children or adults due to immature hepatic/renal clearance, higher intake-to-body-weight ratio, rapid organ development, and increased gastrointestinal absorption.
Neonates and infants up to 12 months have incomplete blood-brain barrier development, immature Phase I/II metabolic enzymes (particularly CYP3A4, UGT1A1), and higher gastrointestinal permeability. Equivalent doses produce higher internal concentrations and longer residence times.
Risk for pregnant and nursing people
Context-dependentPregnancy alters the metabolism and distribution of Codeine, potentially increasing fetal exposure. The developing embryo/fetus is vulnerable during organogenesis (weeks 3-8) and neurological development. Placental transfer should be assumed.
No specific reproductive toxicity data identified, but pregnancy-specific safety data is limited for most chemicals. Precautionary minimization of exposure is recommended.
Regulatory consensus
2 regulatory and scientific bodies have classified Codeine. The classifications differ — that's the data.
| Agency | Year | Classification | Notes |
|---|---|---|---|
| DEA | 1970 | Schedule II controlled substance (pure) / Schedule III-V in combinations | |
| WHO | 2023 | Essential Medicine — Step 2 analgesic ladder |
Regulators apply different standards of evidence — animal-data weighting, exposure-pattern assumptions, epidemiological power thresholds — which is why two scientific bodies can review the same data and reach different conclusions. The disagreement is the data.
Where kids encounter codeine
- Pharmaceutical
- Illicit Drug
Safer alternatives
Lower-risk approaches that achieve a similar outcome to Codeine:
-
Ibuprofen + acetaminophen combination
Trade-offs: No cough suppressant effect. GI side effects (ibuprofen). Hepatotoxicity risk (acetaminophen overdose). Non-addictive.Relative cost: Lower
-
Dextromethorphan (DXM)
Trade-offs: Non-opioid cough suppressant. Abuse potential at high doses. Less effective for severe cough.Relative cost: Similar
Frequently asked questions
Is codeine safe for kids?
Infants are more vulnerable to Codeine than children or adults due to immature hepatic/renal clearance, higher intake-to-body-weight ratio, rapid organ development, and increased gastrointestinal absorption.
What should I do if my child is exposed to codeine?
Minimize infant exposure through source control. For breastfeeding mothers: reduce maternal exposure. For formula-fed infants: use certified low-migration bottles and verified water sources. Consult pediatrician regarding any concerns.
See Codeine in the baby app
Look up products containing codeine, compare to alternatives, and explore the full data record.
Open in baby View raw API dataSources (1)
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Reference data, not professional advice. Aggregates publicly available regulatory and scientific data; not a substitute for veterinary, medical, legal, or regulatory advice. Why we built ALETHEIA →