CADTH is committed to supporting Canada’s health care decision-makers through this challenging and uncertain time.
For evidence, tools, and resources related to COVID-19, visit our COVID-19 Evidence Portal.

 

Begin main content

Codeine for Acute Extremity Pain: A Review of Clinical Effectiveness

Last updated: January 12, 2021
Project Number: RC1324-000
Product Line: Rapid Response
Research Type: Drug
Result type: Report

Question

  1. What is the clinical effectiveness of codeine for patients with acute extremity pain?
  2. What is the clinical effectiveness of codeine with acetaminophen and/or an NSAID for patients with acute extremity pain?

Key Message

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.