Tuesday, February 09, 2010
WHEN SOMEONE'S ALLERGIC TO CODEINE
May 1994
"What safe alternatives are available for the patient who requires narcotics for the management of metastatic carcinoma and has a history of allergy to codeine (hives, bronchospasm)?" asks EDWARD GUTMAN, MD, of Toronto, Ont. "Is there a role for desensitization therapy or concurrent treatment with antihistimines or steroids?"
It is fairly safe assumption that an allergic reaction to codeine will not generalize to an allergy to all narcotics. Therefore, it is usually safe to go ahead with a trial of an alternate narcotic such as oxycodone, hydromorphone or morphine. If you're concerned about a cross-reaction, a test dose under observation with facilities for treatment of an allergic reaction would be indicated. Desensitization therapy or concurrent antihistimines or steroids would very rarely be indicated. JJ
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