Pharmacogenetic insights into codeine analgesia: Implications to pediatric codeine use

Codeine has been used medicinally since the 1800s as an analgesic and antitussive agent. Although very few studies have methodically examined the safety of codeine use in the pediatric age group, it is nonetheless commonly prescribed to children and breastfeeding mothers. Empirical evidence over the last century has suggested variability in the efficacy of codeine, and recent genomic advancements have shed important light on the mechanisms leading to such variability. Aside from evaluating the role of genetic variability in drug-metabolizing enzymes, receptors and transporters, the development of the blood-brain-barrier and the ontogeny of drug-metabolizing enzymes must also be considered in newborns and young children.