I am a new nurse, with an anaphylactic reaction to codeine. When I first had my reaction, I was 17 and almost died. A Pathologist doctor that examined me told me to stay away from all opiates due to the severity of my reaction. I later found out that others in my extended family had a life threatening opiate allergy as well. In later years, after the birth of my son, he was given codeine as a child, and he reacted seriously as well. Here's my issue:
1. though other opiates in various classes are slightly different, this does not mean that someone with a serious life threatening reaction to ANY opiate, synthetic or non synthetic won't react.
2. that even if there is only a 10% chance of a reaction, that does not mean I want to take the chance! anaphylaxis is terrifying and 10% is way too high a chance.
3. If a patient were allergic to penicillin we would never give them amoxicillin or other variants of this class, why do we give other variants of opiates?
4. I can't tell you how many times doctors have prescribed me Norco or Tramadol for pain issues when they knew I was allergic to codeine, despite my reserve, only to have the pharmacist say no way and refuse to fill. (I learned, before nursing, never to take ANY type of opiate, ever).
Nurses, please be careful with this. BTW, Immodium has low dose opiate in it, so low it's not even called an opiate, yet family members with opiate allergies have reacted to it. (other anti-diarrheal meds have the same thing, that's their mechanism of action ** opiates cause constipation, a reaction that is desired in diarrhea pts).
Thanks for reading, you may save a life of a rare allergic individual.