Norco given to patient with codeine allergy

loriangel14, RN · Jan 15, 2013

You get off of AN and go and tell the RN what happened.You will need to notify the MD ASAP.

TheCommuter, BSN, RN · Jan 15, 2013

Many patients who have codeine allergies can tolerate hydrocodone/acetaminophen (Norco) just fine. Norco is not codeine. I would leave the issue alone and continue to monitor your patient.

aligar89 · Jan 15, 2013

Awesome thanks the commuter my supervisor said the same

KelRN215, BSN, RN · Jan 15, 2013

Norco is Vicodin, right? So it's hydrocodone and acetaminophen. It's not the same thing as codeine.

Editorial Team / Admin · Jan 15, 2013

You get off of AN and go and tell the RN what happened.You will need to notify the MD ASAP.

That's one of the things I've wondered when I read posts like this- why are you asking for information on an anonymous message board? Get up from the computer, and go ask someone you know has the proper knowledge, not some person on a message board who can't prove they have the required knowledge. Admitting mistakes is a sign of strength, not of weakness, especially when they are learned from!

NEWnurse5813 · Jan 10, 2017

Hi,

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.

brownbook · Jan 17, 2017

I still can't use the quote function. I am too stupid for my computer.

beekee · Jan 18, 2017

Also, ask the patient what the reaction to codeine was in the past.

applesxoranges, BSN, RN · Jan 18, 2017

Some people can tolerate other forms of pain medications. Some people say codeine makes them sick as their allergy even though that isn't a true allergy. Some people list pain meds in hopes of getting stronger pain meds. It's awkward explaining to people that they are not allergic to toradol because "it doesn't work" doesn't qualify as an allergy.

Meriwhen, ASN, BSN, MSN, RN · Jan 18, 2017

Also, ask the patient what the reaction to codeine was in the past.

This. The patient may have had a bona-fide allergic reaction as one of the PP had. Or they may have had something innocuous such as bad nausea and thought (or was suggested to say) it was an allergic reaction. And I've known more than a couple of people who used the "allergy" excuse to avoid contact with certain medications...or to obtain other medications.

That being said, it's best to err on the side of caution and not give the medication in question until talking with the patient AND the PCP.