Is cough syrup w/codeine safe?

[4tloml]

We all got flu shots, but my PALS has the flu. Came on suddenly last night with coughing and fever. He always uses the auto-servo bipap at night, Trilogy on and off throughout the day as needed and cough assist morning and evening. He takes Mucinex 12 hr morning and night and does breath stacking 3-4 times a day. But last night he used cough assist nearly every hour and still could hardly breathe.

Called clinic 1st thing this morning and they sent him to primary care. PC did a chest x-ray but we don't have results on that. Strep was negative; flu test positive. Doc prescribed tamiflu and a cough syrup with codeine.

I am concerned about the codeine depressing his breathing but can't find anything online relative to ALS on that. Does anyone have any experience with codeine and already-compromised lung function? His FVC in Dec. was 65%. This morning his O2 varied between 91 & 95. Fever is running between 101 & 102.4 on extra-strength acetominophen. What are your thoughts?

Thank you.

 

[lgelb]

Yes, we used codeine to break up coughing cycles even with much less lung function than your PALS. The prescribed dose is unlikely to significantly exacerbate respiratory compromise. If he's prescribed two spoonfuls every X hrs, you can split them up, too -- that can help, to have fewer hrs bt doses. Coughing and the CA further exhaust the expiratory muscles so it is worthwhile to try to break the cycle. Of course, you know this but plenty of high-nutrition liquids, including warm drinks if he still drinks, humidification might need adjustment, temp in room, probably best to stick to liquids/purees for now even if he could eat solids and to focus on what's easily digestible, whether through mouth or tube. Might try increasing inspiration time setting/reducing pressure support (sometimes bigger breaths trigger coughs). And when he's not sleeping, favorite movies/TV can be a helpful nonpharmacologic distraction...let us know how he's doing.
--Laurie

 

[4tloml]

Laurie, thank you so much!

The cough syrup did finally calm the cough long enough for him to get some sleep. It was a scary first night, so the sleep helped tremendously. And thank you for info on CA settings. By end of night we didn't know if it was helping or exacerbating his trouble.

He's doing better--keeping fever under 100 and TV is on continually. Says it helps him sleep.

Thanks again for reassurance on the codeine, for future use as well, if needed. I won't be such a nervous Nelly about it now.