Respiratory Depression in kids
The combination of promethazine hydrochloride and codeine phosphate is contraindicated in paediatric patients less than six years of age. Concomitant administration of promethazine product with different metabolic process depressants has an association with respiratory depression, and sometimes death, in paediatric patients.
Postmarketing cases of respiratory depression, as well as fatalities, are reported with use of promethazine hydrochloride in paediatric patients but two years older. The large amount of weight-based doses of promethazine hydrochloride have resulted in respiratory depression in these patients.
Death associated with Ultra-Rapid Metabolism of codeine to morphine
Respiratory depression and even death have occurred in kids. WHO received codeine following extirpation and/or adenoidectomy and had proof of being ultra-rapid metabolizers of codeine due to a CYP2D6 polymorphism.