Abstract
The study aimed to determine the effect of a high dosage of codeine-containing cough syrup administration on some biochemical parameters of the liver in albino rats. Codeine at 80 mg/kg/day, 160 mg/kg/day, 240 mg/kg/day, 320 mg/kg/day cough syrup were administered orally to albino rats for 21 days, biochemical parameters were analyzed for the activities of Alanine aminotransferase (ALT), Aspartate aminotransferase (AST), Alkaline phosphatase (ALP), Bilirubin, Total protein and Albumin. Results obtained revealed that a high dosage of codeine administration significantly increased plasma levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), bilirubin and albumin while it reduced total protein level when compared with the control rats. The study confirmed the risk of increased hepatotoxicity due to a high dosage of codeine administration. Although codeine is reported to be effective in pain management, its toxicity should be kept in mind.
Highlights
Codeine is an opioid that functions as an ingredient in multiple medications
Codeine metabolism resulted in several metabolites, it is morphine, a product of codeine O-demethylation by enzyme cytochrome P 450 2D6 (CYP 2D6), that is responsible for its analgesic effect [4, 5]
Effect of high dosage of codeine-containing cough syrup administration on AST, ALT and alkaline phosphatase (ALP) activities Administration of codeine-containing cough syrup at 80 mg/kg, 160 mg/kg, 240 mg/kg and 320 mg/kg doses significantly increased the activity of AST by 18.1%, 19.0%, 22.1%, 23.5% respectively, ALT activity by 17.0%, 18.7%, 21.9%, 26.0% respectively and ALP activity by 16.7%, 17.5%, 21.9%, 27.9% respectively when compared with the normal rats (Table 1)
Summary
It helps alleviate mild to moderate pain and suppress coughing. The drug is often used to suppress a cough either alone or by combining it with other drugs [1]. The metabolism of codeine occurs mostly in the liver, and to a lesser extent in the intestine and central nervous system [3]. Codeine dosage is highly regulated; its overdose could cause depressive effects on the central nervous system or death from respiration arrest. When someone uses codeine, their liver metabolizes the drug as morphine. People respond differently to codeine partially because each person’s liver metabolizes morphine differently. When someone’s liver metabolizes codeine quickly, they are at greater risk of an overdose. Codeine has contributed to the high rates of addiction and overdose which have characterized the Opioid epidemic [7]
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