Opioids Codeine and liver cirrhosis

[Survival0200]

I wonder if codeine stops working if you have liver cirrhosis? I understand it requires metabolization to morphine in the liver - and if your liver doesn't work properly, can it metabolize codeine?

 

[Jabberwocky]

I think the safer way, over ingesting codeine, is look into how cirrhosis affects enzyme levels. Codeine is metabolized to morphine by the cytochrome enzyme P450 2D6 (CYP2D6). If cirrhosis does not affect levels of enzymes involved in the codeine metabolism to morphine and norcodeine my guess is that you could take codeine normally.

This is only layman's guessing, not advice. Liver cirrhosis is serious condition and codeine is metabolized into morphine, so this isn't a small issue. Take care and be safe!

 

[Jabberwocky]

I have found this study that suggests great caution. Please inform yourself before proceeding with taking codeine.

https://onlinelibrary.wiley.com/doi/full/10.1111/jgh.12560

 

[December Flower]

I have found this study that suggests great caution. Please inform yourself before proceeding with taking codeine.

https://onlinelibrary.wiley.com/doi/full/10.1111/jgh.12560

I strongly agree. Afaik the safest pain-med to take with liver cirrhosis is Acetaminophen/Paracetamol. But don't take Codeine & Paracetamol together.

Codeine + weak/failing liver = no analgesic effects. (since it's not metabolized)
And besides it could actually make it worse.

 

[kaosisallwesee]

The only way to know is to try, take 15mg codeine and double the dose every hour until you feel nice feeling waves over the body.
You might start feel the effects in 300mg as of my limits (I'm very slow metaboliser)

Codeine doesn't work if you re dose within a few hours. Some say 4 hours some say 8 hours. But it's definitely not a drug you can take in many small doses over a short period. It's a pro drug and requires enzymatic conversion within the liver. Those enzymes are not infinite. Take your dose in one go. Perhaps that is why you think you are a low metaboliser? If you were to take 300mg in one dose I'm almost certain you'd feel far more that you do when stacking multiple smaller doses.

 

[AlphaMethylPhenyl]

Assuming that's from alcoholism, clean time will be regenerative. Luckily enough for us drinkers, livers are highly regenerative organs. I think that, though, you should pursue some semblance of sobriety, whether assisted by medication or not.