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Licensed to fill prescriptions for patients in RI, MA, CT, NJ, NH, FL, ME and PA. New York patients are served on a limited basis while nonresident registration is pending.
Prepared to a prescriber's order for one patient. Not FDA-approved.
This is a compounded oral liquid containing codeine phosphate, prepared to a prescriber's order for one patient. Compounded preparations are not FDA-approved. Codeine is a Schedule II controlled substance.
These listings cover every salt or ester form of each drug in the FDA National Drug Code Directory.
FDA-approved products containing codeine are listed in tablet, capsule, solution and syrup forms.
Liquid bases can be aqueous or nonaqueous, and USP <795> classifies the preparation by its water activity. Aqueous preparations carry shorter default beyond-use dates than nonaqueous ones. The date printed on the label is the one to follow.
Codeine is an opioid pain and cough medicine, a controlled substance, that compounding pharmacies prepare as oral capsules, oral liquids and suppositories.
Codeine is a naturally occurring opium alkaloid. It is a prodrug: the liver enzyme CYP2D6 converts a small fraction of it to morphine, which does most of the pain relief by activating mu-opioid receptors, while receptors in the brainstem cough center account for its cough-suppressing effect. Manufactured products include codeine sulfate tablets (Lannett, Hikma), FDA-approved for mild to moderate pain where an opioid is appropriate and alternatives are inadequate, and many combinations with acetaminophen, promethazine, guaifenesin or butalbital. StatPearls notes that codeine powder for compounding is available. A prescriber may order codeine compounded as a single-ingredient liquid, a suppository, a capsule without a specific dye or filler, or a combination that is not manufactured. Codeine alone is a Schedule II controlled substance; the manufactured combination products fall in Schedules III to V. Compounded preparations are not FDA-approved and require a prescription.
Codeine sulfate tablets carry a boxed warning covering addiction, abuse and misuse; life-threatening slowed breathing; fatal overdose from accidental ingestion, especially by children; profound sedation, coma and death with benzodiazepines, alcohol or other sedatives; neonatal opioid withdrawal syndrome after extended use in pregnancy; interactions with drugs that affect CYP2D6 and CYP3A4; and deaths in children who were ultra-rapid metabolizers of codeine, most after tonsillectomy or adenoidectomy. The boxed warning also describes the Opioid Analgesic REMS, under which prescribers are encouraged to complete REMS education and to counsel patients using the Medication Guide. Codeine is contraindicated in all children under 12, in anyone under 18 after tonsillectomy or adenoidectomy, in significant respiratory depression, unmonitored severe asthma, bowel obstruction, codeine allergy, and with MAO inhibitors or within 14 days of them. CYP3A4 inhibitors such as ketoconazole raise morphine levels; inducers such as rifampin lower them. The label advises against breastfeeding because codeine and morphine pass into milk and infant sedation, breathing problems and death have been reported; LactMed notes that any use while nursing should be brief, with the infant watched for sleepiness, feeding trouble or limpness. Common side effects are constipation, nausea and drowsiness. Keep naloxone available, and if side effects are severe or do not go away, talk to your prescriber or pharmacist.
Codeine is a mu-opioid agonist with much weaker receptor affinity than morphine; analgesia is attributed largely to CYP2D6 O-demethylation to morphine (about 5 to 10 percent of a dose). Oral absorption is near complete with peak plasma concentration at about 60 minutes; volume of distribution is 3 to 6 L/kg; plasma protein binding is low, about 7 to 25 percent. About 70 to 80 percent is glucuronidated to codeine-6-glucuronide (UGT2B7), about 10 percent is N-demethylated to norcodeine by CYP3A4, and about 90 percent is excreted renally; plasma half-life of codeine and its metabolites is roughly 3 hours. CYP2D6 ultra-rapid metabolizers generate higher morphine exposure. Labeled indication (codeine sulfate tablets, Lannett): mild to moderate pain where an opioid is appropriate. Prescribers have ordered codeine off-label for chronic cough, refractory restless legs and palliative diarrhea (StatPearls). Dosing, titration and taper are per prescriber. Monitoring: respiratory depression and sedation at initiation and dose changes, misuse and addiction risk, and neonates exposed in utero or through milk. Codeine alone is Schedule II; combinations are Schedules III to V. Electronic prescribing of controlled substances is voluntary under federal DEA rules; CMS applies a prescriber-level threshold for Part D, and a number of states mandate it.
Shake the bottle if your label says to. Measure each dose with the oral syringe or dosing cup the pharmacy gave you, never a kitchen spoon. Give the liquid slowly into the mouth. Rinse the syringe with water after each use. Call the pharmacy if you are unsure how to measure.
Storage depends on the vehicle. Water-based liquids with a preservative usually carry a USP <795> beyond-use date of up to 35 days; without a preservative they are kept refrigerated for up to 14 days. Oil-based (nonaqueous) oral liquids may carry up to 90 days. Your label states whether to refrigerate and the beyond-use date. Keep out of reach of children and discard after that date.
This formulation is compounded by Bayview Pharmacy on a prescriber's order for an individual patient. It is not an FDA-approved drug product, and the FDA has not evaluated it for safety, effectiveness, or manufacturing quality.
A valid prescription is required. Availability depends on Bayview's licensure in your state. This page is general information, not medical advice. Discuss your situation with a licensed healthcare provider.
This preparation is a controlled substance. Additional prescribing, refill, and shipping restrictions apply, and the states Bayview can dispense it to are narrower than for non-controlled preparations.
Search by NCPDP 4106882, or by name and ZIP: Bayview Pharmacy, Warwick, RI 02886. Select it as the destination pharmacy and save it as a favorite. Click any value to copy it.
Compounded preparations have no NDC, so this formula will not appear in your EHR's drug search. Use your system's compound, non-formulary, or free-text prescription entry and name the preparation exactly as written in step 3. If your EHR forces you to pick a listed drug, pick the closest entry for the active ingredient and put the full formula in the prescription body (the Sig or directions field), not in Notes to Pharmacy.
Compounded preparations have no NDC and will not appear in your drug search. For EPCS to validate, select a drug entry your EHR recognizes as controlled, usually the bulk powder entry for the active ingredient (for example Ketamine (bulk) powder, not a branded product), then put the full formula from step 3 in the prescription body. A free-text entry that does not validate as controlled will be rejected by your EPCS module.
Quantity and directions are starting points for this dose form, not treatment recommendations. Dosing remains the prescriber's responsibility.
Transmit from your EHR. For this non-controlled preparation we also accept fax to (401) 284-4506 and phoned orders at (401) 284-4505. Order forms are on the formulation pages and in the prescriber portal.
Transmit with two-factor authentication through your EPCS-enabled EHR. No order form is offered for this preparation; e-prescribing guides for our controlled preparations are on the formulation pages.
Licensed to dispense in RI, MA, CT, NJ, NH, FL, ME, and PA; New York is served on a limited basis while nonresident registration is pending. Compounded preparations are not FDA-approved. A valid prescription is required. Full guide, including steps by EHR: How to e-prescribe to Bayview. Questions about this formula: call (401) 284-4505.
Take orally
