Clinical decision-support only. For use by licensed dental professionals. Not a substitute for professional judgment or a complete drug reference. Always verify with primary sources.
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Allergy

Codeine / opioid allergy

Analgesic/Opioid

Drug classes to avoid

OpioidCodeine

Reaction signs & chairside management

  • Flushing, itching or hives on exposure (pseudoallergic histamine release)

    Most reported opioid "allergy" is direct mast-cell histamine release (a pharmacologic effect, not true IgE allergy), causing flushing, itching, or urticaria; true anaphylaxis is rare.

    Clinical management: Avoid the specific opioid reported; if analgesia beyond acetaminophen/NSAIDs is needed, discuss alternatives with the prescriber rather than assuming full cross-reactivity across all opioids.

Sources

  1. Histamine-Releasing and Allergenic Properties of Opioid Analgesic Drugs: Resolving the Two. Baldo BA, Pham NH. Anaesthesia and Intensive Care, 2012.