Cough

Updated 12 September 2016

DNA testing can prevent codeine deaths

Many children have died after being given too much codeine. DNA testing can identify if your child is at risk.

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In 2009 a two-year-old boy from Canada become the first case of a toddler who died after receiving codeine following surgery for sleep apnoea.

Specific genetic variation

According to The National Post researchers are “issuing fresh warnings that the routine practice of giving children codeine after surgery” should be closely monitored.

Since then, this popular cough mixture ingredient has been fatal to many children. Recently a five-year-old boy from the USA died after he was administered codeine for pain following tonsillitis surgery.

Read: Clamping down on SA's most abused over-the-counter drug

But all these deaths could possibly have been prevented if DNA testing had been done, says Dr Danny Meyersfeld, founder and CEO of DNAlysis. The trend (children dying from codeine) is also not limited to codeine being administered after surgery, but parents giving their children cough mixtures containing this ingredient, are also at risk.

“[The boy from the USA] had a specific genetic variation, prevalent in approximately 10% of the population that resulted in him metabolising the codeine at a much higher rate than normal,” he says.

“Advanced knowledge of his genetic makeup would have made all the difference, as he either would have been given a different drug, or if there was no suitable alternative, prescribed codeine at a much lower dosage.”

What is DNA testing?

We all have small genetic differences, or “spelling errors”, in our DNA; these small differences can make a big difference to the functioning of the genes in which they are found.

“A DNA test is designed to analyse these genetic variations and make diet, nutrition and lifestyle recommendations for an individual that would be unique to their personal requirements,” Meyersfeld explains.

Tests are done by means of a cheek swab; doctors collect cells from the inside of the cheek and process these in the lab to extract your DNA.

Benefits of DNA testing

“The primary benefit would be to ensure that as a patient, you are taking the most suitable medication for any given condition,” says Meyersfeld.

Read: Why SA continues selling 'most abused over-the-counter drug'

The test can help to minimise side effects from medications, increase efficacy, and save money over the long-term by eliminating the trial-and-error approach to prescribing medications that has been followed in the past.

We need stricter laws

Meyersfeld is adamant that South Africa needs stricter laws governing codeine. In Europe codeine is banned for anyone under the age of 12, but in South Africa it’s readily accessible and available in various over-the-counter medications.

“Not everybody is at risk; only those who carry the specific genetic variants that make them ultra-rapid metabolisers. It is not particularly potent in children; it is more a case of it having been commonly used in children’s medications.”

When should you do the test?

Meyersfeld recommends the following people should get DNA testing done:

  • Anybody starting a prescription or chronic medication
  • Anybody taking a chronic medication at higher than recommended dosage
  • Anyone who is suffering side effects from their medications

It is a once-off test, with the information available to you for the rest of your life. “Data is securely stored and confidentiality of patients and results is ensured.”

Read more:

Rapper admits to taking 90 codeine pills a day!

SA to control misuse of codeine

Codeine: watch out!

 

Ask the Expert

Cough Expert

Professor Keertan Dheda has received several prestigious awards including the 2014 Oppenheimer Award, and has published over 160 peer-reviewed papers and holds 3 patents related to new TB diagnostic or infection control technologies. He serves on the editorial board of the journals PLoS One, the International Journal of Tuberculosis and Lung Disease, American Journal of Respiratory and Critical Medicine, Lancet Respiratory Diseases and Nature Scientific Reports, amongst others. Read his full biography at the University of Cape Town Lung Institute.

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