Antitussive codeine medicines in Ukraine: clinical and pharmacological, marketing, regulatory aspects, and forecasts

Introduction. The circulation and use of codeine-containing medicines require strict regulation to ensure effective pain and cough treatment while minimizing misuse risks. In Ukraine, the availability of such medicines is subject to regulatory measures aimed at balancing accessibility and safety. This study examines the effectiveness, diversity of pharmaceutical forms, and regulatory aspects of codeine-containing medicines in compliance with international standards. Materials and methods. The study is based on a systematic review of scientific literature and regulatory documents regarding the circulation and use of codeine-containing medicines in Ukraine. Data analysis included the assessment of pharmaceutical forms, prescription regulations, and restrictions designed to prevent misuse. The study also considered statistical data on the prevalence of codeine-containing medicines and their therapeutic applications in clinical practice. Results and discussion. The study identified a significant variety of codeine-containing pharmaceutical forms, with combination formulations demonstrating advantages in pain and cough management. Strict regulatory measures are in place, including mandatory registration, prescription-only dispensing, and expiration date restrictions. The research highlighted that 95.83% of codeine medicines are combination drugs, which indicates their use for treating multiple conditions simultaneously, such as pain and cough. Only 4.17% of medicines contain exclusively codeine, emphasizing the preference for combination therapy. Additionally, the market for codeine medicines in Ukraine is developing steadily, with an increasing demand for painkillers and cough medicines. However, ensuring patient safety and minimizing the risks of abuse remain essential aspects of regulation. Despite the comprehensive regulatory framework, there are still gaps in public awareness regarding misuse risks and the need for enhanced collaboration between patients and healthcare providers. Conclusions. Codeine medicines remain an important component of pharmacotherapy due to their effectiveness and variety of release forms, which meet a wide range of medical needs. At the same time, responsible use of such medicines should be under the supervision of a doctor and with strict adherence to recommended doses. Although codeine has a less pronounced analgesic effect compared to other opioids, its safety profile allows it to be used in the treatment of patients, especially for short-term use. The vast majority of codeine medicines (95.83%) are combined, which indicates their use for the treatment of several conditions at the same time, such as pain and cough. Only 4.17% of medicines contain exclusively codeine. This trend emphasizes the widespread use of combined codeine medicines used together with other active substances, which allows achieving better treatment results. The codeine medicines market in Ukraine is developing steadily, with the prospect of increasing demand for painkillers and cough medicines. However, a system of control over their circulation remains important, ensuring patient safety and minimizing the risks of abuse. Regulatory measures for the circulation of codeine medicines in Ukraine comply with international standards, with additional restrictions aimed at ensuring safety. The control system provides for the registration of medicines, prescription, and strict control by state authorities. This practice corresponds to global trends in strengthening control over narcotic drugs. An important aspect of the safe use of codeine medicines is warning about the risks of abuse and addiction. To do this, it is necessary to actively cooperate between patients and medical professionals, adhering to all recommendations and ensuring control over treatment. Raising awareness of possible dangers and implementing measures to minimize them will help preserve the health of patients and avoid serious negative consequences.