Codeine/ guaifenesin/ pseudoephedrine

Generic Name: codeine/guaifenesin/pseudoephedrine (KOE-deen/gwye-FEN-e-sin/SOO-doe-e-FED-rin)
Brand Name: Examples include Ambifed CD and Maxifed-G CDX

Some children have had serious and sometimes fatal breathing problems when using codeine after surgery to remove tonsils or adenoids. Talk with your doctor for more information.


Codeine/ guaifenesin/ pseudoephedrine is used for:

Relieving congestion and cough due to colds, flu, or hay fever. It may also be used for other conditions as determined by your doctor.

Codeine/guaifenesin/pseudoephedrine is a decongestant, cough suppressant, and expectorant combination. The decongestant works by constricting blood vessels and reducing swelling in the nasal passages. The cough suppressant works in the brain to help decrease the cough reflex to reduce a dry cough. The expectorant loosens mucus and lung secretions in the chest and makes coughs more productive.

Do NOT use codeine/ guaifenesin/ pseudoephedrine if:

  • you are allergic to any ingredient in codeine/guaifenesin/pseudoephedrine or any other codeine- or morphine-related medicine (eg, oxycodone)
  • you have severe high blood pressure, rapid heartbeat, or other severe heart problems (eg, heart blood vessel disease)
  • you are having an asthma attack
  • you are taking sodium oxybate (GHB) or if you have taken furazolidone or a monoamine oxidase inhibitor (MAOI) (eg, phenelzine) within the last 14 days
  • the patient is a child and has just had surgery to remove tonsils or adenoids

Contact your doctor or health care provider right away if any of these apply to you.

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Before using codeine/ guaifenesin/ pseudoephedrine:

Some medical conditions may interact with codeine/guaifenesin/pseudoephedrine. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

  • if you are pregnant, planning to become pregnant, or are breast-feeding
  • if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
  • if you have allergies to medicines, foods, or other substances
  • if you have had a severe allergic reaction (eg, severe rash, hives, difficulty breathing, dizziness) to morphine, codeine, or any other opiate (eg, dihydrocodeine, hydrocodone, oxycodone)
  • if you have a history of glaucoma; an enlarged prostate gland or other prostate problems; heart problems; diabetes; high blood pressure; blood vessel problems; stroke; liver or kidney problems; blockage of the stomach, bowel, or bladder; adrenal gland problems; or thyroid problems
  • if you have a history of constipation, stomach problems (eg, ulcers), bowel problems (eg, chronic inflammation or ulceration of the bowel), or gallbladder problems (eg, gallstones), or if you have had recent stomach, bowel, or urinary surgery
  • if you have breathing or lung problems (eg, asthma, chronic bronchitis, emphysema), or chronic obstructive pulmonary disease (COPD), or if cough occurs with large amounts of mucus
  • if you have a fever, severe drowsiness, recent head or brain injury, brain tumor, increased pressure in the brain, infection of the brain or nervous system, or a seizure disorder (eg, epilepsy)
  • if you have very poor health or a history of alcohol abuse, other substance abuse, or suicidal thoughts or actions
  • if you are taking medicine for high blood pressure or depression

Some MEDICINES MAY INTERACT with codeine/guaifenesin/pseudoephedrine. Tell your health care provider if you are taking any other medicines, especially any of the following:

  • Digoxin or droxidopa because the risk of irregular heartbeat or heart attack may be increased
  • Beta-blockers (eg, propranolol), catechol-O-methyltransferase (COMT) inhibitors (eg, tolcapone), cimetidine, furazolidone, HIV protease inhibitors (eg, ritonavir), indomethacin, MAOIs (eg, phenelzine), or tricyclic antidepressants (eg, amitriptyline) because they may increase the risk of codeine/guaifenesin/pseudoephedrine's side effects
  • Naltrexone, quinidine, or rifamycins (eg, rifampin) because they may decrease codeine/guaifenesin/pseudoephedrine's effectiveness
  • Bromocriptine or sodium oxybate (GHB) because the risk of their side effects may be increased by codeine/guaifenesin/pseudoephedrine
  • Guanadrel, guanethidine, mecamylamine, methyldopa, or reserpine because their effectiveness may be decreased by codeine/guaifenesin/pseudoephedrine

This may not be a complete list of all interactions that may occur. Ask your health care provider if codeine/guaifenesin/pseudoephedrine may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use codeine/ guaifenesin/ pseudoephedrine:

Use codeine/guaifenesin/pseudoephedrine as directed by your doctor. Check the label on the medicine for exact dosing instructions.

  • Take codeine/guaifenesin/pseudoephedrine by mouth with or without food. If stomach upset occurs, take with food to reduce stomach irritation.
  • Drink plenty of water while taking codeine/guaifenesin/pseudoephedrine.
  • If you miss a dose of codeine/guaifenesin/pseudoephedrine, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use codeine/guaifenesin/pseudoephedrine.

Important safety information:

  • Codeine/guaifenesin/pseudoephedrine may cause dizziness or drowsiness. These effects may be worse if you take it with alcohol or certain medicines. Use codeine/guaifenesin/pseudoephedrine with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.
  • Do not drink alcohol or use medicines that may cause drowsiness (eg, sleep aids, muscle relaxers) while you are using codeine/guaifenesin/pseudoephedrine; it may add to their effects. Ask your pharmacist if you have questions about which medicines may cause drowsiness.
  • Codeine/guaifenesin/pseudoephedrine may cause dizziness, lightheadedness, or fainting; alcohol, hot weather, exercise, or fever may increase these effects. To prevent them, sit up or stand slowly, especially in the morning. Sit or lie down at the first sign of any of these effects.
  • Do not take diet or appetite control medicines while you are taking codeine/guaifenesin/pseudoephedrine without checking with your doctor.
  • Codeine/guaifenesin/pseudoephedrine has pseudoephedrine in it. Before you start any new medicine, check the label to see if it has pseudoephedrine in it too. If it does or if you are not sure, check with your doctor or pharmacist.
  • Do NOT take more than the recommended dose or use for longer than prescribed without checking with your doctor.
  • If your symptoms do not get better within 5 days, if they get worse, or if they go away and then come back, check with your doctor.
  • If your symptoms occur along with fever, rash, or persistent headache, contact your doctor.
  • Do not use codeine/guaifenesin/pseudoephedrine for a cough with a lot of mucus. Do not use it for a long-term cough (eg, caused by asthma, emphysema, smoking). However, you may use it for these conditions if your doctor tells you to.
  • Codeine/guaifenesin/pseudoephedrine may cause you to become sunburned more easily. Avoid the sun, sunlamps, or tanning booths until you know how you react to codeine/guaifenesin/pseudoephedrine. Use a sunscreen or wear protective clothing if you must be outside for more than a short time.
  • Codeine/guaifenesin/pseudoephedrine may interfere with certain lab tests. Be sure your doctor and lab personnel know you are taking codeine/guaifenesin/pseudoephedrine.
  • Tell your doctor or dentist that you take codeine/guaifenesin/pseudoephedrine before you receive any medical or dental care, emergency care, or surgery.
  • Use codeine/guaifenesin/pseudoephedrine with caution in the ELDERLY; they may be more sensitive to its effects, especially confusion, dizziness, drowsiness, dry mouth, excitability, low blood pressure, and trouble urinating.
  • Caution is advised when using codeine/guaifenesin/pseudoephedrine in CHILDREN; they may be more sensitive to its effects, especially excitability.
  • Codeine/guaifenesin/pseudoephedrine should not be used in CHILDREN younger than 6 years old; safety and effectiveness in these children have not been confirmed.
  • PREGNANCY and BREAST-FEEDING: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using codeine/guaifenesin/pseudoephedrine while you are pregnant. Codeine/guaifenesin/pseudoephedrine is found in breast milk. Do not breast-feed while taking codeine/guaifenesin/pseudoephedrine.

Possible side effects of codeine/ guaifenesin/ pseudoephedrine:

All medicines may cause side effects, but many people have no, or minor side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Constipation; dizziness; drowsiness; excitability; headache; nausea; nervousness or anxiety; trouble sleeping; vomiting; weakness.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); blurred vision or other vision changes; confusion; difficulty urinating; fainting; fast, slow, or irregular heartbeat; hallucinations; mental or mood changes; persistent trouble sleeping; seizures; severe dizziness, lightheadedness, or headache; severe drowsiness; shallow breathing; tremor; uncontrolled muscle movement.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately. Symptoms may include blurred vision; confusion; hallucinations; seizures; severe dizziness, lightheadedness, or headache; severe drowsiness; shallow or rapid breathing; unusually fast, slow, or irregular heartbeat; vomiting.

Proper storage of codeine/guaifenesin/pseudoephedrine:

Store codeine/guaifenesin/pseudoephedrine at room temperature, between 59 and 86 degrees F (15 and 30 degrees C). Store away from heat, moisture, and light. Do not store in the bathroom. Keep codeine/guaifenesin/pseudoephedrine out of the reach of children and away from pets.

General information:

  • If you have any questions about codeine/guaifenesin/pseudoephedrine, please talk with your doctor, pharmacist, or other health care provider.
  • Codeine/guaifenesin/pseudoephedrine is to be used only by the patient for whom it is prescribed. Do not share it with other people.
  • If your symptoms do not improve or if they become worse, check with your doctor.
  • Check with your pharmacist about how to dispose of unused medicine.

This information should not be used to decide whether or not to take codeine/guaifenesin/pseudoephedrine or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about codeine/guaifenesin/pseudoephedrine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to codeine/guaifenesin/pseudoephedrine. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using codeine/guaifenesin/pseudoephedrine.

Issue Date: July 2, 2014
Database Edition 14.3.1.001
Copyright © 2014 Wolters Kluwer Health, Inc.

Disclaimer: This information should not be used to decide whether or not to take this medicine or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this medicine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using this medicine.

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