Phenylephrine/ codeine liquid

Generic Name: phenylephrine/codeine (FEN-il-EF-rin/KOE-deen)
Brand Name: Notuss-PE

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.


Phenylephrine/ codeine liquid is used for:

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

Phenylephrine/codeine liquid is a decongestant and narcotic cough suppressant. 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, which reduces a dry cough.

Do NOT use phenylephrine/ codeine liquid if:

  • you are allergic to any ingredient in phenylephrine/codeine liquid or any other codeine- or morphine-related medicine (eg, oxycodone)
  • you have severe high blood pressure, severe heart blood vessel disease, rapid heartbeat, or severe heart problems
  • 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 phenylephrine/ codeine liquid:

Some medical conditions may interact with phenylephrine/codeine liquid. 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 or increased pressure in the eye, prostate problems (eg, enlarged prostate gland), heart problems (eg, cor pulmonale), diabetes, high blood pressure, blood vessel problems, stroke, adrenal gland problems, liver problems, thyroid problems, a narrowing of your urinary tract, or if you have trouble urinating
  • if you have a history of stomach or bowel problems (eg, constipation, inflammation, ulcer), severe diarrhea caused by antibiotic use, or gallbladder problems (eg, gallstones), or if you have had recent stomach or bowel surgery
  • if you have breathing or lung problems (eg, asthma, chronic bronchitis, emphysema, shortness of breath, slow or irregular breathing), or chronic obstructive pulmonary disease (COPD); chronic cough; or if your cough occurs with large amounts of mucus
  • if you are dehydrated, have low blood volume, are very overweight, or have a condition that causes severe drowsiness
  • if you have a head or brain injury, brain tumor, increased pressure in the brain, infection of the brain or nervous system, epilepsy, or seizures, or if you have recently had any of these conditions
  • if you have a history of alcohol or substance abuse, mental or mood problems, or suicidal thoughts or behavior

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

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

This may not be a complete list of all interactions that may occur. Ask your health care provider if phenylephrine/codeine liquid 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 phenylephrine/ codeine liquid:

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

  • Take phenylephrine/codeine liquid by mouth with or without food. If stomach upset occurs, take with food to reduce stomach irritation.
  • Use a measuring device marked for medicine dosing. Ask your pharmacist for help if you are unsure of how to measure your dose.
  • Drinking extra fluids while you are taking phenylephrine/codeine liquid is recommended. Check with your doctor for instructions.
  • If you have trouble sleeping from phenylephrine/codeine liquid, try not to take it within a few hours before bedtime. This may help to decrease sleeplessness caused by phenylephrine/codeine liquid.
  • If you miss a dose of phenylephrine/codeine liquid and you are taking it regularly, 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 phenylephrine/codeine liquid.

Important safety information:

  • Phenylephrine/codeine liquid may cause dizziness or drowsiness. These effects may be worse if you take it with alcohol or certain medicines. Use phenylephrine/codeine liquid 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 phenylephrine/codeine liquid; it may add to their effects. Ask your pharmacist if you have questions about which medicines may cause drowsiness.
  • Do not take diet or appetite control medicines while you are taking phenylephrine/codeine liquid without checking with your doctor.
  • Phenylephrine/codeine liquid has phenylephrine in it. Before you start any new medicine, check the label to see if it has phenylephrine 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 cough or other symptoms persist for more than 7 days, if they come back, or if you also have fever, rash, or persistent headache, check with your doctor.
  • Do not use phenylephrine/codeine liquid 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.
  • Phenylephrine/codeine liquid may interfere with certain lab tests. Be sure your doctor and lab personnel know you are taking phenylephrine/codeine liquid.
  • Tell your doctor or dentist that you take phenylephrine/codeine liquid before you receive any medical or dental care, emergency care, or surgery.
  • Use phenylephrine/codeine liquid with caution in the ELDERLY; they may be more sensitive to its effects, especially confusion, constipation, dizziness, drowsiness, low blood pressure, excitability, and trouble urinating.
  • Caution is advised when using phenylephrine/codeine liquid in CHILDREN because they may be more sensitive to its effects, especially excitability.
  • Phenylephrine/codeine liquid 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 while taking phenylephrine/codeine liquid, discuss with your doctor the benefits and risks of using phenylephrine/codeine liquid during pregnancy. Phenylephrine/codeine liquid is found in breast milk. Do not breast-feed while taking phenylephrine/codeine liquid.

When used for long periods of time or at high doses, phenylephrine/codeine liquid may not work as well and may require higher doses to obtain the same effect as when originally taken. This is known as TOLERANCE. Talk with your doctor if phenylephrine/codeine liquid stops working well. Do not take more than prescribed.

When used for long periods of time or at high doses, some people develop a need to continue taking phenylephrine/codeine liquid. This is known as DEPENDENCE or addiction.

If you suddenly stop taking phenylephrine/codeine liquid, you may experience WITHDRAWAL symptoms including anxiety; diarrhea; fever, runny nose, or sneezing; goose bumps and abnormal skin sensations; nausea; vomiting; pain; rigid muscles; rapid heartbeat; seeing, hearing or feeling things that are not there; shivering or tremors; sweating; trouble sleeping.

Possible side effects of phenylephrine/ codeine liquid:

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; diarrhea; dizziness; drowsiness; excitability; headache; nausea; nervousness or anxiety; stomach pain; trouble sleeping.

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; fast, slow, or irregular heartbeat; hallucinations; loss of coordination; mental or mood changes; numbness or tingling of the skin; persistent loss of appetite; persistent trouble sleeping; ringing in the ears; seizures; severe dizziness, lightheadedness, or headache; severe drowsiness; shortness of breath; tremor; wheezing.

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 chest pain; cold, clammy skin; confusion; fast, slow, or irregular heartbeat; hallucinations; pinpoint pupils; seizures; severe dizziness, lightheadedness, or headache; severe drowsiness; slow or difficult breathing; vomiting.

Proper storage of phenylephrine/codeine liquid:

Store phenylephrine/codeine liquid 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 phenylephrine/codeine liquid out of the reach of children and away from pets.

General information:

  • If you have any questions about phenylephrine/codeine liquid, please talk with your doctor, pharmacist, or other health care provider.
  • Phenylephrine/codeine liquid 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 phenylephrine/codeine liquid 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 phenylephrine/codeine liquid. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to phenylephrine/codeine liquid. 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 phenylephrine/codeine liquid.

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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