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Phenylephrine/ dexchlorpheniramine/ codeine

Generic Name: phenylephrine/dexchlorpheniramine/codeine (FEN-il-EF-rin/DEX-klor-fen-IR-a-meen/KOE-deen)
Brand Name: Vanacof CD

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/ dexchlorpheniramine/ codeine is used for:

Relieving symptoms of sinus congestion, runny nose, sneezing, and cough due to colds, upper respiratory infections, and allergies. It may also be used for other conditions as determined by your doctor.

Phenylephrine/dexchlorpheniramine/codeine is a decongestant, antihistamine, and cough suppressant combination. It works by constricting blood vessels and reducing swelling in the nasal passages. The antihistamine works by blocking the action of histamine, which helps reduce symptoms such as watery eyes and sneezing. The cough suppressant works in the brain to help decrease the cough reflex to reduce a dry cough.

Do NOT use phenylephrine/ dexchlorpheniramine/ codeine if:

  • you are allergic to any ingredient in phenylephrine/dexchlorpheniramine/codeine
  • you have severe high blood pressure, severe heart blood vessel disease, rapid heartbeat, severe heart problems, stomach ulcer, narrow-angle glaucoma, or difficulty urinating, or you are having an asthma attack
  • you are taking sodium oxybate (GHB) or 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.

Slideshow: OTC Medication Use In Pregnancy: Wise or Worrisome?

Before using phenylephrine/ dexchlorpheniramine/ codeine:

Some medical conditions may interact with phenylephrine/dexchlorpheniramine/codeine. 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 recent head injury, severe drowsiness, brain tumor, or increased pressure in the brain
  • if you have a history of adrenal gland problems (eg, adrenal gland tumor); heart problems (eg, cor pulmonale, fast, slow, or irregular heartbeat; heart disease); high or low blood pressure; liver problems; low blood volume; diabetes; blood vessel problems; stroke; glaucoma or increased pressure in the eye; a blockage of your stomach, bladder, or intestines; recent stomach or bowel surgery or other stomach or bowel problems (eg, constipation, diarrhea due to antibiotic use, inflammation; ulcers); trouble urinating; an enlarged prostate or other prostate problems; seizures; mental or mood problems (eg, depression); pancreas problems (eg, pancreatitis); or thyroid problems
  • if you have history of asthma, sleep apnea, other breathing problems (eg, slow or irregular breathing), chronic cough, lung problems (eg, chronic bronchitis, emphysema), or chronic obstructive pulmonary disease (COPD), or if your cough occurs with large amounts of mucus
  • if you have a history of alcohol abuse, drug abuse, or suicidal thoughts or behavior; have trouble sleeping; or are in poor health or are very overweight

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

  • Anticholinergics (eg, scopolamine) because a serious bowel problem (paralytic ileus) may occur
  • 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), MAOIs (eg, phenelzine), muscle relaxants (eg, cyclobenzaprine), opioid analgesics (eg, hydrocodone), phenothiazines (eg, chlorpromazine), sodium oxybate (GHB), or tricyclic antidepressants (eg, amitriptyline) because they may increase the risk of phenylephrine/dexchlorpheniramine/codeine's side effects
  • Naltrexone, quinidine, or rifamycins (eg, rifampin) because they may decrease phenylephrine/dexchlorpheniramine/codeine's effectiveness
  • Bromocriptine or hydantoins (eg, phenytoin) because the risk of their side effects may be increased by phenylephrine/dexchlorpheniramine/codeine
  • Guanadrel, guanethidine, mecamylamine, methyldopa, or reserpine because their effectiveness may be decreased by phenylephrine/dexchlorpheniramine/codeine

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

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

  • Take phenylephrine/dexchlorpheniramine/codeine 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.
  • If you miss a dose of phenylephrine/dexchlorpheniramine/codeine, 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/dexchlorpheniramine/codeine.

Important safety information:

  • Phenylephrine/dexchlorpheniramine/codeine may cause drowsiness, dizziness, or blurred vision. These effects may be worse if you take it with alcohol or certain medicines. Use phenylephrine/dexchlorpheniramine/codeine with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.
  • Phenylephrine/dexchlorpheniramine/codeine 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 drink alcohol or use medicines that may cause drowsiness (eg, sleep aids, muscle relaxers) while you are using phenylephrine/dexchlorpheniramine/codeine; 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 take phenylephrine/dexchlorpheniramine/codeine without checking with your doctor.
  • Phenylephrine/dexchlorpheniramine/codeine 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 use phenylephrine/dexchlorpheniramine/codeine 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.
  • 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 to 7 days or if they get worse, check with your doctor.
  • Phenylephrine/dexchlorpheniramine/codeine may cause you to become sunburned more easily. Avoid the sun, sunlamps, or tanning booths until you know how you react to phenylephrine/dexchlorpheniramine/codeine. Use a sunscreen or wear protective clothing if you must be outside for more than a short time.
  • Phenylephrine/dexchlorpheniramine/codeine may interfere with skin allergy tests. If you are scheduled for a skin test, talk to your doctor. You may need to stop taking phenylephrine/dexchlorpheniramine/codeine for a few days before the tests.
  • Tell your doctor or dentist that you take phenylephrine/dexchlorpheniramine/codeine before you receive any medical or dental care, emergency care, or surgery.
  • Use phenylephrine/dexchlorpheniramine/codeine with caution in the ELDERLY; they may be more sensitive to its effects.
  • Caution is advised when using phenylephrine/dexchlorpheniramine/codeine in CHILDREN; they may be more sensitive to its effects, especially excitability.
  • Phenylephrine/dexchlorpheniramine/codeine 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: It is not known if phenylephrine/dexchlorpheniramine/codeine can cause harm to the fetus. If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using phenylephrine/dexchlorpheniramine/codeine while you are pregnant. It is not known if phenylephrine/dexchlorpheniramine/codeine is found in breast milk. Do not breast-feed while taking phenylephrine/dexchlorpheniramine/codeine.

Some people who use phenylephrine/dexchlorpheniramine/codeine for a long time may develop a need to continue taking it. People who take high doses are also at risk. This is known as DEPENDENCE or addiction.

If you stop taking phenylephrine/dexchlorpheniramine/codeine suddenly, you may have WITHDRAWAL symptoms. These may include anxiety, irregular heartbeat, irritability, restlessness, trouble sleeping, and unusual sweating.

Possible side effects of phenylephrine/ dexchlorpheniramine/ codeine:

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; dry mouth, nose, or throat; excitability; headache; loss of appetite; nausea; nervousness or anxiety; trouble sleeping; upset stomach; 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); confusion; difficulty urinating or inability to urinate; fast or irregular heartbeat; hallucinations; mental or mood changes (eg, irritability); persistent trouble sleeping; restlessness; seizures; severe dizziness, lightheadedness, or headache; severe drowsiness; tremor; unusual bruising or bleeding; vision changes or blurred vision.

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; cold and clammy skin; coma; confusion; hallucinations; seizures; severe dizziness, lightheadedness, or headache; severe drowsiness; unusually fast, slow, or irregular heartbeat; vomiting.

Proper storage of phenylephrine/dexchlorpheniramine/codeine:

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

General information:

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

Issue Date: April 2, 2014
Database Edition 14.2.1.001
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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