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Z-Tuss AC liquid

Generic Name: chlorpheniramine/codeine (KLOR-fen-IR-a-meen/KOE-deen)
Brand Name: Examples include Notuss-AC and Z-Tuss AC

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


Z-Tuss AC liquid is used for:

Relieving 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.

Z-Tuss AC liquid is an antihistamine and narcotic cough suppressant combination. 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, which reduces a dry cough.

Do NOT use Z-Tuss AC liquid if:

  • you are allergic to any ingredient in Z-Tuss AC liquid or any other codeine- or morphine-related medicine (eg, oxycodone)
  • you have severe high blood pressure, severe heart blood vessel disease, angle-closure glaucoma, or peptic ulcers
  • you are unable to urinate or 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.

Before using Z-Tuss AC liquid:

Some medical conditions may interact with Z-Tuss AC 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 heart blood vessel problems, irregular heartbeat, or any other heart problems (eg, cor pulmonale)
  • if you have a history of high blood pressure; diabetes; liver or kidney problems; stroke; glaucoma or increased pressure in the eye; a blockage of your bladder, stomach, or bowels; ulcers; trouble urinating; an enlarged prostate or other prostate problems; or thyroid problems
  • if you have a history of asthma, chronic cough, lung or breathing problems (eg, chronic bronchitis, emphysema, sleep apnea, slow or irregular breathing), or chronic obstructive pulmonary disease (COPD), or if your cough occurs with large amounts of mucus
  • if you have 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 are dehydrated; have very poor health; 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 a history of alcohol or substance abuse or suicidal thoughts or behavior
  • if you are taking medicine for high blood pressure or depression

Some MEDICINES MAY INTERACT with Z-Tuss AC liquid. Tell your health care provider if you are taking any other medicines, especially any of the following:

  • Anticholinergics (eg, scopolamine) because a serious bowel motility problem (paralytic ileus) may occur
  • Cimetidine, furazolidone, HIV protease inhibitors (eg, ritonavir), MAOIs (eg, phenelzine), sodium oxybate (GHB), or tricyclic antidepressants (eg, amitriptyline) because they may increase the risk of Z-Tuss AC liquid's side effects
  • Naltrexone, quinidine, or rifamycins (eg, rifampin) because they may decrease Z-Tuss AC liquid's effectiveness
  • Narcotic pain medicines (eg, hydrocodone) because the risk of their side effects may be increased by Z-Tuss AC liquid

This may not be a complete list of all interactions that may occur. Ask your health care provider if Z-Tuss AC 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 Z-Tuss AC liquid:

Use Z-Tuss AC liquid as directed by your doctor. Check the label on the medicine for exact dosing instructions.

  • Take Z-Tuss AC 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.
  • If you miss a dose of Z-Tuss AC 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 Z-Tuss AC liquid.

Important safety information:

  • Z-Tuss AC liquid may cause dizziness, drowsiness, or blurred vision. These effects may be worse if you take it with alcohol or certain medicines. Use Z-Tuss AC 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 Z-Tuss AC liquid; it may add to their effects. Ask your pharmacist if you have questions about which medicines may cause drowsiness.
  • Z-Tuss AC liquid 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 use Z-Tuss AC 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.
  • Z-Tuss AC liquid has chlorpheniramine in it. Before you start any new medicine, check the label to see if it has chlorpheniramine 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 do not get better within 1 week, or if they come back, or if you also have fever, rash, or persistent headache, check with your doctor.
  • Z-Tuss AC liquid may interfere with skin allergy tests. If you are scheduled for a skin test, talk to your doctor. You may need to stop taking Z-Tuss AC liquid for a few days before the tests.
  • Z-Tuss AC liquid may cause you to become sunburned more easily. Avoid the sun, sunlamps, or tanning booths until you know how you react to Z-Tuss AC liquid. Use a sunscreen or wear protective clothing if you must be outside for more than a short time.
  • Tell your doctor or dentist that you take Z-Tuss AC liquid before you receive any medical or dental care, emergency care, or surgery.
  • Use Z-Tuss AC liquid with caution in the ELDERLY; they may be more sensitive to its effects, especially confusion, dizziness, drowsiness, low blood pressure, excitability, dry mouth, and trouble urinating.
  • Caution is advised when using Z-Tuss AC liquid in CHILDREN; they may be more sensitive to its effects, especially excitability.
  • Z-Tuss AC 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, contact your doctor. You will need to discuss the benefits and risks of using Z-Tuss AC liquid while you are pregnant. It is not known if Z-Tuss AC liquid is found in breast milk. Do not breast-feed while taking Z-Tuss AC liquid.

When used for long periods of time or at high doses, Z-Tuss AC 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 Z-Tuss AC 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 Z-Tuss AC liquid. This is known as DEPENDENCE or addiction.

If you suddenly stop taking Z-Tuss AC 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 Z-Tuss AC 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; dry mouth, nose, or throat; excitability; headache; loss of appetite; nausea; thickening of mucus secretions; upset stomach; vomiting.

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, double vision, or other vision changes; confusion; difficulty urinating or inability to urinate; fast, slow, or irregular heartbeat; loss of coordination; mood or mental changes; nervousness; ringing in the ears; seizures; severe dizziness, lightheadedness, or headache; severe drowsiness; shallow breathing; tremor; trouble sleeping; uncontrolled muscle movements; unusual bruising or bleeding; unusual weakness or tiredness.

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

Proper storage of Z-Tuss AC liquid:

Store Z-Tuss AC 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 Z-Tuss AC liquid out of the reach of children and away from pets.

General information:

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

Issue Date: November 5, 2014
Database Edition 14.4.1.002
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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