codeine and phenylephrine

Generic Name: codeine and phenylephrine (KOE deen and FEN il EFF rin)
Brand Name: Ala-Hist AC, Notuss-PE

What is codeine and phenylephrine?

Codeine is a narcotic cough suppressant. It affects the signals in the brain that trigger cough reflex.

Phenylephrine is a decongestant that shrinks blood vessels in the nasal passages. Dilated blood vessels can cause nasal congestion (stuffy nose).

Codeine and phenylephrine is a combination medicine used to treat cough, stuffy nose, and sinus congestion caused by allergies or the common cold.

This medicine will not treat a cough that is caused by smoking, asthma, or emphysema.

Codeine and phenylephrine may also be used for other purposes not listed in this medication guide.

What is the most important information I should know about codeine and phenylephrine?

Do not use this medicine if you have used an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, tranylcypromine, and others.

What should I discuss with my healthcare provider before taking codeine and phenylephrine?

Do not use this medicine if you have used an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, tranylcypromine, and others.

You should not use codeine and phenylephrine if you are allergic to codeine or phenylephrine.

To make sure this medicine is safe for you, tell your doctor if you have:

  • heart disease or high blood pressure;

  • asthma, chronic obstructive pulmonary disease (COPD), or other breathing disorder;

  • diabetes;

  • cough with mucus, or cough caused by emphysema or chronic bronchitis;

  • thyroid disorder;

  • enlarged prostate or urination problems; or

  • blockage in your intestines.

Codeine may be habit-forming. Never share this medicine with another person, especially someone with a history of drug abuse or addiction. Keep the medication in a place where others cannot get to it.

FDA pregnancy category C. It is not known whether codeine and phenylephrine will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication.

Codeine can pass into breast milk and may harm a nursing baby. The use of codeine by some nursing mothers may lead to life-threatening side effects in the baby. Decongestants may also slow breast milk production. Do not use this medicine without telling your doctor if you are breast-feeding a baby.

How should I take codeine and phenylephrine?

Use exactly as directed on the label, or as prescribed by your doctor. Do not use in larger or smaller amounts or for longer than recommended. Cough or cold medicine is usually taken only for a short time until your symptoms clear up.

Always ask a doctor before giving cough or cold medicine to a child. Death can occur from the misuse of cough or cold medicine in very young children. Codeine and phenylephrine should not be given to a child younger than 6 years old.

Measure liquid medicine with a special dose-measuring spoon or medicine cup. If you do not have a dose-measuring device, ask your pharmacist for one.

Call your doctor if your symptoms do not improve after 7 days of treatment, or if you have a fever with a headache, cough, or skin rash.

Store at room temperature away from moisture and heat.

Keep track of the amount of medicine used from each new bottle. Codeine is a drug of abuse and you should be aware if anyone is using your medicine improperly or without a prescription.

What happens if I miss a dose?

Since codeine and phenylephrine is used when needed, you may not be on a dosing schedule. If you are on a schedule, use the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not use extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose of codeine can be fatal.

Overdose symptoms may include confusion, extreme weakness, pinpoint pupils, cold and clammy skin, weak pulse, slow breathing, fainting, or breathing that stops.

What should I avoid while taking codeine and phenylephrine?

This medicine may cause blurred vision or impair your thinking or reactions. Avoid driving or operating machinery until you know how codeine and phenylephrine will affect you.

Avoid drinking alcohol while you are taking this medication.

Ask a doctor or pharmacist before using any other cold, cough, allergy, or sleep medicine. Decongestants and cough suppressants are contained in many combination medicines. Taking certain products together can cause you to get too much of a certain drug. Check the label to see if a medicine contains a decongestant or cough suppressant.

Codeine and phenylephrine side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Stop using codeine and phenylephrine and call your doctor at once if you have:

  • severe dizziness or drowsiness;

  • weak or shallow breathing;

  • severe restlessness or nervousness;

  • severe constipation;

  • pounding heartbeats or fluttering in your chest;

  • painful or difficult urination; or

  • little or no urinating.

Common side effects may include:

  • mild drowsiness;

  • dryness of your eyes, nose, and mouth;

  • blurred vision; or

  • nausea, vomiting, diarrhea, constipation.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

Codeine and phenylephrine dosing information

Usual Adult Dose for Cough and Nasal Congestion:

Codeine-phenylephrine 10 mg-7.5 mg/5 mL oral liquid:
5 mL orally every 4 to 6 hours not to exceed 30 mL daily.

Codeine-phenylephrine 10 mg-10 mg/5 mL oral liquid:
5 mL orally every 4 hours not to exceed 30 mL daily.

Usual Pediatric Dose for Cough and Nasal Congestion:

Codeine-phenylephrine 10 mg-7.5 mg/5 mL oral liquid:
6 to 11 years: 2.5 mL orally every 4 to 6 hours not to exceed 15 mL daily.
12 years or older: 5 mL orally every 4 to 6 hours not to exceed 30 mL daily.

Codeine-phenylephrine 10 mg-10 mg/5 mL oral liquid:
6 to 11 years: 2.5 mL orally every 4 hours not to exceed 15 mL daily.
12 years or older: 5 mL orally every 4 hours not to exceed 30 mL daily.

What other drugs will affect codeine and phenylephrine?

Taking this medicine with other drugs that make you sleepy or slow your breathing can cause dangerous or life-threatening side effects. Ask your doctor before taking codeine and phenylephrine with a sleeping pill, narcotic pain medicine, muscle relaxer, or medicine for anxiety, depression, or seizures.

Other drugs may interact with codeine and phenylephrine, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell each of your health care providers about all medicines you use now and any medicine you start or stop using.

Where can I get more information?

  • Your pharmacist can provide more information about codeine and phenylephrine.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 2.01. Revision Date: 2013-10-14, 2:44:48 PM.

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