codeine, diphenhydramine, and phenylephrine

Generic Name: codeine, diphenhydramine, and phenylephrine (KOE deen, DYE fen HYE dra meen, and FEN il EFF rin)
Brand Name: Airacof, Endal CD

What is codeine, diphenhydramine, and phenylephrine?

Codeine is a narcotic cough medicine.

Diphenhydramine is an antihistamine that reduces the natural chemical histamine in the body. Histamine can produce symptoms of sneezing, itching, watery eyes, and runny nose.

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

Codeine, diphenhydramine, and phenylephrine is a combination medicine used to treat symptoms of allergies or sinus infections, such as runny nose, sinus congestion, cough, and congestion of the tubes that drain fluid from your inner ears.

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

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

You should not use this medicine if you have bladder obstruction or urination problems, uncontrolled high blood pressure, severe coronary artery disease, narrow-angle glaucoma, a stomach ulcer, or uncontrolled asthma.

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

Do not use this medicine if you have taken 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, and tranylcypromine.

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

Do not use this medicine if you have taken 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, and tranylcypromine.

You should not use codeine, diphenhydramine, and phenylephrine if you are allergic to it, or if you have:

  • bladder obstruction or other urination problems;

  • uncontrolled high blood pressure;

  • severe coronary artery disease (hardened arteries);

  • narrow-angle glaucoma;

  • a stomach ulcer; or

  • uncontrolled asthma.

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

  • blockage in your digestive tract (stomach or intestines);

  • heart disease, high blood pressure;

  • enlarged prostate;

  • glaucoma;

  • liver or kidney disease;

  • a head injury or brain tumor;

  • asthma, COPD, sleep apnea, or other breathing disorder;

  • a thyroid disorder;

  • low blood pressure;

  • diabetes;

  • Addison's disease (an adrenal gland disorder);

  • if you take an antidepressant; or

  • if you take potassium (Cytra, Epiklor, K-Lyte, K-Phos, Kaon, Klor-Con, Polycitra, Urocit-K).

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 this medicine will harm an unborn baby. Codeine may cause addiction or withdrawal symptoms in a newborn if the mother takes the medication during pregnancy. Tell your doctor if you are pregnant or plan to become pregnant while using codeine, diphenhydramine, and phenylephrine.

Codeine, diphenhydramine, and phenylephrine 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. Do not breast-feed while taking this medicine.

How should I take codeine, diphenhydramine, and phenylephrine?

Follow all directions on your prescription label. Never take this medicine in larger amounts, or for longer than prescribed. Cough or cold medicine is usually taken only for a short time until your symptoms clear up.

Do not give this medication to a child younger than 6 years old. Always ask a doctor before giving a cough or cold medicine to a child. Death can occur from the misuse of cough and cold medicines in very young children.

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

If you need surgery or medical tests, tell the surgeon or doctor ahead of time if you have taken this medicine within the past few days.

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 this medicine 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 this medicine can be fatal.

Overdose symptoms may include severe dizziness or drowsiness, behavior changes, dilated pupils, confusion, cold and clammy skin, weak pulse, rapid heartbeats, shallow breathing, seizure (convulsions), fainting, or breathing that stops.

What should I avoid while taking codeine, diphenhydramine, and phenylephrine?

This medication may cause blurred vision and may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert and able to see clearly.

Drinking alcohol can increase certain side effects of codeine, diphenhydramine, and phenylephrine.

Codeine, diphenhydramine, and phenylephrine side effects

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

Stop using this medicine and call your doctor at once if you have:

  • pounding heartbeats or fluttering in your chest;

  • a light-headed feeling, like you might pass out;

  • pale skin, trouble breathing;

  • hallucinations, feelings of extreme happiness;

  • painful or difficult urination;

  • little or no urinating; or

  • dangerously high blood pressure (severe headache, blurred vision, buzzing in your ears, anxiety, confusion, chest pain, shortness of breath, uneven heartbeats, seizure).

Common side effects may include:

  • dizziness, drowsiness, weakness, headache;

  • feeling restless or excited (especially in children);

  • sleep problems (insomnia);

  • flushing (warmth, redness, or tingly feeling);

  • blurred vision;

  • mild itching or rash;

  • dry mouth, increased sweating; or

  • nausea, vomiting, constipation, loss of appetite.

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, diphenhydramine, and phenylephrine dosing information

Usual Adult Dose for Cough and Nasal Congestion:

Codeine/diphenhydramine/phenylephrine 7.5 mg-12.5 mg-7.5 mg/5 mL oral syrup:
10 mL orally every 4 hours not to exceed 40 mL daily.

Usual Pediatric Dose for Cough and Nasal Congestion:

Codeine/diphenhydramine/phenylephrine 7.5 mg-12.5 mg-7.5 mg/5 mL oral syrup:
6 to 11 years: 5 mL orally every 4 hours not to exceed 20 mL daily.
12 years or older: 10 mL orally every 4 hours not to exceed 40 mL daily.

What other drugs will affect codeine, diphenhydramine, 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, diphenhydramine, and phenylephrine with a sleeping pill, narcotic pain medicine, muscle relaxer, or medicine for anxiety, depression, or seizures.

Other drugs may interact with codeine, diphenhydramine, 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, diphenhydramine, 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: 2.02. Revision Date: 2013-10-22, 3:02:43 PM.

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