Guaifenesin / Codeine Phosphate
Pronunciation: (gwye-FEN-e-sin/KOE-deen FOS-fate)Class: Antitussive with expectorants
Trade Names:
Allfen CD
- Tablet codeine 10 mg/guaifenesin 400 mg
Trade Names:
Allfen CDX
- Tablet codeine 20 mg/guaifenesin 400 mg
Trade Names:
Brontex
- Tablets codeine phosphate 10 mg/guaifenesin 300 mg
Trade Names:
CGU WC
- Liquid codeine 6.3 mg/guaifenesin 100 mg per 5 mL
Trade Names:
Cheratussin AC
- Syrup codeine 10 mg/guaifenesin 100 mg per 5 mL
Trade Names:
Dex-Tuss
- Liquid codeine 10 mg/guaifenesin 300 mg
Trade Names:
ExeClear-C
- Syrup codeine 10 mg/guaifenesin 200 mg per 5 mL
Trade Names:
Gani-Tuss NR
- Liquid codeine 10 mg/guaifenesin 100 mg
Trade Names:
M-Clear WC
- Liquid codeine 6.3 mg/guaifenesin 100 mg per 5 mL
Trade Names:
Mar-Cof CG
- Syrup codeine phosphate 7.5 mg/guaifenesin 225 mg per 5 mL
Trade Names:
Mytussin AC
- Syrup codeine phosphate 10 mg/guaifenesin 100 mg per 5 mL
Trade Names:
Romilar AC
- Syrup codeine phosphate 10 mg/guaifenesin 100 mg per 5 mL
Trade Names:
Tussi-Organidin NR
- Liquid codeine 10 mg/guaifenesin 300 mg
Trade Names:
Tussi-Organidin-S NR
- Liquid codeine 10 mg/guaifenesin 300 mg
Trade Names:
Tussiden C
- Liquid codeine 10 mg/guaifenesin 300 mg
Trade Names:
Tusso-C
- Syrup codeine 10 mg/guaifenesin 200 mg
Pharmacology
 |
May enhance output of respiratory tract fluid by reducing adhesiveness and surface tension, enhancing removal of viscous mucus, and making nonproductive coughs more productive and less frequent.
CodeineStimulates opiate receptors in CNS; also causes suppression of cough.
Indications and Usage
Temporary control of cough caused by minor throat and bronchial irritation as occurs with common cold or inhaled irritants; assists in loosening phlegm (mucus) and thins bronchial secretions to make cough more productive.
Contraindications
Hypersensitivity to any component of the product or morphine derivatives; asthma; pregnancy or breast feeding ( CGO WC , M-Clear WC ).
Dosage and Administration
AdultsPO Gani-Tuss NR liquid (codeine phosphate 10 mg/guaifenesin 100 mg per 5 mL) 2 teaspoonfuls (10 mL) every 4 h (max, 12 teaspoonfuls [60 mL]) in 24 h).
Adults and Children 12 yr of age and olderPO Allfen CD (codeine phosphate 10 mg/guaifenesin 400 mg), Allfen CDX (codeine phosphate 20 mg/guaifenesin 400 mg per tablet) 1 tablet every 4 h (max, 6 tablets in 24 h).
Brontex tablets (codeine phosphate 10 mg/guaifenesin 300 mg per tablet) 1 tablet every 4 h (max, 6 tablets in 24 h).
CGO WC expectorant, M-Clear WC (codeine phosphate 6.3 mg/guaifenesin 100 mg per 5 mL) 3 teaspoonfuls (15 mL) every 4 to 6 h (max, 18 teaspoonfuls [90 mL] in 24 h). Cheratussin AC syrup, Romilar AC expectorant (codeine phosphate 10 mg/guaifenesin 100 mg per 5 mL) 2 teaspoonfuls (10 mL) every 4 h (max, 12 teaspoonfuls [60 mL] in 24 h).
Dex-Tuss liquid, Tussiden C liquid, Tussi-Organidin NR liquid, Tussi-Organidin-S NR liquid (codeine phosphate 10 mg/guaifenesin 300 mg per 5 mL) 1 teaspoonful (5 mL) every 4 h (max, 8 teaspoonfuls [40 mL] in 24 h).
ExeClear-C syrup, Tusso-C syrup (codeine phosphate 10 mg/guaifenesin 200 mg per 5 mL) 2 teaspoonfuls (10 mL) every 4 to 6 h (max, 12 teaspoonfuls [60 mL] in 24 h).
Mar-Cof CG expectorant (codeine phosphate 7.5 mg/guaifenesin 225 mg per 5 mL) 1 to 1.5 teaspoonfuls (5 to 7.5 mL) every 4 to 6 h (max, 6 doses in 24 h).
Mytussin AC syrup (codeine phosphate 10 mg/guaifenesin 100 mg per 5 mL) 1 to 2 teaspoonfuls (5 to 10 mL) every 4 to 6 h (max, 12 teaspoonfuls [60 mL] in 24 h).
Children 6 to younger than 12 yr of agePO Allfen CD (codeine phosphate 10 mg/guaifenesin 400 mg per tablet) 0.5 tablet every 4 to 6 h (max, 2 tablets in 24 h).
Allfen CDX (codeine phosphate 20 mg/guaifenesin 400 mg per tablet) 0.5 tablet every 4 to 6 h (max, 3 tablets in 24 h).
CGO-WC expectorant, M-Clear WC (codeine phosphate 6.3 mg/guaifenesin 100 mg per 5 mL) 1.5 teaspoonfuls (7.5 mL) every 4 to 6 h (max, 9 teaspoonfuls [45 mL] in 24 h).
Cheratussin AC syrup, Romilar AC expectorant (codeine phosphate 10 mg/guaifenesin 100 mg per 5 mL) 1 teaspoonful (5 mL) every 4 h (max, 6 teaspoonfuls [30 mL]) in 24 h. Dex-Tuss liquid, Tussiden C liquid, Tussi-Organidin NR liquid, Tussi-Organidin-S NR liquid (codeine phosphate 10 mg/guaifenesin 300 mg per 5 mL) 0.5 teaspoonful (2.5 mL) every 4 h (max, 4 teaspoonfuls [20 mL] in 24 h).
ExeClear-C syrup, Tusso-C syrup (codeine phosphate 10 mg/guaifenesin 200 mg per 5 mL) 1 teaspoonful (5 mL) every 4 to 6 h (max, 6 teaspoonfuls [30 mL] in 24 h). Mar-Cof CG expectorant (codeine phosphate 7.5 mg/guaifenesin 225 mg per 5 mL) 0.5 to 0.75 teaspoonful (2.5 to 3.75 mL) every 4 to 6 h (max, 6 doses in 24 h).
Mytussin AC syrup (codeine phosphate 10 mg/guaifenesin 100 mg per 5 mL) 0.5 to 1 teaspoonful (2.5 to 5 mL) every 4 to 6 h (max, 6 teaspoonfuls [30 mL] in 24 h).
Children 5 to younger than 6 yr of agePO ExeClear-C syrup, Tusso-C syrup (codeine phosphate 10 mg/guaifenesin 200 mg per 5 mL) 0.5 teaspoonful (2.5 mL) every 4 to 6 h (max, 2 teaspoonfuls [10 mL] in 24 h).
Children 3 to younger than 5 yr of agePO ExeClear-C syrup, Tusso-C syrup (codeine phosphate 10 mg/guaifenesin 200 mg per 5 mL) 0.25 teaspoonful (1.25 mL) every 4 to 6 h (max, 1 teaspoonful [5 mL] in 24 h).
Children 2 to younger than 6 yr of agePO Dex-Tuss liquid, Tussiden C liquid, Tussi-Organidin NR liquid, Tussi-Organidin-S NR liquid (codeine phosphate 10 mg/guaifenesin 300 mg per 5 mL) Base dose on 1 mg/kg/day of codeine administered in 4 equally divided doses.
General Advice
- A dispensing device (eg, dropper calibrated for age or weight) should be used to administer the drug to a child.
Storage/Stability
Allfen CD , Allfen CDX tabletsStore at 59° to 86°F. Protect from light and moisture.
Brontex tabletsStore at 59° to 86°F.
Cheratussin AC syrup, CGO WC expectorant, Dex-tuss , Gani-Tuss NR liquid, Mar-Cof CG expectorant, M-Clear WC , Mytussin AC syrup, Romilar AC expectorant, Tusso-C syrup, Tussi-Organidin NR liquid, Tussi-Organidin-S NR liquidStore at 59° to 86°F. Protect from light.
ExeClear-C syrup, Tussiden liquidStore at 68° to 77°F. Protect from light.
Drug Interactions
Anticholinergics (eg, atropine, orphenadrine, scopolamine)Risk of paralytic ileus may be increased.
Antidepressants (eg, MAOIs), sedatives (eg, barbiturates), tranquilizers (eg, benzodiazepines)May cause increased drowsiness.
Laboratory Test Interactions
May cause color interference with the vanillylmandelic acid test for catechols.
Adverse Reactions
Cardiovascular
Bradycardia; circulatory depression; faintness; orthostatic hypotension; palpitations; syncope; tachycardia.
CNS
Depression; convulsions; disorientation; dizziness; dysphoria; euphoria; headache; light-headedness; sedation; transient hallucinations.
Dermatologic
Pruritus; rash; urticaria.
EENT
Visual disturbances.
GI
Abdominal pain; biliary tract spasm; constipation; increased colonic motility in patients with chronic ulcerative colitis; nausea; stomach pain; toxic dilation in patients with acute ulcerative colitis; vomiting.
Genitourinary
Antidiuretic effect; oliguria; urinary retention.
Hypersensitivity
Allergic reaction; anaphylactic reaction, angioedema.
Respiratory
Respiratory depression; shortness of breath.
Miscellaneous
Facial flushing; sweating; weakness.
Precautions
Pregnancy
Category C .
Lactation
CodeineExcreted in breast milk.
GuaifenesinUndetermined.
Children
Not recommended for children younger than 2 yr of age.
BrontexNot recommended for children younger than 12 yr of age.
Elderly
Use with caution.
Renal Function
Use with caution.
Hepatic Function
Use with caution.
Special Risk Patients
Use with caution in young, elderly, or debilitated patients and those with hepatic or renal impairment, Addison disease, convulsive disorders, fever, hypothyroidism, prostatic hypertrophy, ulcerative colitis, severe head injury, increased intracranial pressure, acute abdominal condition, severe CNS depression, severe respiratory depression, or in patients prone to respiratory depression, acute alcoholism, or pulmonary disease, and patients with decreased respiratory reserve, or recent GI or urinary tract surgery.
Dependence
Codeine has abuse potential; may be habit forming.
Persistent cough
Persistent cough may be a sign of a serious condition. Consult health care provider for a cough of more than 1 wk duration or for a cough accompanied by fever, rash, or persistent headache. Do not use for chronic or persistent cough, cough accompanied by excessive phlegm (mucus), shortness of breath, or chronic pulmonary disease without consulting health care provider.
Phenylketonurics
Tusso-C contains phenylalanine, use with caution in patients with phenylketonuria.
Unresponsiveness
The codeine dose should not be increased if cough fails to respond; unresponsive coughs should be reevaluated in 5 days or sooner for possible underlying pathology.
Overdosage
Symptoms
Apnea, bradycardia, cardiac arrest, circulatory collapse, cold and clammy skin, death, extreme somnolence progressing to stupor and coma, hypotension, miosis (mydriasis may occur in terminal necrosis or hypoxia), respiratory depression, skeletal muscle flaccidity.
Patient Information
- Advise patient to take prescribed dose every 4 h as needed, up to 6 times/day.
- Advise patient to take with food or milk if GI upset occurs.
- Advise patients to drink extra fluids.
- Instruct patients or caregiver to obtain and use a dispensing device (eg, dropper calibrated for age or weight) to administer the drug to a child.
- Advise patient that if a dose is missed to take as soon as remembered unless it is nearing time for the next dose. Caution patient to not double the dose to catch up.
- Advise patient that if cough is not controlled, not to increase the dose of medication but to inform health care provider.
- Caution patient that drug may cause drowsiness and to use caution while driving or performing other tasks requiring mental alertness until tolerance is determined.
- Advise patient to avoid alcohol and other CNS depressants because of risk of excessive sedation.
 |
Link to Page |  |
Print Page |  |
Email Page |  | Add to List |
Guaifenesin/Codeine Phosphate Side Effects
