Guaifenesin / Codeine Phosphate

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

User Reviews & Ratings As a treatment for... Avg User Ratings [?] Cough 7 reviews Rate it! 7.2 Compare with other drugs.

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.

Stimulates 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

PO 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).

PO 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).

PO 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).

PO 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).

PO 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).

PO 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

Store at 59° to 86°F. Protect from light and moisture.

Store at 59° to 86°F.

Store at 59° to 86°F. Protect from light.

Store at 68° to 77°F. Protect from light.

Drug Interactions

Risk of paralytic ileus may be increased.

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

Excreted in breast milk.

Undetermined.

Children

Not recommended for children younger than 2 yr of age.

Not 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.

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