Medication Guide App

Promethazine VC with Codeine Side Effects

Generic Name: codeine / phenylephrine / promethazine

Note: This page contains side effects data for the generic drug codeine / phenylephrine / promethazine. It is possible that some of the dosage forms included below may not apply to the brand name Promethazine VC with Codeine.

It is possible that some side effects of Promethazine VC with Codeine may not have been reported. These can be reported to the FDA here. Always consult a healthcare professional for medical advice.

For the Consumer

Applies to codeine / phenylephrine / promethazine: oral elixir, oral syrup

As well as its needed effects, codeine / phenylephrine / promethazine may cause unwanted side effects that require medical attention.

If any of the following side effects occur while taking codeine / phenylephrine / promethazine, check with your doctor immediately:

Incidence not known
  • Abdominal or stomach pain
  • black, tarry stools
  • bleeding gums
  • bloating
  • blood in the urine or stools
  • blurred vision
  • chest pain
  • chills
  • clay-colored stools
  • cold sweats
  • confusion
  • constipation
  • convulsions
  • cough
  • dark urine
  • decrease in the frequency of urination
  • decrease in urine volume
  • difficult or troubled breathing
  • difficulty in passing urine (dribbling)
  • dizziness
  • dizziness, faintness, or lightheadedness when getting up from lying or sitting position
  • fainting
  • fast, pounding, or irregular heartbeat or pulse
  • fever
  • headache
  • high fever
  • increased sweating
  • irregular, fast or slow, or shallow breathing
  • lightheadedness
  • loss of appetite
  • loss of bladder control
  • nausea or vomiting
  • nervousness
  • painful or difficult urination
  • pale or blue lips, fingernails, or skin
  • pinpoint red spots on the skin
  • pounding in the ears
  • rash or itching
  • severe muscle stiffness
  • shakiness in the legs, arms, hands, or feet
  • slow or fast heartbeat
  • sore throat
  • sores, ulcers, or white spots on the lips or in the mouth
  • stomach pain
  • swollen glands
  • tiredness
  • trembling or shaking of the hands or feet
  • unpleasant breath odor
  • unusual bleeding or bruising
  • unusual tiredness or weakness
  • unusually pale skin
  • vomiting of blood
  • yellow eyes or skin

Some codeine / phenylephrine / promethazine side effects may not need any medical attention. As your body gets used to the medicine these side effects may disappear. Your health care professional may be able to help you prevent or reduce these side effects, but do check with them if any of the following side effects continue, or if you are concerned about them:

More common
  • Drowsiness
Incidence not known
  • Anxiety
  • blurred or loss of vision
  • confusion
  • confusion about identity, place, and time
  • constipation
  • disturbed color perception
  • double vision
  • dry mouth
  • false or unusual sense of well-being
  • halos around lights
  • increased sensitivity of the skin to sunlight
  • night blindness
  • overbright appearance of lights
  • redness or other discoloration of the skin
  • relaxed and calm
  • restlessness
  • seeing, hearing, or feeling things that are not there
  • severe sunburn
  • sleepiness or unusual drowsiness
  • trouble sleeping
  • tunnel vision

For Healthcare Professionals

Applies to codeine / phenylephrine / promethazine: oral syrup

Nervous system

Nervous system side effects of codeine have included mental and respiratory depression, stupor, delirium, somnolence, and dysphoria. An increased risk of falls and hip fractures has been associated with codeine therapy, particularly in the elderly. Nervous system side effects of phenylephrine have included headache, dizziness, nervousness, restlessness, tremor, insomnia, convulsions, and central nervous system depression. Nervous system side effects of promethazine are common and include excessive sedation, drowsiness, fatigue, paradoxical excitation, and decreased motor coordination. Extrapyramidal effects (including oculogyric crises, torticollis and tongue protrusion), encephalitic symptoms, convulsions, and psychosis have been rarely reported.

Opioids may result in psychotic symptoms in some patients.

One retrospective study of elderly patients who sustained a hip fracture suggested that the relative risk of hip fracture was 1.6 in patients using codeine compared to age-matched nonusers.

Other

Fever, altered consciousness, autonomic dysfunction, and muscle rigidity are the hallmarks of the neuroleptic malignant syndrome. The neuroleptic malignant syndrome is associated with a case fatality rate of about 20%. Immediate discontinuation of promethazine and intensive monitoring and supportive care are indicated.

Other side effects of codeine have included withdrawal symptoms after either abrupt cessation or fast tapering of narcotic analgesics, including codeine, and have included agitation, restlessness, anxiety, insomnia, tremor, abdominal cramps, blurred vision, vomiting and sweating. Other side effects of promethazine have rarely included the neuroleptic malignant syndrome.

Cardiovascular

Cardiovascular adverse effects of codeine have included hypotension and dizziness. Cardiovascular side effects of phenylephrine have included palpitations, arrhythmias, and cardiovascular collapse with hypotension. Cardiovascular effects of promethazine have included rarely observed tachycardia, bradycardia, and transient hypotension. Prolongation of the QT interval, heart block, and malignant arrhythmias have been reported in association with other phenothiazines.

Gastrointestinal

Gastrointestinal side effects of codeine have included nausea, vomiting, and constipation. Severe constipation and ileus resulting in colonic perforation have been also reported. Four cases of acute pancreatitis have been reported. Gastrointestinal side effects of phenylephrine have included nausea. Gastrointestinal side effects of promethazine have included nausea and vomiting.

Genitourinary

Genitourinary side effects of codeine have included urinary retention. Genitourinary side effects of phenylephrine have included dysuria.

Dermatologic

Dermatologic side effects of codeine have included rash. Codeine-induced rash may be related to direct stimulation of histamine release. There are also case reports of severe scarlatiniform eruptions.

Renal

Renal side effects of codeine have included acute renal failure (which may respond to naloxone therapy).

Immunologic

Immunologic side effects of codeine have included one study of a patient with exercise-induced anaphylaxis and three control subjects. This study found a correlation between codeine wheal size and recent exercise. Immunologic side effects of promethazine have included rare reports of a systemic lupus erythematosus syndrome.

Hypersensitivity

Hypersensitivity reactions have included rare reports of rash, pruritus, hypotension, photosensitivity, and tachycardia.

Hematologic

Hematologic effects of promethazine have included rare cases of neutropenia.

Psychiatric

Psychiatric side effects of phenylephrine have included hallucinations, fear, and anxiety.

Respiratory

Respiratory side effects of phenylephrine have included respiratory difficulty.

General

General side effects of phenylephrine have included pallor and weakness.

More about Promethazine VC with Codeine (codeine / phenylephrine / promethazine)

Consumer resources

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