Phenylephrine/ chlorpheniramine/ codeine syrup
Generic Name: phenylephrine/chlorpheniramine/codeine (FEN-il-EF-rin/KLOR-fen-IR-a-meen/KOE-deen)
Brand Name: Examples include CapCof and Endal CD
Some children have had serious and sometimes fatal breathing problems when using codeine after surgery to remove tonsils or adenoids. Talk with your doctor for more information.
Phenylephrine/ chlorpheniramine/ codeine syrup is used for:
Relieving symptoms of sinus congestion, runny nose, sneezing, itchy nose or throat, itchy or watery eyes, and cough due to colds, hay fever, and allergies. It may also be used for other conditions as determined by your doctor.
Phenylephrine/chlorpheniramine/codeine syrup is a decongestant, antihistamine, and cough suppressant combination. The decongestant works by constricting blood vessels and reducing swelling in the nasal passages. The antihistamine works by blocking the action of histamine, which helps reduce symptoms such as watery eyes and sneezing. The cough suppressant works in the brain to help decrease the cough reflex to reduce a dry cough.
Do NOT use phenylephrine/ chlorpheniramine/ codeine syrup if:
- you are allergic to any ingredient in phenylephrine/chlorpheniramine/codeine syrup
- you have severe or uncontrolled high blood pressure, severe heart blood vessel disease, rapid heartbeat, severe heart problems, increased pressure in the brain, or slow or shallow breathing
- you are unable to urinate or are having an asthma attack
- you are taking droxidopa or sodium oxybate (GHB), or you have taken furazolidone or a monoamine oxidase inhibitor (MAOI) (eg, phenelzine) within the last 14 days
- the patient is a child and has just had surgery to remove tonsils or adenoids
Contact your doctor or health care provider right away if any of these apply to you.
Before using phenylephrine/ chlorpheniramine/ codeine syrup:
Some medical conditions may interact with phenylephrine/chlorpheniramine/codeine syrup. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:
- if you are pregnant, planning to become pregnant, or are breast-feeding
- if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
- if you have allergies to medicines, foods, or other substances
- if you have had an allergic reaction to any other codeine- or morphine-related medicine (eg, dihydrocodeine, oxycodone)
- if you have a recent head or brain injury, severe drowsiness, brain tumor or lesions, increased pressure in the brain, infection of the brain or nervous system, or a seizure disorder (eg, epilepsy)
- if you have a history of adrenal gland problems (eg, adrenal gland tumor), heart problems (eg, cor pulmonale; fast, slow, or irregular heartbeat; heart disease), high or low blood pressure, liver problems, low blood volume, diabetes, blood vessel problems, stroke, glaucoma or increased pressure in the eye, thyroid problems, or trouble sleeping
- if you have history of asthma, chronic obstructive pulmonary disease (COPD), or other lung or breathing problems (eg, chronic bronchitis, emphysema, sleep apnea, slow or irregular breathing); chronic cough; or if your cough occurs with large amounts of mucus
- if you have a history of constipation, stomach problems (eg, ulcers), bowel problems (eg, chronic inflammation, ulceration of the bowel, diarrhea due to antibiotic use), or gallbladder problems (eg, gallstones); a blockage of your stomach, bladder, or bowel; trouble urinating; an enlarged prostate or other prostate problems; or if you have had recent stomach, bowel, or urinary surgery
- if you have a history of alcohol abuse, drug abuse, mental or mood problems (eg, depression), or suicidal thoughts or behavior, or if you are in poor health or are very overweight
- if you are taking medicines for high blood pressure
Some MEDICINES MAY INTERACT with phenylephrine/chlorpheniramine/codeine syrup. Tell your health care provider if you are taking any other medicines, especially any of the following:
- Anticholinergics (eg, scopolamine) because a serious bowel problem (paralytic ileus) may occur
- Digoxin or droxidopa because the risk of irregular heartbeat or heart attack may be increased
- Furazolidone, linezolid, or MAOIs (eg, phenelzine) because severe high blood pressure and fever may occur
- Barbiturates (eg, phenobarbital), beta-blockers (eg, propranolol), cimetidine, catechol-O-methyltransferase (COMT) inhibitors (eg, tolcapone), HIV protease inhibitors (eg, ritonavir), muscle relaxants (eg, cyclobenzaprine), opioid analgesics (eg, hydrocodone), phenothiazines (eg, chlorpromazine), sodium oxybate (GHB), or tricyclic antidepressants (eg, amitriptyline) because they may increase the risk of phenylephrine/chlorpheniramine/codeine syrup's side effects
- Quinidine or rifamycins (eg, rifampin) because they may decrease phenylephrine/chlorpheniramine/codeine syrup's effectiveness
- Bromocriptine or hydantoins (eg, phenytoin) because the risk of their side effects may be increased by phenylephrine/chlorpheniramine/codeine syrup
- Guanadrel, guanethidine, mecamylamine, methyldopa, or reserpine because their effectiveness may be decreased by phenylephrine/chlorpheniramine/codeine syrup
- Naltrexone because it may decrease phenylephrine/chlorpheniramine/codeine syrup's effectiveness. Withdrawal symptoms may also occur in patients who are physically dependent on opioids
This may not be a complete list of all interactions that may occur. Ask your health care provider if phenylephrine/chlorpheniramine/codeine syrup may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.
How to use phenylephrine/ chlorpheniramine/ codeine syrup:
Use phenylephrine/chlorpheniramine/codeine syrup as directed by your doctor. Check the label on the medicine for exact dosing instructions.
- Take phenylephrine/chlorpheniramine/codeine syrup by mouth with or without food. If stomach upset occurs, take with food to reduce stomach irritation.
- Use a measuring device marked for medicine dosing. Ask your pharmacist for help if you are unsure of how to measure your dose.
- If you miss a dose of phenylephrine/chlorpheniramine/codeine syrup and you are taking it regularly, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.
Ask your health care provider any questions you may have about how to use phenylephrine/chlorpheniramine/codeine syrup.
Important safety information:
- Phenylephrine/chlorpheniramine/codeine syrup may cause drowsiness, dizziness, or blurred vision. These effects may be worse if you take it with alcohol or certain medicines. Use phenylephrine/chlorpheniramine/codeine syrup with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.
- Phenylephrine/chlorpheniramine/codeine syrup may cause dizziness, light-headedness, or fainting; alcohol, hot weather, exercise, or fever may increase these effects. To prevent them, sit up or stand slowly, especially in the morning. Sit or lie down at the first sign of any of these effects.
- Do not drink alcohol while you are taking phenylephrine/chlorpheniramine/codeine syrup.
- Check with your doctor before you use medicines that may cause drowsiness (eg, sleep aids, muscle relaxers) while you are taking phenylephrine/chlorpheniramine/codeine syrup; it may add to their effects. Ask your pharmacist if you have questions about which medicines may cause drowsiness.
- Do not take diet or appetite control medicines while you take phenylephrine/chlorpheniramine/codeine syrup without checking with your doctor.
- Before you start any new medicine, check the label to see if it has a decongestant, antihistamine, or cough suppressant in it too. If it does or if you are not sure, check with your doctor or pharmacist.
- Do not use phenylephrine/chlorpheniramine/codeine syrup for a cough with a lot of mucus. Do not use it for a long-term cough (eg, caused by asthma, emphysema, smoking). However, you may use it for these conditions if your doctor tells you to.
- Do NOT take more than the recommended dose or use for longer than prescribed without checking with your doctor.
- If your symptoms do not get better within 7 days, if they get worse, or if they occur along with a fever, check with your doctor.
- If you have a cough that does not get better within 7 days, goes away and comes back, or occurs along with a fever, rash, or persistent headache, check with your doctor.
- Phenylephrine/chlorpheniramine/codeine syrup may cause you to become sunburned more easily. Avoid the sun, sunlamps, or tanning booths until you know how you react to phenylephrine/chlorpheniramine/codeine syrup. Use a sunscreen or wear protective clothing if you must be outside for more than a short time.
- Phenylephrine/chlorpheniramine/codeine syrup may interfere with skin allergy tests. If you are scheduled for a skin test, talk to your doctor. You may need to stop taking phenylephrine/chlorpheniramine/codeine syrup for a few days before the tests.
- Tell your doctor or dentist that you take phenylephrine/chlorpheniramine/codeine syrup before you receive any medical or dental care, emergency care, or surgery.
- Use phenylephrine/chlorpheniramine/codeine syrup with caution in the ELDERLY; they may be more sensitive to its effects, especially confusion, dizziness, drowsiness, low blood pressure, excitability, dry mouth, and trouble urinating.
- Caution is advised when using phenylephrine/chlorpheniramine/codeine syrup in CHILDREN; they may be more sensitive to its effects, especially excitability.
- Phenylephrine/chlorpheniramine/codeine syrup should not be used in CHILDREN younger than 6 years old without first checking with the child's doctor; safety and effectiveness in these children have not been confirmed.
- PREGNANCY and BREAST-FEEDING: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of taking phenylephrine/chlorpheniramine/codeine syrup while you are pregnant. It is not known if this medicine is found in breast milk. Do not breast-feed while taking phenylephrine/chlorpheniramine/codeine syrup.
When used for long periods of time or at high doses, phenylephrine/chlorpheniramine/codeine syrup may not work as well and may require higher doses to obtain the same effect as when originally taken. This is known as TOLERANCE. Talk with your doctor if phenylephrine/chlorpheniramine/codeine syrup stops working well. Do not take more than prescribed.
Some people who use phenylephrine/chlorpheniramine/codeine syrup for a long time may develop a need to continue taking it. People who take high doses are also at risk. This is known as DEPENDENCE or addiction.
If you suddenly stop taking phenylephrine/chlorpheniramine/codeine syrup, you may experience WITHDRAWAL symptoms, including anxiety; diarrhea; fever, runny nose, or sneezing; goose bumps and abnormal skin sensations; nausea; vomiting; pain; rigid muscles; rapid heartbeat; seeing, hearing or feeling things that are not there; shivering or tremors; sweating; and trouble sleeping.
Possible side effects of phenylephrine/ chlorpheniramine/ codeine syrup:
All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:
Seek medical attention right away if any of these SEVERE side effects occur:
Anxiety; constipation; dizziness; drowsiness; dry mouth, nose, or throat; excitability; headache; loss of appetite; nausea; trouble sleeping; upset stomach; vomiting; weakness.
Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); confusion; difficulty urinating or inability to urinate; fainting; fast, slow, or irregular heartbeat; fever, chills, or persistent sore throat; hallucinations; loss of coordination; mental or mood changes (eg, depression); nervousness; persistent trouble sleeping; restlessness; ringing in the ears; seizures; severe or persistent constipation; severe or persistent dizziness, light-headedness, or headache; severe or persistent drowsiness; slow or shallow breathing; tremor; uncontrolled muscle movements; unusual bruising or bleeding; unusual tiredness or weakness; vision changes or blurred vision.
This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.
If OVERDOSE is suspected:
Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately. Symptoms may include blurred vision; cold and clammy skin; coma; confusion; hallucinations; seizures; severe dizziness, light-headedness, or headache; severe drowsiness; slow or shallow breathing; unusually fast, slow, or irregular heartbeat; vomiting.Proper storage of phenylephrine/chlorpheniramine/codeine syrup:
Store phenylephrine/chlorpheniramine/codeine syrup at room temperature, between 68 and 77 degrees F (20 and 25 degrees C). Store away from heat, moisture, and light. Do not store in the bathroom. Keep phenylephrine/chlorpheniramine/codeine syrup out of the reach of children and away from pets.
- If you have any questions about phenylephrine/chlorpheniramine/codeine syrup, please talk with your doctor, pharmacist, or other health care provider.
- Phenylephrine/chlorpheniramine/codeine syrup is to be used only by the patient for whom it is prescribed. Do not share it with other people.
- If your symptoms do not improve or if they become worse, check with your doctor.
- Check with your pharmacist about how to dispose of unused medicine.
This information should not be used to decide whether or not to take phenylephrine/chlorpheniramine/codeine syrup or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about phenylephrine/chlorpheniramine/codeine syrup. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to phenylephrine/chlorpheniramine/codeine syrup. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using phenylephrine/chlorpheniramine/codeine syrup.
Disclaimer: This information should not be used to decide whether or not to take this medicine or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this medicine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using this medicine.