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Chlorpheniramine / Codeine / Pseudoephedrine Dosage

Applies to the following strength(s): 2 mg-10 mg-30 mg/5 mL ; 2 mg-8 mg-30 mg/5 mL

The information at Drugs.com is not a substitute for medical advice. Always consult your doctor or pharmacist.

Usual Adult Dose for:

Usual Pediatric Dose for:

Additional dosage information:

Usual Adult Dose for Cold Symptoms

Chlorpheniramine 2 mg/codeine 10 mg/pseudoephedrine 30 mg per 5 mL oral liquid:
10 mL orally every 4 hours as needed; not to exceed 4 doses in 24 hours

Chlorpheniramine 2 mg/codeine 8 mg/pseudoephedrine 30 mg per 5 mL oral liquid:
10 mL orally every 4 to 6 hours as needed; not to exceed 40 mL in 24 hours

Comments:
-Liquid preparations should be measured with an accurate milliliter measuring device.

Uses: For the temporary relief symptoms due to the common cold, hay fever (allergic rhinitis), or other upper respiratory allergies.

Usual Pediatric Dose for Cold Symptoms

Under 2 years: Not recommended

Age: 2 to 6 years: Physician should be consulted
-Chlorpheniramine: up to 1 mg every 4 to 6 hours not to exceed 6 mg in 24 hours
-Codeine: 1 mg/kg/day in 4 equally divided doses
-Pseudoephedrine: 15 mg every 4 to 6 hours not to exceed 60 mg in 24 hours
Maximum doses of any of the ingredients should not be exceeded

Age: 6 to 12 years:
-Chlorpheniramine 2 mg/codeine 10 mg/pseudoephedrine 30 mg per 5 mL oral liquid:
5 mL orally every 4 hours as needed; not to exceed 4 doses in 24 hours
-Chlorpheniramine 2 mg/codeine 8 mg/pseudoephedrine 30 mg per 5 mL oral liquid:
5 mL orally every 4 to 6 hours as needed; not to exceed 20 mL in 24 hours

Age: 12 years or older:
-Chlorpheniramine 2 mg/codeine 10 mg/pseudoephedrine 30 mg per 5 mL oral liquid:
10 mL orally every 4 hours as needed; not to exceed 4 doses in 24 hours
-Chlorpheniramine 2 mg/codeine 8 mg/pseudoephedrine 30 mg per 5 mL oral liquid:
10 mL orally every 4 to 6 hours as needed; not to exceed 40 mL in 24 hours

Comments:
-The FDA supports action by the Consumer Healthcare Products Association (CHPA) and many drug manufacturers to place "do not use in children under 4 years of age" on the label of all over the counter (OTC) cough and cold medicines.
- The America Academy of Pediatrics (AAP) warns against use of combination cough and cold products in children due to lack of well-controlled efficacy studies and the potential for adverse effects and overdose.
-This product should not be administered to children who have a chronic respiratory disease or shortness of breath, persistent or chronic cough such as occurs with asthma or if cough is accompanied by excessive phlegm (mucus)or who are taking other drugs unless directed by a doctor."

Uses: For the temporary relief symptoms due to the common cold, hay fever (allergic rhinitis), or other upper respiratory allergies.

Renal Dose Adjustments

Use with caution, especially in patients with severe renal impairment

Liver Dose Adjustments

Use with caution, especially in patients with severe renal impairment

Precautions

US BOXED WARNING: DEATH RELATED TO ULTRA-RAPID METABOLISM OF CODEINE TO MORPHINE:
-Respiratory depression and death have occurred in children who received codeine following tonsillectomy and/or adenoidectomy and had evidence of being ultra-rapid metabolizers of codeine due to CYP450 2D6 polymorphism.

Safety and efficacy have not been established in patients younger than 2 years.
-Children under 6 years of age should not use this product without physician supervision.
-Consumer Healthcare Products Association (CHPA) has recommended all combination cough and cold products be labeled "Do not use in children under 4 years of age".

Consult WARNINGS section for additional precautions.

US Controlled Substance: Schedule V

Dialysis

Data not available

Other Comments

Administration advice:
-Take orally with or without food
-Oral measuring devices should be provided to ensure accuracy in dosing

Storage requirements:
-Protect from moisture and light

General:
-Patients who are ultra-rapid metabolizers of codeine due to a CYP450 2D6 polymorphism, will convert codeine more rapidly and completely to morphine resulting in unexpectedly high morphine levels, which may be life-threatening.
-Codeine use is contraindicated in the postoperative period in children who have undergone tonsillectomy and/or adenoidectomy.
-Professional organizations are concerned with use of all cough and cold medicines in children; prescription and non-prescription alternatives to codeine for cough also have risks.

Monitoring:
-Cardiovascular: Monitor for signs of hypotension, especially in those whose blood pressure is compromised
-Respiratory: Monitor for respiratory depression
-Gastrointestinal: Monitor for constipation and decreased bowel motility in post-operative patients.
-Patients should be monitored for the development of addiction, abuse, or misuse.
with their healthcare provider regarding concomitant use of other CNS depressants.

Patient advice:
-Patients should understand that codeine use can result in addiction, abuse, and misuse; recommended doses should not be exceeded.
-Patients should be understand that this product is for temporary relief of cough; if cough persists for longer than 1 week, recurs, or is accompanied by fever, rash, or persistent headache, a health care professional should be consulted.
-Patients should understand risks of life-threatening respiratory depression and when this risk is greatest; patients should be aware that a genetic mutation may result in greater codeine toxicity in some patients; breastfed infants of women who have this genetic mutation are also at risk.
-Women who are breastfeeding, pregnant, or planning to become pregnant should speak to their healthcare provider before using this product.
-This drug may cause drowsiness, dizziness, or impair thinking or motor skills; patients should avoid driving or operating machinery until adverse effects are determined.
-Concomitant use of alcohol, sedatives, and tranquilizers may increase drowsiness; patients should avoid alcohol and consult with their healthcare provider regarding concomitant use of other CNS depressants.
-Pseudoephedrine may cause sleeplessness, especially if it is taken up to several hours before going to bed.

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