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Codeine / Guaifenesin Dosage

Applies to the following strength(s): 10 mg-100 mg/5 mL ; 10 mg-300 mg ; 2.5 mg-75 mg/5 mL ; 10 mg-300 mg/5 mL ; 10 mg-200 mg/5 mL ; 7.5 mg-225 mg/5 mL ; 9 mg-200 mg ; 6.3 mg-100 mg/5 mL ; 10 mg-400 mg ; 20 mg-400 mg ; 8 mg-200 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 Cough

1 dose orally every 4 to 6 hours as needed
-Codeine: Single dose: up to 20 mg; Maximum dose: 120 mg in 24 hours
-Guaifenesin: Single dose: up to 400 mg; Maximum dose: 2400 mg in 24 hours
Maximum dose should not exceed maximum dose of either of the single ingredient doses

Comments:
-Liquid preparations should be measured with an accurate milliliter measuring device.
-This combination drug should not be used in patients with chronic pulmonary disease or shortness of breath unless directed by a health care professional.

Uses: Temporary relief of coughs due to minor throat and bronchial irritations as may occur with the common cold or inhaled irritants; helps loosen phlegm and thin bronchial secretions to make cough more productive.

Usual Pediatric Dose for Cough

Less than 2 years of age: Not Recommended

2 to less than 6 years old: Under physician supervision:
1 dose orally every 4 to 6 hours as needed
-Codeine: 1 mg/kg/day in equally divided doses
-Guaifenesin: Single dose: up to 100 mg; Maximum dose: 600 mg/24 hours

6 to less than 12 years old:
1 dose orally every 4 to 6 hours as needed
-Codeine: Single dose: up to 10 mg; Maximum dose: 60 mg/24 hours
-Guaifenesin: Single dose: up to 200 mg; Maximum dose: 1200 mg/24 hours

1 dose orally every 4 to 6 hours as needed
-Codeine: Single dose: up to 20 mg; Maximum dose: 120 mg/24 hours
-Guaifenesin: Single dose: up to 400 mg; Maximum dose: 2400 mg/24 hours

Comments:
-Maximum doses should not exceed maximum dose of either of the single ingredient doses
-Liquid preparations should be measured with an accurate milliliter measuring device.
-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, or those taking other medications unless directed by a physician.

Uses: Temporary relief of coughs due to minor throat and bronchial irritations as may occur with the common cold or inhaled irritants; helps loosen phlegm and thin bronchial secretions to make cough more productive.

Renal Dose Adjustments

Dose adjustments not recommended

Liver Dose Adjustments

Dose adjustments not recommended

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.

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; take with plenty of water
-Oral measuring devices should be provided to ensure accuracy in dosing; a household teaspoon should not be considered an accurate measuring device

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.

Patient advice:
-Patients should understand that codeine use can result in addiction, abuse, and misuse.
-Patients should 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 headaches, 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.

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