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chlorpheniramine and codeine

Generic Name: chlorpheniramine and codeine (KLOR fen IR a meed and KOE deen)
Brand Name: Codar AR, Cotab A, Tuzistra XR, Zodryl AC 25, Z-Tuss AC, ...show all 18 brand names

What is chlorpheniramine and codeine?

Chlorpheniramine is an antihistamine that reduces the effects of natural chemical histamine in the body. Histamine can produce symptoms of sneezing, itching, watery eyes, and runny nose.

Codeine is a narcotic cough suppressant. It affects the signals in the brain that trigger cough reflex.

Chlorpheniramine and codeine is a combination medicine used to treat runny nose, sneezing, itching, watery eyes, and cough caused by allergies, the common cold, or the flu.

Chlorpheniramine and codeine will not treat a cough that is caused by smoking, asthma, or emphysema.

Chlorpheniramine and codeine may also be used for purposes not listed in this medication guide.

What is the most important information I should know about chlorpheniramine and codeine?

Codeine can slow or stop your breathing, and may be habit-forming. MISUSE OF THIS MEDICINE CAN CAUSE ADDICTION, OVERDOSE, OR DEATH, especially in a child or other person using the medicine without a prescription.

Do not use this medicine if you have used an MAO inhibitor in the past 14 days, such as isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, or tranylcypromine.

This medicine should not be used to treat cold or flu symptoms in anyone younger than 6 years old, and should not be used as a pain medicine in children younger than 12 or anyone under 18 who recently had surgery to remove the tonsils or adenoids.

Fatal side effects can occur if you use this medicine with alcohol, or with other drugs that cause drowsiness or slow your breathing.

What should I discuss with my healthcare provider before taking chlorpheniramine and codeine?

You should not use this medicine if you are allergic to chlorpheniramine or codeine.

Do not use this medicine if you have used an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, tranylcypromine, and others.

In some people, codeine breaks down rapidly in the liver and reaches higher than normal levels in the body. This can cause dangerously slow breathing and may cause death, especially in a child.

This medicine should not be used to treat cold or flu symptoms in anyone younger than 6 years old.

Chlorpheniramine and codeine should not be used as a pain medicine in children younger than 12 or anyone under 18 who recently had surgery to remove the tonsils or adenoids.

To make sure chlorpheniramine and codeine is safe for you, tell your doctor if you have ever had:

  • asthma or other breathing problems;

  • a head injury or brain tumor;

  • a blockage in your digestive tract (stomach or intestines);

  • enlarged prostate, urination problems;

  • diabetes;

  • liver or kidney disease;

  • a thyroid disorder; or

  • alcoholism or drug addiction.

If you use codeine while you are pregnant, your baby could become dependent on the drug. This can cause life-threatening withdrawal symptoms in the baby after it is born. Babies born dependent on habit-forming medicine may need medical treatment for several weeks. Tell your doctor if you are pregnant or plan to become pregnant.

Do not breast-feed. Codeine can pass into breast milk and may cause drowsiness, breathing problems, or death in a nursing baby. Chlorpheniramine may slow breast milk production.

How should I take chlorpheniramine and codeine?

Follow all directions on your prescription label. Codeine can slow or stop your breathing. Never use chlorpheniramine and codeine in larger amounts, or for longer than prescribed. Cough or cold medicine is usually taken only for a short time until your symptoms clear up.

Codeine may be habit-forming, even at regular doses. Never share this medicine with another person, especially someone with a history of drug abuse or addiction. MISUSE OF NARCOTIC MEDICINE CAN CAUSE ADDICTION, OVERDOSE, OR DEATH, especially in a child or other person using the medicine without a prescription. Selling or giving away codeine is against the law.

You should not use antihistamine medication to make a child sleepy.

Shake the oral suspension (liquid) well just before you measure a dose. Measure liquid medicine with the dosing syringe provided, or with a special dose-measuring spoon or medicine cup. If you do not have a dose-measuring device, ask your pharmacist for one.

Do not take for longer than 7 days in a row. Call your doctor if your symptoms do not improve after 7 days of treatment, or if you have a fever with a headache or skin rash.

If you need surgery or medical tests, tell the surgeon or doctor ahead of time if you have taken this medicine within the past few days.

Store at room temperature away from moisture and heat. Do not allow the liquid to freeze.

Keep track of your medicine. Codeine is a drug of abuse and you should be aware if anyone is using your medicine improperly or without a prescription.

What happens if I miss a dose?

Since this medicine is taken when needed, you may not be on a dosing schedule. If you are taking the medicine regularly, take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. A codeine overdose can be fatal, especially in a child or other person using the medicine without a prescription. Overdose symptoms may include slow breathing and heart rate, severe drowsiness, muscle weakness, cold and clammy skin, pinpoint pupils, and fainting.

What should I avoid while taking chlorpheniramine and codeine?

This medicine may impair your thinking or reactions. Avoid driving or operating machinery until you know how this medicine will affect you. Dizziness or severe drowsiness can cause falls or other accidents.

Avoid getting up too fast from a sitting or lying position, or you may feel dizzy. Get up slowly and steady yourself to prevent a fall.

Do not drink alcohol while you are taking medicine that contains codeine. Dangerous side effects or death can occur when alcohol is combined with a narcotic medicine.

Ask a doctor or pharmacist before using any other cold, allergy, cough, or sleep medicine. Many combination medicines contain antihistamines or cough suppressants. Taking certain products together can cause you to get too much of a certain drug.

Chlorpheniramine and codeine side effects

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Get emergency medical help if a child taking this medicine has breathing problems, blue lips, or severe drowsiness, or if you cannot wake the child up from sleep.

Stop using chlorpheniramine and codeine and call your doctor at once if you have:

  • noisy breathing, sighing, shallow breathing;

  • a slow heart rate or weak pulse;

  • pounding heartbeats or fluttering in your chest;

  • a light-headed feeling, like you might pass out;

  • painful or difficult urination;

  • tremor, uncontrolled muscle movements; or

  • confusion, ringing in your ears.

Serious side effects may be more likely in older adults and those who are overweight, malnourished, or debilitated.

Common side effects may include:

  • dizziness, drowsiness;

  • general ill feeling;

  • mood changes, feeling agitated or irritable;

  • headache, feeling light-headed;

  • feeling restless, nervous, or excited;

  • sleep problems (insomnia);

  • constipation;

  • nausea, vomiting, stomach pain, bloating;

  • blurred vision, double vision; or

  • dry mouth, nose, or throat.

Side effects such as dry mouth, constipation, and confusion may be more likely in older adults.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

Chlorpheniramine and codeine dosing information

Usual Adult Dose for Allergic Rhinitis:

Immediate-release (suspension, liquid, tablets):
1 dose orally every 4 to 6 hours as needed
-Chlorpheniramine: Single dose: up to 4 mg; Maximum dose: 24 mg/24 hours
-Codeine: Single dose: up to 20 mg; Maximum dose: 120 mg/24 hours
Maximum doses should not exceed maximum dose of either of the single ingredient doses

Extended-release suspension: chlorpheniramine polistirex 2.8 mg/codeine polistirex 14.7 mg per 5 mL (equivalent to chlorpheniramine maleate 4 mg/codeine phosphate 20 mg per 5 mL)
5 mL orally every 12 hours
Maximum dose: 10 mL/24 hours

Comments:
-Liquid preparations should be measured with an accurate milliliter measuring device.
-Shake oral suspensions well before measuring dose.

Uses: For the temporary relief of cough due to minor throat and bronchial irritations as may occur with the common cold or inhaled irritants; temporarily decreases runny nose and reduces sneezing, itching of the nose or throat, and itchy, watery eyes due to hay fever or other upper respiratory allergies.

Usual Adult Dose for Cough and Nasal Congestion:

Immediate-release (suspension, liquid, tablets):
1 dose orally every 4 to 6 hours as needed
-Chlorpheniramine: Single dose: up to 4 mg; Maximum dose: 24 mg/24 hours
-Codeine: Single dose: up to 20 mg; Maximum dose: 120 mg/24 hours
Maximum doses should not exceed maximum dose of either of the single ingredient doses

Extended-release suspension: chlorpheniramine polistirex 2.8 mg/codeine polistirex 14.7 mg per 5 mL (equivalent to chlorpheniramine maleate 4 mg/codeine phosphate 20 mg per 5 mL)
5 mL orally every 12 hours
Maximum dose: 10 mL/24 hours

Comments:
-Liquid preparations should be measured with an accurate milliliter measuring device.
-Shake oral suspensions well before measuring dose.

Uses: For the temporary relief of cough due to minor throat and bronchial irritations as may occur with the common cold or inhaled irritants; temporarily decreases runny nose and reduces sneezing, itching of the nose or throat, and itchy, watery eyes due to hay fever or other upper respiratory allergies.

Usual Pediatric Dose for Allergic Rhinitis:

Under 2 years: Not recommended

2 to 6 years: Under physician supervision
-Chlorpheniramine: up to 1 mg every 4 to 6 hours not to exceed 6 mg/24 hours
-Codeine: 1 mg/kg/day in equally divided doses every 4 to 6 hours

6 to 12 years:
Take 1 dose orally every 4 to 6 hours
-Chlorpheniramine: Single dose: up to 2 mg; Maximum dose: 12 mg/24 hours
-Codeine: Single dose up to 10 mg; Maximum dose: 60 mg/24 hours

12 years or older:
1 dose orally every 4 to 6 hours as needed
-Chlorpheniramine: Single dose: up to 4 mg; Maximum dose: 24 mg/24 hours
-Codeine: Single dose: up to 20 mg; Maximum dose: 120 mg/24 hours

Comments:
-Maximum doses should not exceed maximum dose of either of the single ingredient doses.
-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).
-Extended-release products are not indicated for use in patients less than 18 years of age.

Uses: For the temporary relief of cough due to minor throat and bronchial irritations as may occur with the common cold or inhaled irritants; temporarily decreases runny nose and reduces sneezing, itching of the nose or throat, and itchy, watery eyes due to hay fever or other upper respiratory allergies.

Usual Pediatric Dose for Cough and Nasal Congestion:

Under 2 years: Not recommended

2 to 6 years: Under physician supervision
-Chlorpheniramine: up to 1 mg every 4 to 6 hours not to exceed 6 mg/24 hours
-Codeine: 1 mg/kg/day in equally divided doses every 4 to 6 hours

6 to 12 years:
Take 1 dose orally every 4 to 6 hours
-Chlorpheniramine: Single dose: up to 2 mg; Maximum dose: 12 mg/24 hours
-Codeine: Single dose up to 10 mg; Maximum dose: 60 mg/24 hours

12 years or older:
1 dose orally every 4 to 6 hours as needed
-Chlorpheniramine: Single dose: up to 4 mg; Maximum dose: 24 mg/24 hours
-Codeine: Single dose: up to 20 mg; Maximum dose: 120 mg/24 hours

Comments:
-Maximum doses should not exceed maximum dose of either of the single ingredient doses.
-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).
-Extended-release products are not indicated for use in patients less than 18 years of age.

Uses: For the temporary relief of cough due to minor throat and bronchial irritations as may occur with the common cold or inhaled irritants; temporarily decreases runny nose and reduces sneezing, itching of the nose or throat, and itchy, watery eyes due to hay fever or other upper respiratory allergies.

What other drugs will affect chlorpheniramine and codeine?

Ask a doctor or pharmacist before using this medicine if you are also using any other drugs, including prescription and over-the-counter medicines, vitamins, and herbal products. Some medicines can cause unwanted or dangerous effects when used together. Not all possible interactions are listed in this medication guide.

Taking chlorpheniramine and codeine with other drugs that make you sleepy or slow your breathing can cause dangerous side effects or death. Ask your doctor before taking a sleeping pill, narcotic pain medicine, prescription cough medicine, a muscle relaxer, or medicine for anxiety, depression, or seizures.

Where can I get more information?

  • Your pharmacist can provide more information about chlorpheniramine and codeine.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 9.01.

Date modified: July 24, 2017
Last reviewed: June 08, 2017

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