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codeine and promethazine

Generic Name: codeine and promethazine (KOE deen and proe METH a zeen)
Brand Name: Codeine Phosphate-Promethazine HCl, Promethazine with Codeine, Phenergan with Codeine, Promethazine HCl and Codeine Phosphate, Promethazine HCl with Codeine

What is codeine and promethazine?

Codeine is a narcotic. It is a pain reliever and a cough suppressant. Promethazine is an antihistamine. It blocks the effects of the naturally occurring chemical histamine in your body.

Codeine and promethazine is a combination medicine used to treat cold or allergy symptoms such as runny nose, sneezing, and cough.

Codeine and promethazine may also be used for purposes not listed in this medication guide.

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

You should not use this medication if you have asthma, pneumonia, or other lung problems.

This medicine is not for use in children younger than 6 years old, and is not for use in anyone under 18 who recently had surgery to remove the tonsils or adenoids.

Taking this medicine during pregnancy may cause life-threatening withdrawal symptoms in the newborn.

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 codeine and promethazine?

You should not use this medicine if you are allergic to codeine or promethazine, or if you have asthma, pneumonia, or other lung problems.

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.

Codeine and promethazine should not be given to a child younger than 6 years old.

Do not give codeine to anyone younger than 18 years old who recently had surgery to remove the tonsils or adenoids.

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

  • asthma, COPD, sleep apnea, or other breathing disorders;

  • drug or alcohol addiction;

  • seizures:

  • a head injury or brain tumor;

  • severe or ongoing cough;

  • glaucoma;

  • heart disease;

  • a blood cell disorder;

  • diabetes;

  • stomach problems;

  • liver or kidney disease;

  • a thyroid disorder;

  • an enlarged prostate, urination problems;

  • Addison's disease (an adrenal gland disorder); or

  • surgery on your stomach or urinary tract.

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. Do not breast-feed. Antihistamines may also slow breast milk production.

How should I take codeine and promethazine?

Follow all directions on your prescription label. Codeine and promethazine can slow or stop your breathing. Never use codeine and promethazine 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.

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.

Call your doctor if your symptoms do not improve after 5 days of treatment.

Store at room temperature away from moisture, heat, and light.

Keep track of your medicine. Codeine and promethazine 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?

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 codeine and promethazine?

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.

Do not drink alcohol. Dangerous side effects or death could occur.

Avoid exposure to sunlight or tanning beds. Codeine and promethazine can make you sunburn more easily. Wear protective clothing and use sunscreen (SPF 30 or higher) when you are outdoors.

Codeine and promethazine 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 this medicine and call your doctor at once if you have:

  • noisy breathing, sighing, shallow breathing;

  • a slow heart rate or weak pulse;

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

  • confusion, agitation, hallucinations, unusual thoughts or behavior;

  • seizure (convulsions);

  • little or no urination;

  • severe constipation, stomach pain;

  • jaundice (yellowing of the skin or eyes);

  • increased blood pressure--severe headache, blurred vision, pounding in your neck or ears, anxiety, nosebleed; or

  • severe nervous system reaction--very stiff (rigid) muscles, high fever, sweating, confusion, fast or uneven heartbeats, tremors, feeling like you might pass out.

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

Common side effects may include:

  • nausea, vomiting;

  • confusion, drowsiness;

  • fast heartbeats, feeling restless;

  • urination problems;

  • dry mouth, nose, or throat; or

  • trouble breathing.

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.

Side Effects (complete list)

Codeine and promethazine dosing information

Usual Adult Dose for Cough:

Promethazine 6.25 mg/ Codeine 10 mg per 5 mL:
Average effective dose: 5 mL orally every 4 to 6 hours as needed
Maximum dose: 30 mL (promethazine 37.5 mg; codeine: 60 mg) in 24 hours

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

Uses: Temporary relief of coughs and upper respiratory symptoms associated with allergy or the common cold.

Usual Pediatric Dose for Cough:

Less than 12 years: Contraindicated

12 years and older:
Promethazine 6.25 mg/ Codeine 10 mg per 5 mL:
Average effective dose: 5 mL orally every 4 to 6 hours as needed
Maximum dose: 30 mL (promethazine 37.5 mg; codeine: 60 mg) in 24 hours

Comments:
-Liquid preparations should be measured with an accurate milliliter measuring device.
-This product should not be administered to adolescents who have risk factors for respiratory depression such as obesity, obstructive sleep apnea, or severe pulmonary disease.

Uses: Temporary relief of coughs and upper respiratory symptoms associated with allergy or the common cold.

What other drugs will affect codeine and promethazine?

Some medicines can interact with codeine and promethazine and cause a serious condition called serotonin syndrome. Be sure your doctor knows if you also take medicine for depression, mental illness, Parkinson's disease, migraine headaches, serious infections, or prevention of nausea and vomiting. Ask your doctor before making any changes in how or when you take your medications.

Taking codeine and promethazine 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.

Other drugs may interact with codeine and promethazine, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

Where can I get more information?

  • Your pharmacist can provide more information about codeine and promethazine.
  • 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: November 15, 2017
Last reviewed: June 27, 2017

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