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Codeine, dexchlorpheniramine, and phenylephrine

Generic name: codeine, dexchlorpheniramine, and phenylephrine (KOE deen, DEX klor fen IR a meen, FEN il EFF rin)
Brand name: Vanacof CD, Dexphen w/C, Pro-Red AC
Dosage forms: oral liquid (9 mg-1 mg-5 mg/5 mL)
Drug class: Upper respiratory combinations

Medically reviewed by on Aug 3, 2020. Written by Cerner Multum.

What is codeine, dexchlorpheniramine, and phenylephrine?

Codeine is a cough suppressant. Dexchlorpheniramine is an antihistamine. Phenylephrine is a decongestant.

Codeine, dexchlorpheniramine, and phenylephrine is a combination medicine used to treat cough, runny or stuffy nose, sneezing, itching in the nose or throat, and watery eyes caused by allergies, the common cold, or the flu.

Codeine, dexchlorpheniramine, and phenylephrine may also be used for purposes not listed in this medication guide.


MISUSE OF THIS MEDICINE CAN CAUSE ADDICTION, OVERDOSE, OR DEATH. Keep the medication in a place where others cannot get to it.

This medicine is not approved for use by anyone younger than 18 years old.

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

Before taking this medicine

You should not use this medicine if you are allergic to codeine, phenylephrine, or dexchlorpheniramine.

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.

Ask a doctor or pharmacist if this medicine is safe to use if you have ever had:

If you use this medicine while you are pregnant, your baby could become dependent on codeine. 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.

Do not breastfeed. Codeine can pass into breast milk and cause drowsiness, breathing problems, or death in a nursing baby.

How should I take codeine, dexchlorpheniramine, and phenylephrine?

Follow the directions on your prescription label and read all medication guides. Never use this medicine 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.

Never share this medicine with another person, especially someone with a history of drug abuse or addiction. MISUSE CAN CAUSE ADDICTION, OVERDOSE, OR DEATH. Keep the medicine in a place where others cannot get to it. Selling or giving away opioid medicine is against the law.

Measure liquid medicine carefully. Use the dosing syringe provided, or use a medicine dose-measuring device (not a kitchen spoon).

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.

Call your doctor if your cough does not improve after 7 days, or if you have a fever, rash, or headaches.

Do not stop using this medicine suddenly after long-term use, or you could have unpleasant withdrawal symptoms. Ask your doctor how to safely stop using this medicine.

Store at room temperature away from moisture and heat. Keep track of your medicine. You should be aware if anyone is using it improperly or without a prescription.

What happens if I miss a dose?

Since cough and cold is used when needed, you may not be on a dosing schedule. Skip any missed dose if it's almost time for your next dose. Do not use two doses at one time.

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, dexchlorpheniramine, and phenylephrine?

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

Avoid driving or hazardous activity until you know how this medicine will affect you. Dizziness or drowsiness can cause falls, accidents, or severe injuries.

Ask a doctor or pharmacist before using other cough or cold medicines that may contain similar ingredients.

codeine, dexchlorpheniramine, and phenylephrine 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.

Opioid medicine can slow or stop your breathing, and death may occur. A person caring for you should seek emergency medical attention if you have slow breathing with long pauses, blue colored lips, or if you are hard to wake up.

Stop taking this medicine and call your doctor at once if you have:

  • weak or shallow breathing, breathing that stops during sleep;

  • confusion, severe drowsiness;

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

  • severe constipation; or

  • nervousness, trouble sleeping.

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

Common side effects may include:

  • drowsiness; or

  • feeling restless or excited (especially in children).

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.

Codeine, dexchlorpheniramine, and phenylephrine dosing information

Usual Adult Dose for Cough and Nasal Congestion:

10 mL orally every 4 to 6 hours
Maximum dose: 60 mL in 24 hours

-Each 5 mL contains codeine 9 mg, dexchlorpheniramine 1 mg, and phenylephrine 5 mg
-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 and Nasal Congestion:

Less than 12 years: Not Recommended

12 years or older:
10 mL orally every 4 to 6 hours
Maximum dose: 60 mL in 24 hours

-Each 5 mL contains codeine 9 mg, dexchlorpheniramine 1 mg, and phenylephrine 5 mg
-Liquid preparations should be measured with an accurate milliliter measuring device.
-Codeine should not be used in adolescents who are obese or have conditions such as sleep apnea or severe lung disease which may increase the risk of serious breathing problems.

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

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What other drugs will affect codeine, dexchlorpheniramine, and phenylephrine?

You may have breathing problems or withdrawal symptoms if you start or stop taking certain other medicines. Tell your doctor if you also use an antibiotic, antifungal medication, heart or blood pressure medication, seizure medication, or medicine to treat HIV or hepatitis C.

Opioid medication can interact with many other drugs and cause dangerous side effects or death. Be sure your doctor knows if you also use:

This list is not complete and many other drugs may affect codeine, dexchlorpheniramine, and phenylephrine. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.

More about codeine / dexchlorpheniramine / phenylephrine

Consumer resources

Other brands
Pro-Red AC, Vanacof CD

Related treatment guides

Further information

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.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.