Chlorcyclizine / codeine / pseudoephedrine Side Effects
For the Consumer
Applies to chlorcyclizine / codeine / pseudoephedrine: liquid
Check with your doctor if any of these most COMMON side effects persist or become bothersome:
Seek medical attention right away if any of these SEVERE side effects occur while taking chlorcyclizine / codeine / pseudoephedrine:
Constipation; diarrhea; dizziness; drowsiness; dry mouth, nose, or throat; excitability; headache; loss of appetite; nausea; nervousness or anxiety; trouble sleeping; upset stomach; vomiting; weakness.
Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); confusion; difficulty urinating or inability to urinate; fainting; fast, slow, or irregular heartbeat; hallucinations; loss of coordination; mental or mood changes (eg, irritability); persistent trouble sleeping; restlessness; ringing in the ears; seizures; severe dizziness, lightheadedness, or headache; severe drowsiness; shallow breathing; tremor; uncontrolled muscle movements; unusual weakness or tiredness; vision changes or blurred vision.
For Healthcare Professionals
Applies to chlorcyclizine / codeine / pseudoephedrine: oral liquid
Nervous system side effects have included excitability, drowsiness, nervousness, and sleeplessness.[Ref]
Cardiovascular side effects have included hypotension and dizziness.[Ref]
Dermatologic side effects including rashes, severe scarlatiniform eruptions, and generalized dermatitis have been reported rarely.[Ref]
Gastrointestinal side effects including nausea, vomiting, and constipation have been reported frequently. Severe constipation and ileus resulting in colonic perforation have also been reported. Four cases of acute pancreatitis have been reported.[Ref]
Genitourinary side effects including urinary retention have been reported.[Ref]
Ocular side effects including a temporary 26% decrease in pupil diameter following the administration of intravenous codeine have been reported.[Ref]
Other side effects including withdrawal symptoms after either abrupt cessation or fast tapering of narcotic analgesics have been reported. These withdrawal symptoms have included agitation, restlessness, anxiety, insomnia, tremor, abdominal cramps, blurred vision, vomiting, and sweating.[Ref]
1. Zolezzi M, Al Mohaimeed SA "Seizures with intravenous codeine phosphate." Ann Pharmacother 35 (2001): 1211-3
2. Shorr RI, Griffin MR, Daugherty JR, Ray WA "Opioid analgesics and the risk of hip fracture in the elderly: codeine and propoxyphene." J Gerontol 47 (1992): m111-5
3. de Groot AC, Conemans J "Allergic urticarial rash from oral codeine." Contact Dermatitis 14 (1986): 209-14
4. Max MB, Schafer SC, Culnane M, et al "Association of pain relief with drug side effects in postherpeticneuralgia: a single-dose study of clonidine, codeine, ibuprofen, and placebo." Clin Pharmacol Ther 43 (1988): 363-71
5. Bradley CM, Nicholson AN "Effects of a mu-opoiod receptor agonist (codeine phosphate) on visuo-motor coordination and dynamic visual acuity in man." Br J Clin Pharmacol 22 (1986): 507-12
6. "Product Information. Notuss-NXD (chlorcyclizine / codeine / pseudoephedrine)." SJ Pharmaceuticals formerly Stewart-Jackson Pharmacal Inc, Atlanta, GA.
7. Malek-Ahmadi P, Ramsey ML "Acute psychosis associated with codeine and acetaminophen: a case report." Neurobehav Toxicol Teratol 7 (1985): 193-4
8. Stambaugh JE Jr, McAdams J "Comparison of the analgesic efficacy and safety of oral ciramadol, codeine, and placebo in patients with chronic cancer pain." J Clin Pharmacol 27 (1987): 162-6
9. Cox RG "Hypoxaemia and hypotension after intravenous codeine phosphate." Can J Anaesth 41 (1994): 1211-3
10. Redpath JB, Pleuvry BJ "Double-blind comparison of the respiratory and sedative effects of codeine phosphate and (+/-)-glaucine phosphate in human volunteers." Br J Clin Pharmacol 14 (1982): 555-8
11. Parke TJ, Nandi PR, Bird KJ, Jewkes DA "Profound hypotension following intravenous codeine phosphate: three case reports and some recommendations." Anaesthesia 47 (1992): 852-4
12. Hunskaar S, Dragsund S "Scarlatiniform rash and urticaria due to codeine." Ann Allergy 54 (1985): 240-1
13. Rodriguez F, Fernandez L, Garciaabujeta JL, Maquiera E, Llaca HF, Jerez J "Generalized dermatitis due to codeine." Contact Dermatitis 32 (1995): 120
14. Gonzalogarijo MA, Revengaarranz F "Fixed drug eruption due to codeine." Br J Dermatol 135 (1996): 498-9
15. Hastier P, Buckley MJM, Peten EP, Demuth N, Dumas R, Demarquay JF, CaroliBosc FX, Delmont JP "A new source of drug-induced acute pancreatitis: Codeine." Am J Gastroenterol 95 (2000): 3295-8
16. Stringer MD, Greenfield S, McIrvine AJ "Stercoral perforation of the colon following postoperative analgesia." J R Soc Med 80 (1987): 115-6
17. Knaggs RD, Crighton IM, Cobby TF, Fletcher AJ, Hobbs GJ "The pupillary effects of intravenous morphine, codeine, and tramadol in volunteers." Anesth Analg 99 (2004): 108-12
18. "Product Information. Calcidrine (codeine)." Abbott Pharmaceutical, Abbott Park, IL.
Not all side effects for chlorcyclizine / codeine / pseudoephedrine may be reported. You should always consult a doctor or healthcare professional for medical advice. Side effects can be reported to the FDA here.
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