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Tussar-2 Side Effects

Generic name: codeine / guaifenesin / pseudoephedrine

Medically reviewed by Last updated on Dec 4, 2023.

Note: This document contains side effect information about codeine / guaifenesin / pseudoephedrine. Some dosage forms listed on this page may not apply to the brand name Tussar-2.

Applies to codeine / guaifenesin / pseudoephedrine: oral liquid, oral solution, oral syrup.


For all patients taking this drug:
  • This drug has an opioid drug in it. Opioid drugs can put you at risk for addiction, abuse, and misuse. Misuse or abuse of this drug can lead to overdose and death. If you have questions, talk with your doctor.
  • This drug has an opioid drug in it. Severe side effects have happened when opioid drugs were used with benzodiazepines or other drugs that may make you drowsy or slow your actions. This includes slow or troubled breathing and death. Benzodiazepines include drugs like alprazolam, diazepam, and lorazepam. Benzodiazepines may be used to treat many health problems like anxiety, trouble sleeping, or seizures. If you have questions, talk with your doctor.
  • Many drugs interact with this drug and can raise the chance of side effects like deadly breathing problems. Talk with your doctor and pharmacist to make sure it is safe to use this drug with all of your drugs.
  • Do not take with alcohol or products that have alcohol. Unsafe and sometimes deadly effects may happen.
  • Get medical help right away if you feel very sleepy, very dizzy, or if you pass out. Caregivers or others need to get medical help right away if the patient does not respond, does not answer or react like normal, or will not wake up.
  • Very bad and sometimes deadly breathing problems have happened with this drug. Talk with the doctor.
  • Get medical help right away if you have slow breathing, shallow breathing, or trouble breathing.
  • This drug is not for use in children younger than 18 years of age. The benefits of taking this drug for a cough due to allergies, a cold, or other infection do not outweigh the risks in children. If your child has been given this drug or if you have any questions, talk with your child's doctor.

Serious side effects of Tussar-2

WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:

Other side effects of Tussar-2

All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away:

These are not all of the side effects that may occur. If you have questions about side effects, call your doctor. Call your doctor for medical advice about side effects.

You may report side effects to the FDA at 1-800-332-1088. You may also report side effects at

For Healthcare Professionals

Applies to codeine/guaifenesin/pseudoephedrine: oral liquid, oral tablet.


The more commonly expected adverse effects include nausea, vomiting, and dizziness.[Ref]

Nervous system


Frequency not reported: CNS depression, lightheadedness, dizziness, sedation, headache, convulsions, weakness


Frequency not reported: Restlessness, dizziness, weakness, headache, drowsiness, tremor[Ref]



Frequency not reported: Tachycardia, bradycardia, palpitation, faintness, syncope, orthostatic hypotension, circulatory depression


Frequency not reported: Tachycardia, palpitations, cardiac arrhythmias, hypertension, impaired circulation to the extremities, coronary artery spasm, chest pain[Ref]

Hypotension is rare and has been reported most frequently with high doses of codeine.

Pseudoephedrine causes vasoconstriction which generally does not produce hypertension, but may be problematic for patients with preexisting hypertension. Arrhythmias may be produced in predisposed patients. Rarely, pseudoephedrine has been reported to cause coronary artery spasm and chest pain.[Ref]



Frequency not reported: Nausea, vomiting, constipation, biliary tract spasm, increased colonic motility, toxic dilation


Frequency not reported: Abdominal pain (upper), diarrhea, nausea, vomiting


Frequency not reported: Nausea, vomiting, dry mouth, ischemic colitis[Ref]

Patients with chronic ulcerative colitis may experience increased colonic motility, while patients with acute ulcerative colitis have experienced toxic dilation with codeine use.[Ref]



Frequency not reported: Oliguria, urinary retention, antidiuretic effect


Frequency not reported: Urinary retention[Ref]



Frequency not reported: Pruritus, giant urticaria, angioneurotic edema, laryngeal edema


Frequency not reported: Hypersensitivity reactions (pruritus, urticaria)


Frequency not reported: Fixed drug eruptions[Ref]



Frequency not reported: Rash


Frequency not reported: Rash


Frequency not reported: Fixed drug eruption in the form of erythematous nodular patches, rash[Ref]



Frequency not reported: Visual disturbances


Frequency not reported: Angle-closure glaucoma



Frequency not reported: Euphoria, dysphoria, transient hallucination, disorientation


Frequency not reported: Hallucinations (particularly in children), anxiety, excitability, insomnia



Frequency not reported: Respiratory depression

Respiratory depression has been associated with antitussive use of codeine in young children. Respiratory depression and death have occurred in children who received codeine in the postoperative period following tonsillectomy and/or adenoidectomy. Further investigation has shown these patients to be ultra-rapid metabolizers of codeine. Children with obstructive sleep apnea who are treated with codeine appear to be particularly sensitive to the respiratory depressant effects of codeine.

More about Tussar-2 (codeine / guaifenesin / pseudoephedrine)

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1. Covington TR, eds., Lawson LC, Young LL (1993) "Handbook of Nonprescription Drugs." Washington, DC: American Pharmaceutical Association

2. de Groot AC, Conemans J (1986) "Allergic urticarial rash from oral codeine." Contact Dermatitis, 14, p. 209-14

3. (2001) "Product Information. Robitussin (guaifenesin)." Wyeth-Ayerst Laboratories

4. Gordon RD, Ballantine DM, Bachmann AW (1992) "Effects of repeated doses of pseudoephedrine on blood pressure and plasma catecholamines in normal subjects and in patients with phaeochromocytoma." Clin Exp Pharmacol Physiol, 19, p. 287-90

5. Mores N, Campia U, Navarra P, Cardillo C, Preziosi P (1999) "No cardiovascular effects of single-dose pseudoephedrine in patients with essential hypertension treated with beta-blockers." Eur J Clin Pharmacol, 55, p. 251-4

6. Gill ND, Shield A, Blazevich AJ, Zhou S, Weatherby RP (2000) "Muscular and cardiorespiratory effects of pseudoephedrine in human athletes." Br J Clin Pharmacol, 50, p. 205-13

7. (2022) "Product Information. Robitussin-DAC (codeine / guaifenesin / pseudoephedrine)." Apothecon Inc

8. Dowd J, Bailey D, Moussa K, Nair S, Doyle R, CulpepperMorgan JA (1999) "Ischemic colitis associated with pseudoephedrine: Four cases." Am J Gastroenterol, 94, p. 2430-4

9. Shelley WB, Shelley ED (1987) "Nonpigmenting fixed drug eruption as a distinctive reaction pattern: examples caused by sensitivity to pseudoephedrine hydrochloride and tetrahydrozoline." J Am Acad Dermatol, 17, p. 403-7

10. Tomb RR, Lepoittevin JP, Espinassouze F, Heid E, Foussereau J (1991) "Systemic contact dermatitis from pseudoephedrine." Contact Dermatitis, 24, p. 86-8

11. Camisa C (1988) "Fixed drug eruption due to pseudoephedrine." Cutis, 41, p. 339-40

12. Quan MB, Chow WC (1996) "Nonpigmenting fixed drug eruption after pseudoephedrine." Int J Dermatol, 35, p. 367-70

13. Vidal C, Prieto A, PerezCarral C, Armisen M (1998) "Nonpigmenting fixed drug eruption due to pseudoephedrine." Ann Allergy Asthma Immunol, 80, p. 309-10

14. Hunskaar S, Dragsund S (1985) "Scarlatiniform rash and urticaria due to codeine." Ann Allergy, 54, p. 240-1

15. Gonzalogarijo MA, Revengaarranz F (1996) "Fixed drug eruption due to codeine." Br J Dermatol, 135, p. 498-9

Further information

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

Some side effects may not be reported. You may report them to the FDA.