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All about: codeine, phenylephrine, and promethazine

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Generic Name: codeine, phenylephrine, and promethazine (KOE deen, phen ill EFF rin, and pro METH ah zeen)
Brand Names: M-Phen, Phenergan VC with Codeine

What is codeine, phenylephrine, and promethazine?

Codeine is a narcotic. It is a pain reliever and a cough suppressant.

Phenylephrine is a decongestant. It works by constricting (shrinking) blood vessels (veins and arteries) in your body. Constriction of blood vessels in your sinuses and nose decreases congestion.

Promethazine is an antihistamine. It blocks the effects of the naturally occurring chemical histamine in your body.

Codeine, phenylephrine, and promethazine is used to treat symptoms such as itching, runny nose; sneezing; congestion; and coughing due to allergies or the common cold.

Codeine, phenylephrine, and promethazine may also be used for purposes other than those listed in this medication guide.

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

Use caution when driving, operating machinery, or performing other hazardous activities. Codeine, phenylephrine, and promethazine may cause dizziness or drowsiness. If you experience dizziness or drowsiness, avoid these activities. Use alcohol cautiously. Alcohol may increase drowsiness and dizziness while taking codeine, phenylephrine, and promethazine.

Who should not take codeine, phenylephrine, and promethazine?

Do not take codeine, phenylephrine, and promethazine if you have taken a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), phenelzine (Nardil), or tranylcypromine (Parnate) in the last 14 days. A very dangerous drug interaction could occur, leading to serious side effects.

Before taking codeine, phenylephrine, and promethazine, tell your doctor if you have

  • epilepsy or another seizure disorder;

  • been diagnosed with sleep apnea (periods of not breathing during sleep);

  • thyroid problems;

  • asthma;

  • gallbladder disease;

  • a head injury;

  • Addison's disease;

  • diabetes;

  • glaucoma;

  • an ulcer or an obstruction in the stomach;

  • bladder problems or difficulty urinating;

  • an enlarged prostate;
  • high blood pressure, irregular heartbeats, or any type of heart disease;

  • kidney problems; or
  • liver problems.

You may not be able to take codeine, phenylephrine, and promethazine, or you may require a dosage adjustment or special monitoring during treatment if you have any of the conditions listed above.

Codeine, phenylephrine, and promethazine is in the FDA pregnancy category C. This means that it is not known whether codeine, phenylephrine, and promethazine will harm an unborn baby. Do not take codeine, phenylephrine, and promethazine without first talking to your doctor if you are pregnant or if you are planning a pregnancy. It is not known whether codeine, phenylephrine, and promethazine passes into breast milk. Do not take codeine, phenylephrine, and promethazine without first talking to your doctor if you are breast-feeding a baby. If you are over 60 years of age, you may be more likely to experience side effects from codeine, phenylephrine, and promethazine. You may require a lower dose of this medication. The safety of codeine, phenylephrine, and promethazine for children younger than 2 years of age has not been established.

How should I take codeine, phenylephrine, and promethazine?

Take codeine, phenylephrine, and promethazine exactly as directed by your doctor. If you do not understand the directions on your prescription bottle, ask your pharmacist, nurse, or doctor to explain the instructions to you.

Codeine, phenylephrine, and promethazine can be taken with or without food.

To ensure that you get a correct dose, measure the liquid form of codeine, phenylephrine, and promethazine with a special dose-measuring spoon or cup, not with a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist where you can get one.

Store codeine, phenylephrine, and promethazine at room temperature away from moisture and heat.

What happens if I miss a dose?

Take the missed dose as soon as you remember. However, if it is almost time for the next dose, skip the missed dose and take only the next regularly scheduled dose. Do not take a double dose of this medication unless otherwise directed by your doctor.

What happens if I overdose?

Seek emergency medical attention.

Symptoms of a codeine, phenylephrine, and promethazine overdose include severe drowsiness, dizziness, headache, seizures, dry mouth, cold and clammy skin, flushing, nausea, vomiting, difficulty or decreased breathing, and unconsciousness.

What should I avoid while taking codeine, phenylephrine, and promethazine?

Use caution when driving, operating machinery, or performing other hazardous activities. Codeine, phenylephrine, and promethazine may cause dizziness or drowsiness. If you experience dizziness or drowsiness, avoid these activities. Use alcohol cautiously. Alcohol may increase drowsiness and dizziness while taking codeine, phenylephrine, and promethazine. Avoid prolonged exposure to sunlight. Codeine, phenylephrine, and promethazine may increase the sensitivity of your skin to sunlight. Use a sunscreen and wear protective clothing when exposure to the sun is unavoidable.

What are the possible side effects of codeine, phenylephrine, and promethazine?

If you experience any of the following serious side effects, stop taking codeine, phenylephrine, and promethazine and seek emergency medical attention or contact your doctor immediately:
  • an allergic reaction (difficulty breathing; closing of your throat; swelling of your lips, tongue, or face; or hives);

  • uncontrollable movements of your eyes, lips, tongue, face, arms, or legs; or

  • confusion, hallucinations, or unusual behavior.

Other, less serious side effects may be more likely to occur. Continue to take codeine, phenylephrine, and promethazine and talk to your doctor if you experience

  • dizziness, drowsiness, or sleepiness;

  • restlessness or irritability;

  • blurred vision;

  • constipation;

  • dry mouth, nausea, vomiting, or decreased appetite;

  • muscle twitches;

  • sweating;

  • itching;

  • decreased urination;

  • increased sensitivity to sunlight.

Codeine may be habit forming.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

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

Do not take codeine, phenylephrine, and promethazine if you have taken a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), phenelzine (Nardil), or tranylcypromine (Parnate) in the last 14 days. A very dangerous drug interaction could occur, leading to serious side effects.

Codeine, phenylephrine, and promethazine may increase the effects of other drugs that cause drowsiness, including antidepressants, alcohol, sedatives (used to treat insomnia), pain relievers, anxiety medicines, and muscle relaxants. Tell your doctor about all medicines that you are taking, and do not take any medicine unless your doctor approves.

Drugs other than those listed here may also interact with codeine, phenylephrine, and promethazine. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines.

Where can I get more information?

  • Your pharmacist has more information about codeine, phenylephrine, and promethazine written for health professionals that you may read.

What does my medicine look like?

Codeine, phenylephrine, and promethazine is available with a prescription generically and under the brand names M-Phen and Phenergan VC with Codeine. Other brand or generic formulations may also be available. Ask your pharmacist any questions you have about this medication, especially if it is new to you.

  • 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
  • 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 1996-2006 Cerner Multum, Inc. Version: 2.03. Revision Date: 2/13/04 4:04:24 PM.

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