Promethazine HCl with Codeine Phosphate
This medication is a Schedule V drug.
Brand Name: Phenergan with Codeine
Generic Available
Common Dosage Forms:
Syrup (per 5 mL): 6.25 mg promethazine HCl and 10 mg codeine phosphate with 7% alcohol
FDA Indications/Dosages:
Temporary relief of coughs and upper respiratory symptoms associated with allergies or the common cold: Adults: One teaspoonful (5 mL) every 4-6 hours. Children (6-12 years old): ½ to 1 teaspoonful every 4-6 hours. Children (2-6 years old): ¼ to ½ teaspoonful every 4-6 hours.
Phenergan with Codeine is not recommended for children under 2 years of age.
Do not exceed the following dosage in 24 hours:
Adults and children over 6 years of age: 30 mL
2-6 years old weighing 18 kg: 9 mL
2-6 years old weighing 16 kg: 8 mL
2-6 years old weighing 14 kg: 7 mL
2-6 years old weighing 12 kg: 6 mL
Pharmacology/Pharmacokinetics: Promethazine competitively inhibits histamine at the H1 receptor site causing a spasmolytic and decongestant effect. Antihistamines will prevent, but not reverse, histamine mediated reactions. Codeine depresses the cough reflex center in the medulla oblongata. Therapeutic effects begin to occur 15 minutes after administration and lasts for about 3 hours. Peak effects are seen 45-60 minutes after administration.
Drug Interactions: Anticholinergics may decrease effects. CNS depression may increase with alcohol and other CNS depressants. Use with metrizamide may decrease seizure threshold. Barbiturates may decrease actions.
Contraindications/Precautions: Use is contraindicated in patients hypersensitive to this drug combination, other phenothiazines, and in patients with lower respiratory tract symptoms (including asthma). Use with caution in patients with narrow-angle glaucoma, coma, jaundice, sleep apnea, seizure disorders, stenosing peptic ulcers, pyloroduodenal obstruction, urinary bladder obstruction due to symptomatic prostatic hypertrophy and narrowing of the bladder neck, increased intracranial pressure, chronic respiratory disease, and in atopic children. Pregnancy Category C.
Adverse Effects: Drowsiness, constipation, nausea, vomiting, orthostatic hypotension, lightheadedness, and dizziness.
Patient Consultation:
May be taken with food or milk if GI upset occurs.
May cause drowsiness. Use caution while operating machinery or when mental alertness is required.
Avoid alcohol while taking this medication.
WARNING: This medication may be habit-forming.
Store in a cool, dry place away from sunlight and children.
Contact a physician if the above side effects are severe or persistent.
If a dose is missed, skip it and return to normal dosing schedule.