Codeine, Phenylephrine and Dexchlorpheniramine

  • Generic Name or Active Ingridient: Codeine
Drug Class: Codeine, Phenylephrine And Dexchlorpheniramine > Codeine > Opiate > Opioids > Opioid Agonist > Analgesic.


Your doctor may have prescribed codeine, phenylephrine and dexchlorpheniramine to treat your symptoms associated with a cold, upper respiratory infection or allergies. Symptoms include sinus congestion, cough, runny nose and sneezing. You can use this combination decongestant, antihistamine and cough suppressant preparation before going to bed, attending class or going to work.

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Other, off label uses for this medicine

Off-label use of this medication includes use as treatment for chronic coughs due to asthma, emphysema and smoking.

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Codeine, phenylephrine and dexchlorpheniramine preparations are sold under the brand name Vanacof CD. Each 5 ml teaspoon contains 10 mg of codeine, 1 mg of dexchlorpheniramine and 5 mg of phenylephrine. The typical adult dose is 5 ml to 10 ml, one to two teaspoons, every 4 to 6 hours. Do not exceed 60 ml in a 24-hour period. Children over the age of 12 years may take the adult dose. The usual dose for children aged six to eleven years is 2.5 ml to 5 ml (one-half teaspoon to one teaspoon) every 4 to 6 hours, not to exceed 30 ml daily. Do not administer codeine, phenylephrine and dexchlorpheniramine preparations to children under the age of six years. Your doctor probably prescribed codeine, phenylephrine and dexchlorpheniramine to be taken on a regular schedule rather than as needed to control symptoms. If you miss a dose and it is a long time before the next scheduled dose, take the missed dose as soon as possible. If it is nearly time to take another dose and you can tolerate the symptoms, skip the missed dose and resume your normal schedule. Do not take extra doses to make up for missed doses.

Contact the prescribing physician if your symptoms do not go away after five to seven days or if your symptoms get worse. Do not take more than the prescribed dose in an effort to control your symptoms - this may lead to dangerous overdose. Do not continue taking this medication after your healthcare provider recommends stopping.

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Codeine is an antitussive, which means it suppresses a cough. Codeine works by acting directly on the part of the brain responsible for the cough reflex; codeine makes your brain unaware of the need to cough. Phenylephrine is a decongestant that works by constricting blood vessels inside the lining of nasal passages to reduce the sensation of a stuffy nose. Dexchlorpheniramine is an antihistamine. It works by blocking natural histamines that cause itchy and watery eyes, runny nose and sneezing. More About How Codeine, Phenylephrine and Dexchlorpheniramine Works


Notify the prescribing physician and pharmacist filling the prescription about any allergies, especially if you are allergic to any active or inactive ingredient in codeine, phenylephrine and dexchlorpheniramine. Do not take this medication if you are allergic to any opioid, such as morphine or oxycodone. An allergic reaction is a serious medical emergency that could deteriorate into a life threatening situation without warning. Seek emergency assistance at the first sign of an allergic reaction. Symptoms of an allergic reaction include difficulty breathing, tightness in the chest, hives or swelling of the face, lips, or tongue.

You may not be able to take this medicine if you have a history of certain medical conditions, or the prescribing physician may change your dose of codeine, phenylephrine and dexchlorpheniramine. This medication may worsen your medical condition or interfere with treatment. Your illness may change the way codeine, phenylephrine and dexchlorpheniramine works for you. Tell your healthcare provider about any significant illnesses or conditions, including a recent head injury, severe drowsiness, brain tumor, or increased pressure in the brain. Notify your physician if you have a history of adrenal gland problems such as adrenal gland tumor, high or low blood pressure or liver problems. Talk with your healthcare provider about any heart problems, especially cor pulmonale, fast, slow, or irregular heartbeat, heart disease, low blood volume, blood vessel problems or if you have suffered a stroke. Your doctor should know if you have diabetes, glaucoma or thyroid problems.

Make sure your caregiver knows about a blockage of your stomach, bladder, or intestines. It is important your doctor is aware of recent stomach or bowel surgery or other stomach or bowel problems, such as constipation, diarrhea due to antibiotic use, inflammation or ulcers. Tell your physician about any trouble urinating, an enlarged prostate or other prostate problems, seizures or pancreas problems.

Your doctor may prescribe a different drug to treat your symptoms if you have history of asthma, sleep apnea, other breathing problems, especially slow or irregular breathing. Tell your physician if you have a chronic cough, lung problems such as chronic bronchitis or emphysema, COPD or if your cough occurs with large amounts of mucus.

It is especially important for the prescribing physician to know if you have a history of mental or mood problems, especially depression. Confide in your physician if you have a history of alcohol abuse, drug abuse, or suicidal thoughts or behavior. She may recommend a different medication if you have trouble sleeping, are in poor health or are very overweight.

This medication may make you dizzy or drowsy. Alcohol and other medicines may enhance this effect, including cold and allergy preparations, sedatives, antidepressants and pain killers. Do not operate heavy machinery or drive a car until you know how this medication affects you.

Do not take this medication with diet or appetite control medicines without the consent of the prescribing physician. Do not use this preparation to treat a cough with a lot of mucus. This medication may cause dizziness, light-headedness or even fainting. Hot weather, alcohol consumption, exercise or fever may worsen this effect. Sit or lie down at the first sign of these effects. To prevent these effects, stand up slowly from a chair. Sit at the edge of the bed for a few minutes before rising to a standing position. You may sunburn more easily when taking codeine, phenylephrine and dexchlorpheniramine. Avoid tanning beds, sunlamps and exposure to direct sun while taking this medication. Use sunscreen or wear protective clothing whenever you go outside for a long time.

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Do not use if you have: severe high blood pressure, severe heart blood vessel disease, rapid heartbeat, severe heart problems, stomach ulcer, narrow-angle glaucoma, or difficulty urinating, or you are having an asthma attack. The Food and Drug Administration, or FDA, classifies drugs according to the potential harm they pose to the consumer or to an unborn child. The FDA classifies this medicine as a pregnancy Category C; researchers still do not know if taking this drug during pregnancy will harm an unborn child. Some components of this drug pass into breast milk and onto your nursing child. Never take this medication while breastfeeding your baby. Tell the prescribing physician if you are pregnant or plan to become pregnant while using this medication. Notify your healthcare provider if you become pregnant while taking this drug.

Do not stop taking this medication abruptly unless directed to do so by a physician. Quitting suddenly might cause uncomfortable, flu-like withdrawal symptoms. If you feel ill when you do not take this medication, try weaning yourself from this drug by taking increasingly smaller doses further apart. Confide in your doctor or seek out a rehabilitation specialist if withdrawal symptoms prevent you from quitting this medication.

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Drug Interactions

Codeine, phenylephrine and dexchlorpheniramine may interact with other medications in unsafe or unfavorable ways. Give a list of all your medications to the prescribing physician and to the pharmacist filling your prescription. Include all prescriptions, over-the-counter medications and herbal remedies in your list. Some drugs are known to interact with codeine, phenylephrine and dexchlorpheniramine. Taking codeine, phenylephrine and dexchlorpheniramine preparations with anticholinergics, especially scopolamine, are not recommended because a serious bowel problem known as paralytic ileus may occur. Taking codeine, phenylephrine and dexchlorpheniramine with Digoxin or droxidopa increases your risk of irregular heartbeat or heart attack. Some medicines increase the risk for side effects associated with codeine, phenylephrine and dexchlorpheniramine. These drugs include beta-blockers such as propranolol), COMT inhibitors, cimetidine, furazolidone, HIV protease inhibitors and MAOIs, especially phenelzine. Muscle relaxants, opioid analgesics such as hydrocodone, phenothiazines, GHB and tricyclic antidepressants such as amitriptyline also increase the risk for side effects associated with codeine, phenylephrine and dexchlorpheniramine. Codeine, phenylephrine and dexchlorpheniramine increases the side effects of bromocriptine and hydrantoins. Codeine, phenylephrine and dexchlorpheniramine may decrease the effectiveness of guanadrel, guanethidine, mecamylamine, methyldopa and reserpine.

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Side effects

Some patients report side effects when taking codeine, phenylephrine and dexchlorpheniramine. Most of the common side effects are not serious. Contact your doctor if these common side effects become intolerable or do not go away on their own.

Common side effects include:

  • Constipation.
  • Diarrhea.
  • Dizziness or Drowsiness.
  • Dry Mouth, Nose or Throat.
  • Excitability.
  • Headache.
  • Loss of Appetite.
  • Nausea or Vomiting.
  • Nervousness or Anxiety.
  • Trouble Sleeping.
  • Upset Stomach.
  • Weakness.

Some side effects can be serious, even life threatening. Seek immediate medical care if you experience serious side effects, such as:

  • Confusion.
  • Difficulty Urinating or Inability To Urinate.
  • Fast or Irregular Heartbeat.
  • Hallucinations.
  • Mental or Mood Changes.
  • Persistent Trouble Sleeping.
  • Restlessness.
  • Seizures.
  • Severe Dizziness, Lightheadedness or Headache.
  • Severe Drowsiness.
  • Tremor.
  • Unusual Bruising or Bleeding.
  • Vision Changes or Blurred Vision.

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Drug overdose is a very serious, potentially fatal medical emergency. If you think you or someone you know has taken an overdose of drugs, contact poison control center at 1-800-222-1222 or go to the emergency room. Overdose symptoms include:

  • Blurred Vision.
  • Cold and Clammy Skin.
  • Coma.
  • Confusion.
  • Hallucinations.
  • Seizures.
  • Severe Dizziness, Lightheadedness or Headache.
  • Severe Drowsiness.
  • Unusually Fast, Slow or Irregular Heartbeat.
  • Vomiting.

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To abuse drugs means to use them outside the recommended guidelines established by your physician. Drug abuse includes using drugs for recreational purposes and continuing to use a drug after a doctor has suggested you stop using it. Codeine is a favorite among drug abusers because of the way codeine gets them high.

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When your body becomes dependent on a drug, you need to continue taking the drug to feel good. If you stop taking the drug, you experience withdrawal symptoms. Withdrawal symptoms are a natural physiologic response to the changing chemistry within your body. Experiencing withdrawal symptoms does not necessarily indicate criminal drug use - some people feel withdrawal symptoms after receiving pain killers in the hospital. A person with a physical dependence on drugs may feel withdrawal symptoms when he stops using the drug but he will not crave the drug unless he makes the cognitive connection between the withdrawal symptoms and the drug. Withdrawal symptoms include anxiety, irregular heartbeat, irritability, restlessness, trouble sleeping, and unusual sweating.


Drug dependence is a complex condition, frequently requiring the help of highly trained rehabilitation specialists to overcome. The most effective rehabilitative treatment programs address each aspect of the complicated syndrome of drug dependence, including overcoming withdrawal symptoms, cleansing the drug from your body and addressing any social issues that contribute to drug dependence. During the first phase of rehabilitation, physicians administer medication to detoxify and cleanse your body while easing your withdrawal symptoms. Once physically stabilized, you may choose to participate in a counseling program or other social services to address any issues that lead to or is the result of your dependence on drugs, such as family problems or legal issues. Rapid detox is state-of-the-art, humane and extremely effective way to overcome withdrawal. During rapid detox, specially trained physicians administer anesthesia and sedatives along with detoxification medications. You sleep through the withdrawal process, unaware of the unpleasant withdrawal symptoms. When you awaken, you will have no memory of the withdrawal process. Learn More About Codeine, Phenylephrine and Dexchlorpheniramine Detoxification Programs


Keep codeine, phenylephrine and dexchlorpheniramine at temperatures between 59 and 86 degrees Fahrenheit, away from excessive heat, moisture and light. Do not store this drug in your bathroom. Put this medication out of the reach of children and pets. Do not allow adults to take this medication by accident or on purpose. Read More About Storing Codeine, Phenylephrine and Dexchlorpheniramine