Codeine, Phenylephrine and Pyrilamine

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


Physicians usually prescribe codeine, phenylephrine and pyrilamine to treat symptoms associated with the common cold, allergies or the flu. Symptoms include cough, sneezing and runny nose, watery and itchy eyes. You use this medicine to help you sleep through the night, go to work or attend class without suffering annoying and distracting symptoms. Learn More About Codeine, Phenylephrine and Pyrilamine Uses


Codeine, phenylephrine and pyrilamine preparations come in a liquid form otherwise known as syrup. Brand name forms include Pro-Red AC and Zotex-C. Each preparation contains differing amounts of codeine, phenylephrine and pyrilamine. Each 5 ml teaspoon of Pro-Red AC contains 5 mg of codeine, 5 mg of phenylephrine and 8.33 mg of pyrilamine while Zotex-C contains 10 mg of codeine and 5 mg each of phenylephrine and pyrilamine.

Adult dosage for both medicines is one to two 5 ml teaspoonfuls every 4 to 6 hours. Do not exceed 12 teaspoonfuls of Zotex-C or four doses of Pro-Red AC in a 24-hour period. Children 12 years and older may take adult doses.

Zotex-C dosage for children aged 6 to 12 is one half to one teaspoon every four to six hours, not to exceed 12 teaspoons in a 24-hour period. Children between the ages of 6 and 12 may use one teaspoon of Pro-Red AC every six hours, not to exceed four doses in a 24-hour period. Neither medication is recommended for use in children younger than six years old.

Pediatricians should use extreme caution when prescribing codeine, phenylephrine and pyrilamine syrup to children. Researchers have not yet confirmed the safety and effectiveness of this medication for young patients.

Physicians should use extra care when prescribing codeine, phenylephrine and pyrilamine to elderly patients. Older people are more sensitive to the effects of codeine, phenylephrine and pyrilamine, especially breathing problems and issues with drowsiness.

Take codeine, phenylephrine and pyrilamine with or without food. Take this drug with food if this medication upsets your stomach.

Use a measuring device approved for dosing medication. Do not use a household teaspoon, which is an inaccurate measuring device. You can purchase an inexpensive measuring spoon at your local pharmacy.

If your healthcare provider suggested you take this medicine on a strict schedule and you miss a dose, take the missing dose as soon as you remember. If it is nearly time to take another dose, skip the missed dose and resume your normal schedule. Never take more than the prescribed dose in an effort to catch up.

Notify your physician if the prescribed dose stops working for you or does not adequately control your symptoms. Your doctor may adjust the dosages or switch medications.

Talk with the prescribing physician if you symptoms do not improve after seven days. Notify your physician if you develop a high fever or persistent headache while taking codeine, phenylephrine and pyrilamine syrup.

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Codeine, phenylephrine and pyrilamine combine a cough suppressant, antihistamine and decongestant to provide relief from several upper respiratory symptoms. When a foreign substance, like a virus or allergen, enters your respiratory system, your body takes a variety of defensive actions. If an object or mucus irritates your lungs, your nervous system sends a message to your brain, which responds by issuing a command for a forceful cough. Codeine acts directly on the part of your brain responsible for the cough reflex - codeine makes your brain unaware of the need to cough. Phenylephrine is a decongestant. It works by constricting the blood vessels inside the lining of your nasal passages. Pyrilamine is an antihistamine that works by blocking the production of histamines, which are natural substances that cause symptoms like sneezing, runny nose and itchy, watery eyes.

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Do not use codeine, phenylephrine and pyrilamine preparations if you allergic to any component in the medication or if you are allergic to other opioids, like morphine. An allergic reaction is a very serious medical condition that requires immediate medical care. Seek professional assistance at the first symptom of an allergic reaction - a person's condition can deteriorate rapidly without warning.

Symptoms of an allergic reaction include rash, hives and difficulty breathing. You might also experience tightness in the chest, swelling of the mouth, face, lips or tongue.

Tell the prescribing physician about any significant medical conditions. She may change your dosage or recommend a different drug if you have suffered from certain maladies. Codeine, phenylephrine and pyrilamine may worsen these conditions or interfere with the treatment of those diseases. Your medical condition might also change the way codeine, phenylephrine and pyrilamine affects your body.

Tell your physician about any significant illnesses or conditions, including:

  • History of Drug or Alcohol Abuse.
  • History of Suicidal Thoughts or Behavior.
  • Increased Cranial Pressure or Brain Tumor.

Codeine, phenylephrine and pyrilamine syrup may make you drowsy or dizzy. Do not operate heavy machinery or engage in risky behavior until you know how this medication affects you. Drinking alcohol or taking other medications that make you dizzy or drowsy, such as tranquilizers and sedatives, may enhance this effect.

Codeine is habit-forming. Developing a drug habit increases your risk for growing physically dependent on or even addicted to that drug. Symptoms of a drug habit include taking the drug even when you no longer need it or after the prescribing physician has recommended you stop using it. You may feel irritable or agitated when it is almost time to take another dose; you find yourself watching the clock and taking the dose at the earliest possible moment. You might even seek ways to sneak in refills and extra doses.

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Do not take codeine, phenylephrine and pyrilamine if you have diarrhea associated with antibiotic use or from a bacterial infection, like that caused by eating or drinking contaminated food or water.

Do not take codeine, phenylephrine and pyrilamine if you have severe high blood pressure, severe heart problems, rapid heartbeat or severe heart blood vessel disease.

The Food and Drug Administration, or FDA, classifies drugs according to the potential harm they pose to you or your unborn child. The FDA classifies codeine as a pregnancy Category C, which means scientists have not yet determined whether taking this drug during pregnancy will harm an unborn child. Codeine does readily pass into breast milk and onto your nursing child; do not take codeine while breastfeeding your baby. Tell your doctor if you are pregnant or plan to become pregnant while taking this medication. Call your physician if you become pregnant while using this drug.

Do not stop taking this medication unless directed to do so by a physician. Sudden cessation may result in unpleasant withdrawal symptoms. Wean yourself from codeine, phenylephrine and pyrilamine syrup by taking smaller doses further apart. Talk with your doctor or rehabilitation specialist if withdrawal symptoms prevent you from weaning yourself from this medication.

More Warnings About Using Codeine, Phenylephrine and Pyrilamine

Drug Interactions

Codeine, phenylephrine and pyrilamine syrup may interact with other drugs in dangerous or adverse ways. Give the prescribing physician and pharmacist a complete list of all your medications, including prescriptions, over-the-counter preparations and herbal remedies. This is especially important if you see more than one physician or have your prescriptions filled at more than one pharmacy. Do not start, stop or change the way you take any medication, including over-the-counter and herbal remedies, without consulting your healthcare provider.

Do not take codeine, phenylephrine and pyrilamine if you have taken MAO inhibitors in the past 14 days. Taking this drug while MAO inhibitors are still in your system may cause serious, even fatal, drug interactions. MAO inhibitors are typically prescribed to treat depression or Parkinson's. If you are unsure if you have taken MAO inhibitors, review a list of your medications with your prescribing physician or pharmacist.

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Side effects

Some patients have reported side effects after taking codeine, phenylephrine and pyrilamine. Telephone the prescribing physician if you cannot tolerate these side effects or if they don't go away on their own.

Common side effects include:

  • Constipation.
  • Dizziness.
  • Drowsiness.
  • Dry Mouth, Throat or Nose.
  • Excitement.
  • Nausea.
  • Stomach Upset.
  • Thickening or Mucus in Nose or Throat.

Seek medical attention right away if you experience these serious side effects:

  • Difficulty Urinating.
  • Fast or Irregular Heartbeat.
  • Flushing or Redness of Your Face.

Learn More About Codeine, Phenylephrine and Pyrilamine Side Effects


According to the Centers for Disease Control and Prevention, or CDC, deaths from drug overdoses have tripled since 1990. In 2008, more people died from overdoses of narcotics than cocaine and heroin combined. Overdose is a serious medical condition that can rapidly deteriorate into a life-or-death emergency. If you suspect that you or someone you know has taken an overdose of this or any other medication, contact the poison control center at 1-800-222-1222 or go to the emergency room immediately. Overdose symptoms include:

  • Agitation.
  • Coma.
  • Confusion.
  • Deep Sleep or Loss of Consciousness.
  • Difficulty Breathing.
  • Diminished Mental Alertness.
  • Hallucinations.
  • Hot or Cold Skin.
  • Large and Unchanging Pupils.
  • Sedation.
  • Seizures.
  • Shaking.
  • Sleeplessness.
  • Slowed Breathing.
  • Slow Heartbeat.

Learn More About Codeine, Phenylephrine and Pyrilamine Overdose


To abuse drugs means to habitually take addictive or illegal drugs in a way they were not intended to be used. You abuse drugs when you take them recreational purposes or by continuing to take medication after your physician has discontinued the prescription. You can also abuse drugs by taking large doses of a drug or taking it more often than prescribed. Codeine is a favorite amongst recreational drug abusers because of the sense of euphoria codeine provides. Abusers get this drug through many illicit channels, including submitting phony prescriptions to pharmacies, visiting multiple doctors or by stealing drugs from friends, family members and strangers. Codeine is also widely available on the street.

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Everyone experiences withdrawal symptoms in a slightly different way; withdrawal is more severe for some than for others. You may be able to quit taking this drug on your own, or severe withdrawal symptoms may prevent you from quitting without the assistance of rehabilitation specialists. Confide in your healthcare provider if severe withdrawal symptoms prevent you from quitting this drug. Withdrawal symptoms include:

  • Anxiety.
  • Diarrhea.
  • Fever.
  • Runny Nose or Sneezing.
  • Goose Bumps and Abnormal Skin Sensations.
  • Nausea and Vomiting.
  • Pain.
  • Rigid Muscles.
  • Seeing, Hearing or Feeling Things That Are Not There.
  • Shivering or Tremors.
  • Sweating.
  • Trouble Sleeping.

Learn More About Codeine, Phenylephrine and Pyrilamine Withdrawal


Rehabilitation is a complex procedure designed to address the complicated condition of drug dependence and withdrawal. First, you must overcome withdrawal symptoms, cleanse the drug from your body and then address any social issues that may have contributed to your dependence on codeine. During rehabilitation, specialists will give your medication to detoxify and cleanse your body while easing your withdrawal symptoms. Once you are physically stabilized, you may wish to participate in a counseling program or other social services to increase your chances of successfully quitting codeine. Rapid detox is state-of-the-art rehabilitation care. Some consider it the most humane way to overcome withdrawal. During rapid detox, physicians administer anesthesia and sedatives along with detoxification medications so that you sleep through the withdrawal process, unaware of the unpleasant withdrawal symptoms. When you awaken, you will have no memory of any physical discomfort associated with codeine withdrawal. Learn More About Codeine, Phenylephrine and Pyrilamine Detoxification Programs


Keep codeine, phenylephrine and pyrilamine syrup at room temperature, between 59 and 86 degrees Fahrenheit. Store away from excessive heat, light and moisture; do not keep this medication in your bathroom. Put this drug out of the reach of children and pets. Make sure adults do not take this medication by accident or on purpose; preparations containing codeine are a favorite among drug abusers. To discourage theft, do not tell anyone except your doctor, pharmacist and healthcare provider that you have this drug in your home.

Read More About Storing Codeine, Phenylephrine and Pyrilamine