Codeine and Promethazine

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

Uses

Your doctor prescribed codeine and promethazine to treat your symptoms associated with the common cold or allergy symptoms such as coughing, sneezing and runny nose. You can use this medication to ease symptoms enough to get a good night's sleep, attend class or go to work. Your physician may recommend codeine and promethazine for other uses. Learn More About Codeine and Promethazine Uses

Administration/Dosage

Codeine and promethazine come in a combined liquid form, or syrup. Brand name preparations include Codeine Phosphate-Promethazine HCl, Promethazine HCl and Codeine Phosphate, Promethazine with Codeine, Phenergan with Codeine and Promethazine HCl with Codeine.

Each 5 ml teaspoon generic preparation of codeine and promethazine contains 10 mg of codeine and 6.25 mg of promethazine. This preparation also contains 7 percent alcohol and inactive ingredients including a pleasant pineapple flavoring.

The typical adult dose is one 5 ml teaspoon every four to six hours as needed, not to exceed 30 ml in a 24-hour period. Children over the age of twelve years can take an adult dose. The usual dose for children between the ages of six and twelve years is 2.5 ml, or half a teaspoon, every four to six hours as needed, not to exceed 30 ml daily. Codeine and promethazine is not recommended for children under the age of six years.

If you miss a dose, take the missed dose as soon as possible, providing it is not almost time to take another dose, in which case you should just wait to resume your normal schedule. Never take more than one dose at a time in an effort to catch up.

Tell your doctor if the prescribed dose stops working for you. Do not increase the dosage on your own or take it more frequently than recommended. Notify the prescribing physician if your medicine does not provide complete coverage for your symptoms. This same physician may adjust the dosages or switch medications.

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Action

Codeine and promethazine combine a cough suppressant and an antihistamine to provide relief from coughing, sneezing and runny nose. When a foreign substance, like a virus or allergen, enters your respiratory system, your body takes action. If an object or mucus irritates your lungs, your nervous system sends a message to your brain, which immediately responds by issuing a command for a cough forceful enough to blast the irritant from your respiratory tract. Codeine acts directly on the part of your brain in charge of the cough reflex - codeine makes your brain unaware of the need to cough. For this reason, codeine should not be used when you need to clear excessive mucus from your lungs. Promethazine is a decongestant that works by constricting the blood vessels inside the lining of your nasal passages to reduce inflammation in a way that allows air to move through your nose more freely. In animal studies, researchers noted the cough-suppressing action of codeine takes effect about 15 minutes after oral administration with peak effectiveness reached 45 minutes to an hour after ingestion. The effects seem to wear off after about three hours. The effects of promethazine are apparent within 15 minutes of ingestion and typically last four to six hours, although promethazine may provide relief from symptoms up to twelve hours.

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Precautions

Do not take codeine and promethazine preparations if you are allergic to either of the main ingredients or to any of the inactive ingredients. Do not take codeine if you are allergic to other opioids, like morphine. Tell the prescribing physician and pharmacist about any drug allergies. An allergic reaction is a serious medical condition that can deteriorate rapidly into a life-or-death emergency. Contact your doctor or go to the emergency room immediately when you first notice symptoms of an allergic reaction. Symptoms of an allergic reaction include hives, difficulty breathing and swelling of the face, tongue, lips or throat.

You should not take codeine and promethazine preparations if you have had certain medical conditions. This medication may worsen your condition or interfere with treatment. Additionally, your medical condition may change the way codeine and promethazine work.

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

  • Epilepsy or Other Seizure Disorder.
  • Asthma, COPD, Sleep Apnea or Other Breathing Disorders.
  • Glaucoma.
  • Stomach Ulcer.
  • Digestive Obstruction.
  • A Weak Immune System.
  • Addison's Disease.
  • Enlarged Prostate.
  • Urination Problems.
  • High Blood Pressure.
  • Low Blood Pressure.
  • Heart Disease.
  • Liver Disease.
  • Kidney Disease.
  • Underactive Thyroid.
  • Gallbladder Disease.
  • A Head Injury.
  • Brain Tumor.

Codeine and promethazine can make you dizzy or drowsy, or interfere with your ability to make decisions. Avoid operating heavy machinery, driving a car or engaging in risky behavior until you know how codeine and promethazine preparations affect you. Alcohol and other medications that make you sleepy, like other cold and allergy drugs, other pain medications, muscle relaxers and anti-depressants can enhance this effect.

Codeine is habit-forming. Drug habits can develop into physical and mental dependence on or even addiction to that drug. Symptoms of a developing 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 watch the clock and take the dose at the earliest possible moment. You might even seek ways to sneak in refills and extra doses.

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Warnings

Do not use codeine and promethazine if you have asthma or other lung diseases. This preparation may cause respiratory depression, which means your airflow is too inadequate to allow for the proper exchange of oxygen and carbon dioxide. A person with respiratory depression exhibits slow and shallow breathing.

The Food and Drug Administration, or FDA, classifies substances according to the potential harm they pose to the consumer or to an 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 passes readily into breast milk and onto your nursing child; do not take this medication while breastfeeding your baby. Tell the prescribing physician if you are pregnant or plan to become pregnant while taking this medication. Contact your doctor immediately if you become pregnant while using codeine.

Do not stop taking this medication suddenly unless directed to do so by a physician. Quitting suddenly may cause you to experience unpleasant withdrawal symptoms. Wean yourself from this drug by taking increasingly smaller doses further apart. Confide in your doctor or seek out a qualified rehabilitation specialist if withdrawal symptoms prevent you from quitting this medication.

More Warnings About Using Codeine and Promethazine

Drug Interactions

Codeine and promethazine preparations can interact with other medications in unsafe or unfavorable ways. Give your doctor and pharmacist a complete list of all prescription medications, over-the-counter preparations and herbal remedies. Do not start or stop using any medication or change the dosage of any drug, including over-the-counter and herbal remedies, without consulting with the prescribing physician.

Tell your doctor if you are taking:

  • Sedatives or Anxiety Medications.
  • Antidepressants.
  • Narcotic Pain Medicines.
  • Phenobarbital, Amobarbital or Secobarbinal.
  • MAO Inhibitors.

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Side effects

You may experience side effects from using this medication. Contact your doctor if your common side effects become intolerable or if they don't go away on their own.

Common side effects include:

  • Dizziness, Drowsiness, Sleepiness.
  • Feeling Restless, Nervous, or Anxious.
  • Blurred Vision.
  • Ringing In Your Ears.
  • Constipation.
  • Mild Nausea or Vomiting.
  • Warmth, Redness, or Tingly Feeling under Your Skin.
  • Sleep Problems, Insomnia.
  • Increased Sweating.
  • Dry Mouth.
  • Mild Skin Rash.

Contact your doctor or local emergency room if you experience serious side effects. These side effects may become life-threatening.

Serious side effects include:

  • Restless Muscle Movements in Your Eyes, Tongue, Jaw, or Neck.
  • Tremor or Uncontrolled Shaking.
  • Shallow Breathing.
  • Slow Heartbeat.
  • Feeling Like You Might Pass Out.
  • Yellowing of the Skin or Eyes.
  • Confusion.
  • Agitation.
  • Hallucinations, Unusual Thoughts or Behavior.
  • Seizure.
  • Urinating Less Than Usual or Not At All.
  • Very Stiff, Rigid Muscles.
  • High Fever.
  • Sweating.
  • Fast or Uneven Heartbeats.
  • Fainting.

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Overdose

Deaths from drug overdoses have tripled since 1990, according to the Centers for Disease Control and Prevention, or CDC. In 2008, more people died from overdoses of prescription opioids than from cocaine and heroin combined. Drug 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 codeine and promethazine or any other medication, contact the poison control center at 1-800-222-1222 or go to the emergency room immediately.

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Abuse

The U.S. Drug Enforcement Agency has classified codeine and promethazine preparations as Schedule V drugs, which means they have a low potential for abuse in comparison to all other controlled substances. Drug abuse means to habitually take addictive or illegal drugs for recreational purposes or by continuing to take a drug after your physician has discontinued the prescription. Drug abuse is also characterized by taking large doses of a drug or taking it more often than prescribed. Codeine is often the target of recreational drug abusers because it gets them high. Drug abusers get codeine by presenting bogus prescriptions to pharmacies, "doctor shopping" or by stealing it. Codeine is also widely available on the streets.

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Withdrawal

If you take large doses of codeine, phenylephrine and pyrilamine, you may become physically and mentally dependent on codeine. Physical dependence on drugs means your body needs that chemical to feel normal; you feel unpleasant withdrawal symptoms if you do not take the drug. Physicians and rehabilitations specialists recognize withdrawal symptoms as the predictable, normal physiological response to taking large doses of opioids or taking them for a long time. Withdrawal symptoms are not necessarily a sign of criminal drug abuse - you could experience withdrawal symptoms after taking drugs given to you in the hospital or as part of treatment for a chronic illness. Tell your doctor if your withdrawal symptoms prevent you from quitting this medication.

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Detox

Dependence on drugs is a complex condition. Successful rehabilitative treatment addresses 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 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 physically stabilized, you may participate in a counseling program or other social services to increase your chances of success. Rapid detox is state-of-the-art rehabilitation care, considered by some to be the most humane and 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 and Promethazine Detoxification Programs

Storage

Store codeine and promethazine preparations at room temperature, away from excessive heat, light and moisture. Keep this and all drugs out of the reach of children and pets. Make sure adults do not take this medication, either by accident or on purpose. Account for all doses; codeine is frequently a drug of choice for recreational drug users.

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Miscellaneous information

Codeine is one of the naturally occurring phenanthrene alkaloids of opium derived from the opium poppy. Pharmacologists classify codeine as a narcotic analgesic. The chemical structure, uses and affects of codeine are similar to morphine. Codeine is a less effective antitussive than morphine but the effects associated with codeine are milder than morphine; codeine causes less sedation, respiratory depression, gastrointestinal and urinary problems. Miscellaneous Information About Codeine and Promethazine