Codeine, Pseudoephedrine and Chlorcyclizine

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

Uses

Doctors prescribe codeine, pseudoephedrine and chlorcyclizine preparations to treat symptoms associated with the common cold, allergies or the flu. Symptoms include cough, runny nose, watery and itchy eyes, stuffy nose and sneezing. Use codeine, pseudoephedrine and chlorcyclizine to relieve symptoms so you can sleep through the night, go to work or school. Learn More About Codeine, Pseudoephedrine and Chlorcyclizine Uses

Administration/Dosage

Codeine, pseudoephedrine and chlorcyclizine are available in a combined liquid form under the brand name Notuss-NXD. Every 5 ml teaspoon of this preparation contains 10 mg of codeine phosphate, 30 mg of pseudoephedrine hydrochloride and 9.375 mg of chlorcyclizine hydrochloride. Inactive ingredients include a pleasant berry flavoring. This preparation does not contain alcohol or dyes.

The typical adult dosage for individuals over the age of twelve is 10 ml, or two teaspoons, every six to eight hours as needed to relieve symptoms. Do not exceed 40 ml in a 24-hour period. Do not take more than the prescribed dose or take it more often than recommended.

Consult with your pediatrician before giving codeine, pseudoephedrine and chlorcyclizine to a child between the ages of six and twelve years. Do not administer codeine, pseudoephedrine and chlorcyclizine to a child under the age of six years unless directed to do so by a pediatrician. Misuse of cough and cold preparations may cause death in very young children.

Doctors usually prescribe this medication to be taken only when you need to control symptoms, rather than on a schedule, so you don't need to be concerned about missed doses. If your physician has 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 one dose at a time in an effort to catch up.

Tell your doctor if the prescribed dose stops working for you or does not provide complete coverage for your symptoms. Your physician may adjust the dosages or switch medications.

Do not take codeine, pseudoephedrine and chlorcyclizine for more than seven days in a row. Consult with your physician if your symptoms do not improve within one week. Talk with your doctor if you develop a fever with a headache or skin rash.

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Action

Codeine, pseudoephedrine and chlorcyclizine work in different ways to relieve symptoms associated with allergies, a cold or the flu. Codeine works directly on the part of the brain responsible for the cough reflex, rendering your brain unaware of the need to cough. Pseudoephedrine is a decongestant - it shrinks blood vessels in the lining of your nasal passages to relieve the sensation of a stuffy nose. Chlorcyclizine is an antihistamine; it reduces the amount of the natural chemicals, histamines, which cause symptoms commonly associated with allergies, including watery, itchy eyes, runny nose and sneezing.

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Precautions

Do not take this preparation if you are allergic to codeine, pseudoephedrine, chlorcyclizine or any other ingredient in the medication. Do not take this medication if you are allergic to any other narcotic, such as morphine or oxycodone. Allergic reaction is a very serious, potentially life-threatening, medical condition. Seek immediate medical assistance at the first sign or symptoms of an allergic reaction.

Symptoms of an allergic reaction include:

  • Hives.
  • Difficulty Breathing.
  • Swelling of the Face, Lips, Tongue or Throat.

You may not be able to take codeine, pseudoephedrine and chlorcyclizine preparations if you have had a history of certain medical conditions. This medication may worsen these conditions or your illness may interfere with the way this drug works.

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

  • Intestinal or Stomach Blockage.
  • Colostomy or Ileostomy.
  • Diabetes.
  • Liver or Kidney Disease.
  • Epilepsy or Other Seizure Disorder.
  • Cough with Mucus.
  • Cough Caused by Smoking, Emphysema or Chronic Bronchitis.
  • Enlarged Prostate or Urination Problems.
  • An Adrenal Gland Tumor or Disorder.
  • If You Take Potassium

Codeine, pseudoephedrine and chlorcyclizine preparations may make you feel dizzy or drowsy, or impair your decision-making. Avoid operating heavy machinery, including automobiles, while taking this medication. Do not drink alcohol while taking products containing codeine or other narcotics; dangerous side effects, including death, can occur.

Products containing codeine and other opioids may be habit-forming, especially if you take high doses or use this product for a long period of time. Symptoms of drug habit include taking the medication even when you do not have symptoms, growing impatient between doses or taking more than the prescribed amount.

Codeine, pseudoephedrine and chlorcyclizine preparations may affect the outcome of some medical laboratory tests. Tell your doctor, laboratory technician or phlebotomist if you have taken codeine, pseudoephedrine and chlorcyclizine within the past few days.

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Warnings

Do not use codeine, pseudoephedrine and chlorcyclizine preparations if you have ever had liver disease, severe constipation, severe colitis or toxic megacolon. Do not use this medication if you are unable to urinate or if you have been sick with diarrhea. Do not use codeine, pseudoephedrine and chlorcyclizine if you recently drank large amounts of alcohol, or if you have a brain tumor or head injury. Do not use codeine, pseudoephedrine and chlorcyclizine or any cough and cold medicine if you have untreated or uncontrolled diseases such as glaucoma, breathing problems such as asthma or COPD, high blood pressure, heart disease, or overactive thyroid.

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 this medicine as a pregnancy Category C, which means scientists have not yet determined whether taking this drug during pregnancy will harm an unborn child. Some components of this drug may pass into breast milk and onto your nursing child; do not take this medication 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. Try weaning yourself from this drug by taking smaller doses further apart. Talk with your doctor or rehabilitation specialist if withdrawal symptoms prevent you from quitting this medication.

More Warnings About Using Codeine, Pseudoephedrine and Chlorcyclizine

Drug Interactions

Codeine, pseudoephedrine and chlorcyclizine may interact with other drugs in unsafe or unfavorable ways. Supply your doctor and pharmacist with a complete list of all your medications, including prescriptions, over-the-counter preparations and herbal remedies. Do not start or stop any medication, including over-the-counter and herbal remedies, while taking codeine, pseudoephedrine and chlorcyclizine without first notifying your physician.

Do not take codeine, pseudoephedrine and chlorcyclizine preparations, or any other cough and cold medications, if you have taken MAO inhibitors in the past 14 days. Taking codeine, pseudoephedrine and chlorcyclizine while an MAO inhibitor is still in your system can cause a serious, even fatal, drug interaction. Brand name MAO inhibitors include Furoxone, Marplan, Nardil, Azilect, Eldepryl, Emsam, Zelapar, and Parnate. Ask your physician or pharmacist if you unsure if you are taking an MAO inhibitor.

Tell your doctor if you are taking naloxone, sold under the brand names Narcan and Suboxone, or topiramate, better known as Topamax. Before taking codeine, pseudoephedrine and chlorcyclizine products, tell your physician if you are taking tramadol, zonisamide or a diuretic, commonly known as a water pill. Let your doctor know if you are taking an antidepressant such as Elavil or Wellbutrin. Some anti-nausea medications such as Donnatal, Dramamine and Transderm Scop may interfere with the way codeine, pseudoephedrine and chlorcyclizine preparations work. Tell your prescribing physician if you are using bladder or urinary medications such as Enablex or Detrol. Talk with your doctor before taking bowel cleansing preparations such as Half Lytely, Fleet Prep Kit, Evac-Q-Kwik, GoLytely, Supraprep, and others. Codeine, pseudoephedrine and chlorcyclizine preparations may be contraindicated if you use bronchodilators such as ipratropium or tiotropium, sold under the brand names Atrovent and Spiriva. Consult with your physician or pharmacist if you take irritable bowel medications or ulcer medicine.

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Side effects

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

Common side effects include:

  • Blurred Vision.
  • Dizziness, Drowsiness, Problems with Memory or Concentration.
  • Dry Mouth, Nose or Throat.
  • Increased Sweating.
  • Increased Urination.
  • Mild Stomach Pain, Diarrhea or Constipation.
  • Sleep Problems, Such As Insomnia.
  • Sensations of Warmth, Redness or Tingly-Feeling.

Contact your doctor or local emergency room if you experience serious side effects. These side effects may become life-threatening suddenly and without warning.

Serious side effects include:

  • Fast or Pounding Heartbeats.
  • Confusion, Hallucinations, Unusual Thoughts or Behavior.
  • Severe Dizziness, Anxiety, Restless Feeling, or Nervousness.
  • Urinating Less Than Usual or Not At All.
  • Easy Bruising or Bleeding, Unusual Weakness, Fever, Chills, Body Aches, Flu Symptoms.
  • Symptoms of Dangerously High Blood Pressure, Including Severe Headache, Blurred Vision, Buzzing In Your Ears, Anxiety, Chest Pain, Feeling Short of Breath, Uneven Heartbeats or Seizure.

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Overdose

Overdose is a serious medical condition that may deteriorate rapidly into a life-or-death emergency. Overdose frequently accidental and can occur from combining medications that contain a common drug. 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 extreme weakness, confusion, pinpoint pupils or cold and clammy skin. Other symptoms of overdose include a weak pulse, fainting, slow breathing or breathing that stops.

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Abuse

Drug abuse means to habitually take addictive or illegal drugs. You can abuse drugs by taking medication for recreational purposes or by continuing to take a drug 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 often the target of recreational drug abusers because of the sense of euphoria you feel after taking this product. Addictive behavior includes trying to get this drug by filing phony prescriptions at pharmacies, visiting multiple doctors or by stealing it.

The United Stated Drug Enforcement Administration classifies drugs according to their potential for abuse as a way to predict which medications carry a high risk for dependence and addiction. The DEA classifies codeine as a Schedule II drug, which means it is associated with a high potential for abuse which may lead to severe psychological or physical dependence. When a codeine, pseudoephedrine and chlorcyclizine preparations is used as prescribed for short periods of time, it carries a lower risk for physical dependence than when codeine is used for recreational purposes. Drug abusers frequently target codeine because of the pleasant feeling of relaxation and euphoria codeine causes. Recreational users and abusers get codeine by forging prescriptions, calling in bogus orders to pharmacies, going to multiple doctors or by stealing codeine. Codeine is also widely available on the street.

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Withdrawal

Drug dependence means you need to continue taking the drug to avoid unpleasant physical withdrawal symptoms. Withdrawal symptoms are a predictable, normal physiological response to taking large doses of narcotics or taking these drugs for a long period of time. Withdrawal symptoms are not necessarily a sign of illegal drug abuse - a person may experience withdrawal symptoms after taking drugs given to them in the hospital or to treat a chronic illness. Everyone experiences withdrawal in a slightly differently way. Some people may be able to stop taking codeine or other opioids on their own, while severe withdrawal symptoms may prevent other people from stopping without the assistance of qualified rehabilitation specialists. Tell your doctor if your withdrawal symptoms prevent you from quitting this drug. Learn More About Codeine, Pseudoephedrine and Chlorcyclizine Withdrawal

Detox

Successful detoxification is a complex procedure that requires a great deal of knowledge about the physical, emotional and social ramifications of drug dependence and addiction. During detoxification, rehabilitation specialists will give your medication to detoxify and cleanse your body while easing your withdrawal symptoms. Some programs include counseling and other social services to increase your chances of successfully overcoming your addiction to codeine or other opioids. Rapid detox is state-of-the-art treatment technique that is humane and effective. 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 withdrawal. Learn More About Codeine, Pseudoephedrine and Chlorcyclizine Detoxification Programs

Storage

Keep this medication at room temperature, away from excessive heat and moisture. Do not freeze codeine, pseudoephedrine and chlorcyclizine preparations. Put this drug out of the reach of children and pets. Make sure adults do not take this medication by accident or on purpose. Keep track of your medication and check for missing doses.

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