J-MAX DHC

Uses

Doctors prescribe J-MAX DHC to provide temporary relief from nasal congestion and a dry cough caused by allergies, the common cold or an upper respiratory tract infection affecting the nose, sinuses, upper throat and voice box.

Other, off label uses for this medicine

Ingredients in J-MAX DHC also relieve pain and produces pleasant feelings of relaxation.

General Drug Information

JayMac Pharmaceuticals offers J-MAX DHC in a purple grape-flavored liquid form for oral use. Each 5 mL teaspoon of J-MAX DHC contains 7.5 mg of dihydrocodeine and 100 mg of guaifenesin. J-MAX DHC does not contain alcohol.

Dihydrocodeine is an opioid cough suppressant, sometimes called a narcotic antitussive. Guaifenesin is an expectorant that increases secretions in the respiratory tract and loosens phlegm to make it easier to cough this mucus and fluid from the lungs.

Administration/Dosage

The usual dosage for adults and children over the age of 12 years is one to two 5 mL teaspoonfuls every four to six hours as needed. The typical prescription for children younger than 12 years old calls for one-half to one 5 mL teaspoonfuls every four to six hours as needed to control symptoms.

J-MAX DHC is not appropriate for children younger than six years.

Healthcare providers should always use an approved measuring device when dispensing J-MAX DHC. Using a household spoon may yield inadequate doses or dangerous overdoses.

Action

Dihydrocodeine suppresses the cough reflex in the cough center of the brain - the medulla. Dihydrocodeine also depresses respiratory centers to slow breathing and to cause shallow and uneven breathing patterns.

Guaifenesin thins secretions, making the cough reflex more efficient by improving the way the body removes thinned secretions from the lungs and airway.

In other actions, dihydrocodeine works directly on the central nervous system, or CNS, to produce effects such as pain relief, sedation, anti-anxiety and a pleasant sense of euphoria. Additionally, opioids increase the tone of smooth muscles, like those lining intestinal walls, bladder and in the gall bladder. Opioids like the dihydrocodeine in J-MAX DHC also cause vasodilation, or widening of the blood vessels in a way that reduces blood pressure.

Warnings

Respiratory Depression

Like all opioids, the dihydrocodeine in J-MAX DHC depresses breathing centers in the brain and may cause respiratory depression, a dangerous and sometimes fatal breathing problem. During respiratory depression, the lungs do a poor job of exchanging oxygen for carbon dioxide, resulting in oxygen starvation and high carbon dioxide levels.

Elderly and debilitated patients are more susceptible to respiratory depression, usually following large initial doses in consumers who are not accustomed to taking opioids, or when the consumer takes J-MAX DHC with another drug that slows breathing.

Patients with the breathing problem COPD or the heart condition known as cor pulmonale should use J-MAX DHC with caution, as should those with decreased lung capacity, low oxygen levels, high carbon dioxide levels or pre-existing respiratory depression.

Hypotension

The opioids in J-MAX DHC widen blood vessels; this vasodilation lowers blood pressure to cause hypotension in patients already struggling to maintain an adequate blood pressure, either because they have lost a lot of blood or because they are taking another drug that causes hypotension.

J-MAX DHC may cause blood pressure to plummet when the consumer rises from a seated position quickly, a condition known as orthostatic hypotension.

Healthcare providers should administer J-MAX DHC with caution to patients in shock, since the vasodilation associated with dihydrocodeine can cause worsen hypotension and further decrease the amount of blood pumped in each heartbeat.

Special Risk Consumers

Patients with high blood pressure, diabetes and some types of heart, thyroid, eye or prostate problems should use J-MAX DHC with considerable caution. Elderly consumers are more likely to experience adverse reactions.

Patients with liver problems should use J-MAX DHC with caution, as should those with kidney dysfunction or biliary tract diseases like pancreatitis.

Dependence

While physicians normally prescribe J-MAX DHC to treat symptoms of a cold or allergies, some people abuse this drug because of the pleasant euphoria dihydrocodeine provides. Anyone who takes J-MAX DHC regularly, for therapeutic or recreational purposes, for more than a few weeks can become opioid dependent. Healthcare providers should prescribe and administer J-MAX DHC with caution, especially to those with a history of substance abuse problems.

Precautions

J-MAX DHC can make the consumer dizzy or drowsy, or impair her physical and mental abilities. A consumer should not operate a motor vehicle or heavy machinery until she knows how J-MAX DHC will affect her.

Contraindications

Individuals who are hypersensitive to dihydrocodeine, codeine or any ingredient in J-MAX DHC should not use this product.

J-MAX DHC is not appropriate in any situation where opioids can cause harm. Individuals suffering from respiratory depression in unmonitored settings or in locations without resuscitative equipment should not use J-MAX DHC. Patients with acute or severe asthma, high carbon dioxide levels or the type of bowel obstruction known as paralytic ileus should not use J-MAX DHC.

The guaifenesin in J-MAX DHC is not appropriate for patients with severe high blood pressure, asthma, stomach ulcer and some types of heart, urinary and eye problems.

Pregnancy, Labor and Delivery, Breastfeeding

J-MAX DHC is an FDA Pregnancy Category C; there are no adequate scientific studies to establish the potential harm to women or fetus. Pregnant women should take J-MAX DHC only when the benefits clearly outweigh the possible risks, especially during the first three months of pregnancy.

Babies born to mothers who take J-MAX DHC and other opioids regularly during pregnancy will be born opioid dependent and suffer withdrawal symptoms during the first days of life. A baby suffering from neonatal withdrawal symptoms seems irritable, cries excessively and has tremors, hyperactive reflexes, rapid breathing, yawning, increased stools, sneezing, vomiting and fever. The intensity of neonatal withdrawal symptoms does not always correspond to the dosage or duration of the mother"s J-MAX DHC use.

Caregivers should not administer J-MAX DHC during labor as it may cause the newborn to suffer respiratory depression after delivery.

The ingredients in J-MAX DHC may pass into human milk and onto a nursing baby. Mothers should not breastfeed while taking J-MAX DHC.

Drug Interactions

The guaifenesin in J-MAX DHC can interfere with the action of some drugs intended to lower blood pressure, especially methyldopa, mecamylamine, reserpine and veratrum alkaloids.

The dihydrocodeine in J-MAX DHC can interact with other CNS depressants to cause an additive depressant effect on the central nervous system. Example of other CNS depressants include other opioid drugs like codeine or morphine, sedatives, muscle relaxants, general anesthetics, anti-nausea drugs, anti-psychotic drugs, tranquilizers and alcohol. When a patient needs both J-MAX DHC and another CNS depressant, the physician should lower the dosage of one or both medications.

J-MAX DHC can interact with MAOIs, commonly used to treat high blood pressure, depression and other ailments. All opioids, including the dihydrocodeine in J-MAX DHC, can interact with MAOI drugs to excite the central nervous system and cause high blood pressure. MAOIs and beta-blockers, also used to control blood pressure, can increase the effects of guaifenesin.

Side effects

As with all medications, J-MAX DHC can cause adverse reactions in some consumers. Patients have most commonly reported feeling lightheaded, dizzy, drowsy, fatigued or sedated. Other consumers report headache, sweating, nausea and vomiting, constipation, itching and skin reactions. Except for constipation, most of these non-serious side effects disappear with continued J-MAX DHC use at therapeutic doses.

J-MAX DHC may sometimes cause respiratory depression, orthostatic hypotension, suppression of a necessary cough, confusion, diarrhea, pinpoint pupils, dry mouth, indigestion and loss of appetite, spasm in the biliary tract and urinary retention.

Guaifenesin may cause other reactions, such as extreme fatigue, nausea, giddiness, dry mouth, blurred vision, irregular heartbeat and flushing, an uncomfortable warmth and redness that spreads over the face and neck. Guaifenesin may increase irritability or excitement, especially in children.

Overdose

Overdose of J-MAX requires immediate medical attention, as it is a dangerous and sometimes life-threatening condition. Overdose of J-MAX DHC and other prescription opioid drugs kill nearly 15,000 Americans each year.

Symptoms of J-MAX DHC overdose include pinpoint pupils, respiratory depression, limp muscles, excessive sleepiness that worsens to stupor, unconsciousness or coma and cold, clammy skin. The victim may suffer seizures or collapse of the cardiovascular system; death may occur.

Care for J-MAX DHC overdose includes ipecac to induce vomiting along with a drug to encourage bowel movements; nurses will introduce charcoal into the stomach to absorb excess J-MAX DHC and then pump the patient"s stomach to remove any remaining medication. Nurses will start intravenous fluids to stabilize blood pressure. Doctors will administer naloxone or other medications to lower dihydrocodeine levels if the patient shows signs of respiratory depression; while naloxone counteracts the effects of respiratory depression, this drug can also cause withdrawal symptoms which would complicate the treatment for overdose in opioid-dependent patients.

Abuse

Recreational drug abusers target J-MAX DHC because of the euphoria dihydrocodeine produces. The DEA classifies J-MAX DHC as a schedule III narcotic, meaning it poses the same moderate risk for abuse as anabolic steroids or Tylenol with codeine. To reduce its availability to drug abusers, J-MAX DHC is available only with a doctor"s prescription.

Recreational drug abuse increases the risk for dangerous side effects, overdose, addiction and physical dependence.

Withdrawal

An opioid-dependent person suffers withdrawal symptoms when he stops taking J-MAX DHC abruptly. Symptoms of withdrawal from the dihydrocodeine include irritability, anxiety, restlessness and trouble sleeping, excessive sweating and irregular heartbeat.

To avoid these withdrawal symptoms, opioid-dependent individuals should try tapering J-MAX DHC use by taking successively smaller doses increasingly further apart. This method works well for most people but persistent and powerful withdrawal symptoms prevent many individuals from discontinuing J-MAX DHC when they no longer need it to control allergy and cold symptoms.

Detox

Many local healthcare institutions now offer detoxification services to help people overcome dependence on opioids like the dihydrocodeine in J-MAX DHC. Detoxification typically entails drugs to lower opioid levels along with multiple medications to ease withdrawal symptoms.

Rapid detox offers humane and efficient treatment for opioid dependence. During rapid detox procedures, board-certified anesthesiologists sedate and anesthetize the patient before administering the standard detoxification and anti-withdrawal drugs.

Storage

J-MAX DHC should be stored in a tightly sealed, light-resistant container at temperatures between 59 and 86 degrees Fahrenheit.

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