Pherazine DM vs. Phenergan with Codeine for Cold Symptoms and Cough: Important Differences and Potential Risks.

Key takeaways

Promethazine DM (promethazine/dextromethorphan) and Promethazine with Codeine (promethazine/codeine) are both combination medications used to treat cough and upper respiratory symptoms caused by allergies or respiratory infections. They both contain promethazine, an antihistamine. However promethazine DM also contains dextromethorphan, an antitussive, while Promethazine with Codeine contains codeine, an opioid, which is why it is a controlled substance. Both medications are available as an oral liquid. Both medications are typically taken very 4 to 6 hours, but promethazine DM is not recommended for children under 2 years old whereas Promethazine with Codeine is not recommended for children under 12 years old. Common side effects of Promethazine DM include drowsiness and stomach upset, while Promethazine with Codeine can cause sleepiness, dizziness, and dry mouth. Both medications should not be taken with alcohol, but Promethazine with Codeine can cause dangerously slow breathing if mixed with alcohol or opioids.

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Summary for Pherazine DM

Prescription only

Promethazine DM is a combination medication that contains promethazine and dextromethorphan. It temporarily relieves symptoms of allergies and the common cold and is only approved for adults and children age 2 years and older. Promethazine DM shouldn't be taken by children younger than 2 years old because it can cause serious harm in this age group. This medication is taken by mouth, typically every 4 to 6 hours. Some common side effects of promethazine DM include drowsiness and stomach upset.

Indications for Pherazine DM

Short-term relief of cough and upper respiratory symptoms (e.g., itching or runny nose, sneezing) caused by allergies or the common cold

Pros and Cons for Pherazine DM

Pros

Combines two medications into one product for convenience
Available as a lower-cost generic medication
Starts working within 30 minutes for symptoms of allergies and common cold

Cons

Shouldn't be taken with alcohol since it can cause extreme drowsiness
Not a safe option for children under 2 years old
Not meant to be used long-term

Common Side Effects for Pherazine DM

The following side effects are those reported with dextromethorphan:

Drowsiness
Dizziness
Stomach upset

The following side effects are those reported with promethazine:

Feeling drowsy or tired
Dizziness
Blurry vision
Dry mouth
Nausea
Vomiting

Warnings for Pherazine DM

Potentially life-threatening slow breathing (respiratory depression)
Excessive sleepiness
Risk of serious nerve problems (neuroleptic malignant syndrome)
Uncontrollable body movements
Seizures
Higher risk of infection (from low white blood cell count)
Overdose

Summary for Phenergan with Codeine

Prescription only

Promethazine with codeine is a combination medication containing a phenothiazine and an opioid. It's used to treat cough and nasal symptoms caused by respiratory infections or allergies in adults. Promethazine with codeine comes as an oral solution that's taken by mouth every 4 to 6 hours. It's meant for short-term use only because it can be habit-forming. Possible side effects of this medication include sleepiness, dizziness, and dry mouth. Avoid drinking alcohol while taking promethazine with codeine because doing so can result in slowed breathing, a dangerous interaction.