promethazine / codeine

The codeine in promethazine with codeine carries a risk of addiction or misuse, even at recommended doses. In serious cases, addiction and misuse of an opioid medication can lead to overdose and death. Your healthcare professional (HCP) will prescribe the lowest amount of promethazine with codeine for the shortest period of time needed to treat your symptoms. If you've taken promethazine with codeine for 5 days and your cough hasn't gotten better, then this medication isn't likely a good choice for you. In this case, contact your prescriber to discuss alternatives.

Promethazine with codeine can cause dangerously slow breathing, which can be life-threatening. This can happen at any time, but you're at higher risk 1 to 3 days right after you start promethazine with codeine or if your HCP raises your dose. Drinking alcohol and taking other medications, like benzodiazepines, can also raise your risk for this dangerous side effect. You also might be at risk if you have certain genetics that affect the way your body processes promethazine with codeine.

Promethazine with codeine can cause extreme sleepiness and lower your ability to think, react, and focus. Your risk is higher if you're taking other medications that can make you sleepy, such as benzodiazepines, muscle relaxants, and sleep medications. Make sure you know how this medication affects you before driving a car or doing activities that require your concentration. Talk to your HCP right away if you feel too sleepy from taking promethazine with codeine.

To prevent accidentally taking too much promethazine with codeine, only use a accurate milliliter measuring device, such as an oral medication syringe, to measure your dose. If you don't already have one at home, ask your pharmacist.

Promethazine with codeine can interact with many medications. For example, taking certain medications, like erythromycin (Ery-tab) and ritonavir (Norvir), can raise the level of codeine and put you at higher risk for breathing problems. And starting certain medications, like rifampin (Rifadin) or carbamazepine (Tegretol), while you're already taking promethazine with codeine might lower the level of codeine and put you at risk for withdrawal symptoms.

If you take promethazine with codeine during pregnancy, you can pass the medication to your unborn baby. Long-term use during pregnancy can cause your unborn baby to become dependent on opioids. Once your baby is born, they can experience withdrawal symptoms, such as high-pitched crying, poor feeding and sucking behavior, trembling, irritability, abnormal sleep patterns, and seizures. This condition is called neonatal opioid withdrawal syndrome and can be life-threatening if not recognized and treated in time. Let your healthcare provider know if you've used promethazine with codeine during pregnancy or if you notice these symptoms in your baby.

Promethazine with codeine can cause extremely low blood pressure, including a drop in blood pressure when you stand from a sitting or lying down position. This can lead to dizziness and fainting. To avoid falling, get up slowly if you've been sitting or lying down. If dizziness or lightheadedness doesn't go away, talk to your HCP.

Though rare, opioids like promethazine with codeine can cause your adrenal hormone levels to drop. This is more likely to happen after taking opioids for longer than 1 month. Symptoms include nausea, vomiting, not feeling hungry, tiredness, dizziness, and weakness. Let your HCP know right away if you experience these symptoms because you might need to stop promethazine with codeine and be treated with corticosteroids.

Opioids can cause people with a history of seizures to have seizures more often. Promethazine with codeine can also raise your risk of seizures in certain situations. Let your HCP know if you have seizures more often while taking promethazine with codeine.

The promethazine in promethazine with codeine can cause a rare, but life-threatening condition called neuroleptic malignant syndrome (NMS). Symptoms include fever, sweating, stiff muscles, confusion, not aware of your surroundings, and fast or irregular heartbeat. If you experience any of these symptoms while taking promethazine with codeine, seek medication attention as soon as possible. You HCP will likely have you stop taking promethazine with codeine and switch you to something else.

The promethazine in promethazine with codeine can cause uncontrolled body movements, such as eye-twitching or lip-smacking. The risk is higher for people who are dehydrated. If you experience any uncontrolled movements and aren't able to stop them, talk to your HCP right away.

People with certain medical conditions shouldn't take promethazine with codeine.