Codeine/chlorpheniramine is a combination medication that helps relieve cough and symptoms from the common cold and allergies in adults. It requires a prescription from your provider, because it's a lot stronger than over-the-counter cough and cold medications.
Cough and symptoms due to the common cold and allergies
Codeine/chlorpheniramine is a combination of two medications that work together to treat symptoms from the common cold and allergies.
Codeine is an opioid pain reliever that also works in your brain to lessen your urge to cough.
Chlorpheniramine is an antihistamine. It blocks a natural substance in your body called histamine from causing irritation in the lining of your respiratory tract (nose, lungs, throat). It helps relieve itchy, runny nose and sneezing related to allergies and the common cold.
Codeine/chlorpheniramine can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Risk factors: Personal or family history of substance abuse | History of mental health condition
Like other opioid-containing medications, codeine/chlorpheniramine has a potential for abuse, misuse, or addiction, which can lead to serious complications, such as overdose and death. This can happen even if you're using the medication at prescribed or recommended doses. It's recommended to use codeine/chlorpheniramine at the lowest possible dose for the shortest period of time needed. If you're using this medication for 5 days and don't feel any better, contact your provider to discuss alternatives.
Risk factors: Age 65 years and older | Genes that quickly break down codeine | Using medications that slow down the body | Drinking alcohol | Severe asthma | History of severe chronic obstructive pulmonary disease (COPD) | Older or weaker people | Accidental overdose | Children | Breastfed infants
Codeine/chlorpheniramine can cause life-threatening breathing problems (respiratory depression) and lead to death. Your risk is higher if you're 65 years or older or have certain medical conditions, such as asthma or COPD. Some people have genes that break down codeine into morphine faster in their body, which raises their exposure to morphine and their risk of serious opioid side effects. In addition, using medications that slow down your body (e.g., benzodiazepines) together with opioid-containing medications like codeine/chlorpheniramine can cause slowed breathing, coma, or death. If you or your loved one has shortness of breath, wheezing, slowed breathing, tiredness or sleepiness during the day, anxiety, or confusion, call for emergency medical help right away.
Codeine/chlorpheniramine should only be used in adults 18 years or older. This medication can cause
life-threatening breathing problems and death in children, especially those ages 12 to 18 years after certain surgeries (tonsil or adenoid removal), those younger than 12 years, and those with certain conditions.
Breastfeeding isn't recommended while taking codeine/chlorpheniramine. Codeine and morphine can pass into breast milk and cause serious side effects in your baby, like breathing problems and even death. Speak to your provider about safer alternatives if you're breastfeeding.
Risk factors: Dosing errors
Never use household measuring spoons or cups to measure your dose of the codeine/chlorpheniramine liquid, since this might cause you to take the wrong dose and lead to overdose. Ask your pharmacist if you need a new measuring syringe or spoon. If you live in a home with children or if children frequently visit your home, store the medication in a secure place. Symptoms of an overdose include slowed breathing, sleepiness, muscle weakness, small pupils, cold or clammy skin, abnormal snoring, slow heart rate, or unresponsiveness. If you, your child, or anyone around you accidentally overdoses on codeine/chlorpheniramine, get emergency medical help right away. A medication called naloxone (Narcan) is available to reverse the side effects of an opioid overdose quickly. Speak to your provider to learn more.
Risk factors: Using other medications that slow down brain function | Drinking alcohol | Taking more codeine/chlorpheniramine than prescribed
Codeine/chlorpheniramine can slow down brain activity and lead to severe sleepiness. Taking codeine/chlorpheniramine with alcohol, benzodiazepines, sleep medications, muscle relaxers, and other opioids can make these side effects worse, and lead to slowed breathing, coma, and even death. If you take any of these medications, work with your healthcare provider to take the lowest and safest dose. Due to the risks of excessive sleepiness and dizziness, don't drive or use any heavy machinery until you know how codeine/chlorpheniramine affects you.
Using codeine/chlorpheniramine with certain medications or suddenly stopping some medications can change the levels of codeine/chlorpheniramine in your body. For example, taking erythromycin (Ery-Tab), ketoconazole, or ritonavir (Norvir) can raise codeine/chlorpheniramine levels, leading to greater side effects, such as slowed breathing. Other medications, like phenytoin (Dilantin), carbamazepine (Tegretol), or rifampin (Rifadin), can lower codeine/chlorpheniramine levels in your body, leading to withdrawal symptoms or lessened pain relief. In these situations, your provider might need to adjust your medications or dosage. Talk to your pharmacist or healthcare provider before starting or stopping any medications, so they can make sure it's safe to continue using codeine/chlorpheniramine.
Risk factors: Long-term use of codeine/chlorpheniramine during pregnancy
Long-term use of codeine/chlorpheniramine during pregnancy can cause your unborn baby to become dependent on opioids the same way that you can. Once your baby is born, they can experience withdrawal symptoms just like if you were to stop the medication suddenly. Withdrawal symptoms in your newborn can include 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 codeine/chlorpheniramine during pregnancy or if you notice these symptoms in your baby.
Risk factors: Age 65 years or older | Taking other medications that lower blood pressure | Dehydration | History of low blood pressure | Taking certain antipsychotics | Starting codeine/chlorpheniramine | Dose adjustments
Codeine/chlorpheniramine can cause severe low blood pressure, including a drop in blood pressure when you stand from a sitting or lying position. This can lead to dizziness and fainting. Your risk is greater if you take medications for high blood pressure or if you take certain antipsychotics. Be careful as you stand up after sitting for an extended period of time and make sure to sit back down if you feel faint or dizzy. The chances of low blood pressure are higher when you first start using codeine/chlorpheniramine or with dose changes. If dizziness or lightheadedness doesn't go away, talk to your healthcare provider.
Risk factors: Using opioids for greater than 1 month | History of low cortisol levels
Using opioids like codeine/chlorpheniramine, especially for longer than 1 month, can lead to low levels of cortisol hormone (adrenal insufficiency). Cortisol helps control your mood, stress, blood pressure, and blood sugar levels. If you have symptoms such as nausea, vomiting, loss of appetite, tiredness, weakness, dizziness, or low blood pressure, let your healthcare provider know so that tests can be performed. If your cortisol levels are too low, your provider will treat you with corticosteroids and you might slowly be weaned off of codeine/chlorpheniramine or switched to another medication if necessary.
Risk factors: History of seizures | Taking other medications or having health conditions that raise your risk of seizures
Codeine/chlorpheniramine can raise your risk of seizures if you have a history of seizures. If your seizures have worsened or become harder to control after starting codeine/chlorpheniramine, let your healthcare provider know right away.
Source:Â DailyMed
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Although serious side effects occur rarely when this medicine is taken as recommended, they may be more likely to occur if: too much medicine is taken, it is taken in large doses, or it is taken for a long period of time.
Get emergency help immediately if any of the following symptoms of overdose occur:
For narcotic antitussive (codeine, dihydrocodeine, hydrocodone, or hydromorphone)-containing
Cold, clammy skin
confusion (severe)
convulsions (seizures)
drowsiness or dizziness (severe)
nervousness or restlessness (severe)
pinpoint pupils of eyes
slow heartbeat
slow or troubled breathing
If you are a nursing mother and you notice any of the following symptoms of overdose in your baby, get emergency help immediately:
Difficulty breathing
difficulty nursing
increased sleepiness (more than usual)
limpness
For acetaminophen-containing
increased sweating
loss of appetite
nausea or vomiting
stomach cramps or pain
swelling or tenderness in the upper abdomen or stomach area
For salicylate-containing
Any loss of hearing
bloody urine
confusion
convulsions (seizures)
dizziness or lightheadedness
drowsiness (severe)
excitement or nervousness (severe)
fast or deep breathing
hallucinations (seeing, hearing, or feeling things that are not there)
increased sweating
nausea or vomiting (severe or continuing)
shortness of breath or troubled breathing (for salicylamide only)
stomach pain (severe or continuing)
uncontrollable flapping movements of the hands, especially in elderly patients
unusual thirst
vision problems
For decongestant-containing
Fast, pounding, or irregular heartbeat
headache (continuing and severe)
nausea or vomiting (severe)
nervousness or restlessness (severe)
shortness of breath or troubled breathing (severe or continuing)
Check with your doctor as soon as possible if any of the following side effects occur:
For antihistamine- or anticholinergic-containing
Clumsiness or unsteadiness
convulsions (seizures
drowsiness (severe)
dryness of mouth, nose, or throat (severe)
flushing or redness of face
hallucinations (seeing, hearing, or feeling things that are not there)
restlessness (severe)
shortness of breath or troubled breathing
slow or fast heartbeat
For iodine-containing
Headache (continuing)
increased watering of mouth
loss of appetite
metallic taste
skin rash, hives, or redness
swelling of face, lips, or eyelids
For acetaminophen-containing
Unexplained sore throat and fever
unusual tiredness or weakness
yellow eyes or skin
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
decreased sweating
difficult or painful urination
dizziness or lightheadedness
drowsiness
dryness of mouth, nose, or throat
false sense of well-being
increased sensitivity of skin to sun
nausea or vomiting
nightmares
stomach pain
thickening of mucus
trouble in sleeping
unusual excitement, nervousness, restlessness, or irritability
unusual tiredness or weakness
Not all of the side effects listed above have been reported for each of these medicines, but they have been reported for at least one of them. There are some similarities among these combination medicines, so many of the above side effects may occur with any of these medicines.
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Combines two medications for convenience
Works well to treat common cold and allergy symptoms
Comes as both a tablet and a liquid suspension
Taken twice a day, unlike other cough and cold medications that are taken every few hours
Doesn't need to be taken with food
Can cause drowsiness
Need to avoid alcohol
Not safe for children younger than 18 years of age
A controlled substance with a risk of dependency, misuse, and overdose
Might cause withdrawal symptoms if stopped suddenly after long-term use
If you're taking codeine/chlorpheniramine liquid, make sure that you use an appropriate measuring device (measuring cup or oral syringe). If one doesn't come with your medication, ask your pharmacist to give you one. Don't use household spoons, because they might cause you to take the wrong dose, which can lead to an overdose.
Taking too much of codeine/chlorpheniramine can cause many serious side effects and can even slow down your breathing, which is very dangerous. Don't take more of this medication than you're prescribed, and only take it every 12 hours.
Avoid drinking alcohol and taking sedatives (e.g., benzodiazepines) when taking codeine/chlorpheniramine, because it can lower your alertness and slow down your breathing, which can lead to death.
Don't drive or perform any activities that require you to be alert until you know how codeine/chlorpheniramine affects you.
If you've been taking codeine/chlorpheniramine for longer than 5 days and your symptoms haven't improved, talk with your provider so they can make sure your cough and symptoms aren't caused by something else. Don't stop taking it suddenly though, as you might experience withdrawal symptoms. Follow your provider's instructions to lower your dose safely.
Codeine/chlorpheniramine contains an opioid (codeine), which can cause or worsen constipation. Make sure to tell your healthcare provider about your full medical history, especially if you have a history of bowel disease. To help with constipation, get plenty of fiber in your diet and drink lots of water. You can also talk to your provider or pharmacist about over-the-counter stool softener or laxative recommendations to avoid getting backed up while taking codeine/chlorpheniramine.
It's not recommend to breastfeed while taking codeine/chlorpheniramine, since codeine passes into breast milk and can cause life-threatening breathing problems in your baby. Speak to your provider about safe cough, cold, and allergy medications if you're breastfeeding.
Dosage | Quantity | Price as low as | Price per unit |
---|---|---|---|
14.7mg/2.8mg/5ml | 60 ml | $82.00 | $1.37 |
It's recommended to use the lowest dose possible for the shortest duration of time to manage your symptoms.
Tuxarin ER (extended-release tablets): The typical dose is 1 tablet by mouth every twelve hours. Each tablet contains 40 mg of codeine and 5.6 mg of chlorpheniramine.
Tuzistra XR (extended-release suspension): The typical dose is 10 mL (two teaspoonfuls) by mouth every twelve hours. Each 10 mL of medication contains 40 mg of codeine and 8 mg of chlorpheniramine.
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking any of these medicines, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using medicines in this class with any of the following medicines is not recommended. Your doctor may decide not to treat you with a medication in this class or change some of the other medicines you take.
Using medicines in this class with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
Children 11 years and younger
Postoperative pain in children 17 years and younger following tonsillectomy (tonsil removal) or adenoidectomy (adenoid removal)
Slowed breathing (respiratory depression)
Severe asthma
Stomach or intestinal blockage (paralytic ileus)
Currently take or have taken a monoamine oxidase inhibitor (MAOI) or have used an MAOI within 14 days
Cough and symptoms due to the common cold and allergies
Cough
Runny nose
Itchy or watery eyes
Itching of the nose and throat
Cough caused by minor throat or lung irritation (e.g., common cold)
Runny nose
Sneezing
Watery eyes
Itching
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