DrugindexOnline^{2nd edition}

Generic Name: codeine and promethazine (KOE deen and proe METH a zeen)
Brand Names: Phenergan with Codeine

What is codeine and promethazine?

Promethazine is an antihistamine. It blocks the effects of the naturally occurring chemical histamine in your body.

Promethazine is used alone to treat allergic symptoms and reactions such as itchy, runny nose; sneezing; itchy, watery eyes; and hives or itchy skin rashes.

Promethazine is also used to cause sedation (sleep), to assist in controlling postoperative pain, to control nausea and vomiting (especially after surgery), and to prevent motion sickness.

Codeine is in a class of drugs called narcotic analgesics. It changes the way your body feels pain, suppresses coughing, and treats diarrhea.

Codeine and promethazine is used to treat coughs and other respiratory and nasal symptoms of allergies and the common cold.

Codeine and promethazine may also be used for purposes other than those listed in this medication guide.

What is the most important information I should know about codeine and promethazine?

Use caution when driving, operating machinery, or performing other hazardous activities. Codeine and promethazine may cause dizziness or drowsiness. If you experience dizziness or drowsiness, avoid these activities. Use alcohol cautiously. Alcohol may increase drowsiness and dizziness while you are taking codeine and promethazine. Call your doctor immediately if you experience uncontrollable movements of your eyes, lips, tongue, face, arms, or legs. These could be early signs of dangerous side effects.

Codeine is a habit-forming drug. Never take more than is prescribed for you, and throw away any unused medication.

Who should not take codeine and promethazine?

Do not take codeine and promethazine if you have taken a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), phenelzine (Nardil), or tranylcypromine (Parnate) in the last 14 days. A very dangerous drug interaction could occur, leading to serious side effects.

Before taking this medication, tell your doctor if you have

• epilepsy or another seizure disorder,

• asthma,

• sleep apnea (periods of not breathing during sleep),

• glaucoma,

• an ulcer or an obstruction in your stomach,

• bladder problems or difficulty urinating,

• high blood pressure or any type of heart disease, or

• liver problems.

You may not be able to take codeine and promethazine, or you may require a lower dose or special monitoring during treatment if you have any of the conditions listed above.

Codeine and promethazine is in the FDA pregnancy category C. This means that it is not known whether codeine and promethazine will harm an unborn baby. Do not take this medication without first talking to your doctor if you are pregnant. It is not known whether codeine and promethazine passes into breast milk. Do not take this medication without first talking to your doctor if you are breast-feeding a baby. If you are over 60 years of age, you may be more likely to experience side effects from codeine and promethazine. You may require a lower dose of this medication. The safety of codeine and promethazine has not been established for children younger than 2 years of age.

How should I take codeine and promethazine?

Take codeine and promethazine exactly as directed by your doctor. If you do not understand these directions, ask your pharmacist, nurse, or doctor to explain them to you.

Take each dose with a full glass of water.

You can take codeine and promethazine with or without food.

To ensure that you get a correct dose, measure the liquid form of codeine and promethazine with a special dose-measuring spoon or cup, not with a regular tablespoon. If you do not have a dose-measuring device, ask your pharmacist where you can get one.

Do not take this medicine more often than is prescribed for you. It should never be taken more often than every 4 to 6 hours. If your symptoms are not being treated, talk to your doctor. Taking more of this medication than is directed could be dangerous.

Store codeine and promethazine at room temperature away from moisture and heat.

What happens if I miss a dose?

Take the missed dose as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and take only your next regularly scheduled dose. Do not take a double dose of this medication.

What happens if I overdose?

Seek emergency medical attention.

Symptoms of a codeine and promethazine overdose include severe drowsiness, dizziness, dry mouth, cold, clammy skin, weakness, a slow heartbeat, flushing, nausea, vomiting, difficulty breathing, seizures, and unconsciousness.

What should I avoid while taking codeine and promethazine?

Use caution when driving, operating machinery, or performing other hazardous activities. Codeine and promethazine may cause dizziness or drowsiness. If you experience dizziness or drowsiness, avoid these activities. Use alcohol cautiously. Alcohol may increase drowsiness and dizziness while you are taking codeine and promethazine. Avoid prolonged exposure to sunlight. Codeine and promethazine may increase the sensitivity of your skin to sunlight. Use a sunscreen and wear protective clothing when exposure to the sun is unavoidable.

Codeine and promethazine side effects

If you experience any of the following serious side effects, stop taking codeine and promethazine and seek emergency medical attention:

• an allergic reaction (difficulty breathing; closing of your throat; swelling of your lips, tongue, or face; or hives);

• uncontrollable movements of your eyes, lips, tongue, face, arms, or legs;

• abdominal pain or yellowing of your skin or eyes; or

• an irregular heartbeat.

Other, less serious side effects may be more likely to occur. Continue to take codeine and promethazine and talk to your doctor or try another similar medication if you experience

• dizziness or fainting;

• drowsiness, sleepiness, or confusion;

• blurred vision or a dry mouth;

• nausea, vomiting, or constipation; or

• increased sensitivity to sunlight.

Codeine is a habit-forming drug. Never take more than is prescribed for you and throw away any unused medication.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect codeine and promethazine?

Do not take codeine and promethazine if you have taken a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), phenelzine (Nardil), or tranylcypromine (Parnate) in the last 14 days. A very serious drug interaction could occur, leading to serious side effects.

Many other drugs can increase the effects of codeine and promethazine, and taking them can lead to heavy sedation. Before taking this medication, tell your doctor if you are taking any of the following drugs:

• antihistamines such as brompheniramine (Dimetane, Bromfed, others), chlorpheniramine (Chlor-Trimeton, Teldrin, others), azatadine (Optimine), clemastine (Tavist), and many others;

• narcotics (pain killers) such as meperidine (Demerol), morphine (MS Contin, MSIR, others), propoxyphene (Darvon, Darvocet), hydrocodone (Lorcet, Vicodin), oxycodone (Percocet, Percodan), fentanyl (Duragesic), and codeine (Fiorinal, Fioricet, Tylenol #3, others);

• other sedatives such as phenobarbital (Solfoton, Luminal), amobarbital (Amytal), and secobarbital (Seconal);

• phenothiazines such as chlorpromazine (Thorazine), fluphenazine (Prolixin), mesoridazine (Serentil), perphenazine (Trilafon), prochlorperazine (Compazine), thioridazine (Mellaril), and trifluoperazine (Stelazine);

• antidepressants such as amitriptyline (Elavil), doxepin (Sinequan), imipramine (Tofranil), nortriptyline (Pamelor), fluoxetine (Prozac), paroxetine (Paxil), and sertraline (Zoloft); or

• any other medications that make you feel drowsy, sleepy, or relaxed.

Drugs other than those listed here may also interact with codeine and promethazine. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines.

Where can I get more information?

• Your pharmacist has more information about codeine and promethazine written for health professionals that you may read.

What does my medication look like?

Codeine and promethazine is available with a prescription under the brand name Phenergan with Codeine. Other brand or generic formulations may also be available. Ask your pharmacist any questions you have about this medication, especially if it is new to you.

• Phenergan with Codeine, 10 mg of codeine and 6.25 mg of promethazine per 5 mL (1 teaspoon)--clear, purple-colored solution

• Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
• Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2006 Cerner Multum, Inc. Version: 3.03. Revision Date: 2/13/04 4:04:22 PM.