Chlorpheniramine Codeine

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Chlorpheniramine Codeine Brand Names

Codeprex Pennkinetic | Cotab A | Cotab AX | EndaCof-C | Notuss-AC | TL-HIST CM | Tuxarin ER | TUZISTRA XR | Zodryl AC | Zodryl AC Adult | Z-Tuss AC

What is Chlorpheniramine Codeine

Chlorpheniramine; codeine is an antihistamine-antitussive combination product.

These products are used to provide temporary relief from rhinorrhea, sneezing, itching of the nose or throat, or itchy watery eyes due to hay fever, upper respiratory allergies, or allergic rhinitis, and cough as may occur from throat irritants or the common cold.

Chlorpheniramine is a sedating antihistamine (H1-blocker) of the alkylamine class. Codeine is an oral, semisynthetic opiate agonist with antitussive effects achieved at lower doses than doses required to produce analgesia.

Codeine is a prodrug that is hepatically metabolized to morphine.

Codeine metabolism is highly variable and unpredictable, particularly in children younger than 12 years; therapeutic response to recommended doses can range from lack of effect in poor metabolizers to fatality in ultra-rapid metabolizers.

Opioid cough and cold medicines that contain codeine are not indicated in pediatric patients under 18 years of age.

These products are contraindicated in neonates, infants and children less than 12 years of age; risks of opioid-containing cough and cold medicines outweigh their benefits in patients younger than 18 years.

Chlorpheniramine; codeine is also contraindicated in adolescent pediatric patients 12 to 18 years of age after tonsillectomy or adenoidectomy.

Indications

  1. allergic rhinitis
  2. common cold
  3. cough
  4. sneezing

For the temporary relief of cough and upper respiratory symptoms (e.g., rhinorrhea, sneezing, itching of the nose or throat or itchy, watery eyes) associated with allergy (allergic rhinitis) or the common cold

Side Effects

  1. abdominal pain
  2. agitation
  3. agranulocytosis
  4. anaphylactoid reactions
  5. anorexia
  6. aplastic anemia
  7. appetite stimulation
  8. asthenia
  9. biliary obstruction
  10. blurred vision
  11. bradycardia
  12. bronchospasm
  13. confusion
  14. constipation
  15. cyanosis
  16. depression
  17. diarrhea
  18. dizziness
  19. drowsiness
  20. dyskinesia
  21. dyspepsia
  22. dyspnea
  23. dysuria
  24. erythema
  25. euphoria
  26. excitability
  27. fever
  28. flushing
  29. gastroesophageal reflux
  30. glycosuria
  31. gynecomastia
  32. headache
  33. hyperamylasemia
  34. hypertension
  35. hypoglycemia
  36. hypotension
  37. ileus
  38. impaired cognition
  39. increased intracranial pressure
  40. increased urinary frequency
  41. insomnia
  42. irritability
  43. lacrimation
  44. lactation suppression
  45. libido increase
  46. menstrual irregularity
  47. miosis
  48. mydriasis
  49. nausea
  50. neonatal opioid withdrawal syndrome
  51. neonatal respiratory depression
  52. ocular hypertension
  53. orthostatic hypotension
  54. palpitations
  55. pancreatitis
  56. photophobia
  57. physiological dependence
  58. pruritus
  59. psychological dependence
  60. pulmonary edema
  61. rash
  62. respiratory arrest
  63. respiratory depression
  64. restlessness
  65. seizures
  66. sinus tachycardia
  67. syncope
  68. thrombocytopenia
  69. tinnitus
  70. tremor
  71. urinary retention
  72. urticaria
  73. vertigo
  74. visual impairment
  75. vomiting
  76. weakness
  77. withdrawal
  78. xerophthalmia
  79. xerostomia

Monitoring Parameters

  • laboratory monitoring not necessary

Contraindications

  • abrupt discontinuation
  • accidental exposure
  • acute abdomen
  • adenoidectomy
  • adrenal insufficiency
  • alcoholism
  • Asian patients
  • asthma
  • biliary tract disease
  • Black patients
  • bladder obstruction
  • brain tumor
  • breast-feeding
  • cardiac disease
  • Caucasian patients
  • children
  • chronic obstructive pulmonary disease (COPD)
  • closed-angle glaucoma
  • coadministration with other CNS depressants
  • coma
  • constipation
  • contact lenses
  • cor pulmonale
  • dehydration
  • depression
  • diarrhea
  • driving or operating machinery
  • ethanol ingestion
  • ethanol intoxication
  • gallbladder disease
  • geriatric
  • GI disease
  • GI obstruction
  • head trauma
  • hepatic disease
  • Hispanic patients
  • hypotension
  • hypothyroidism
  • hypovolemia
  • hypoxemia
  • ileus
  • increased intracranial pressure
  • infants
  • inflammatory bowel disease
  • labor
  • MAOI therapy
  • myxedema
  • neonatal opioid withdrawal syndrome
  • neonates
  • neuromuscular disease
  • obesity
  • obstetric delivery
  • opiate agonist hypersensitivity
  • orthostatic hypotension
  • pancreatitis
  • poor metabolizers
  • potential for overdose or poisoning
  • pregnancy
  • prostatic hypertrophy
  • pulmonary disease
  • renal failure
  • renal impairment
  • respiratory depression
  • respiratory infection
  • respiratory insufficiency
  • scoliosis
  • seizure disorder
  • seizures
  • shock
  • sleep apnea
  • status asthmaticus
  • substance abuse
  • syncope
  • tonsillectomy
  • ulcerative colitis
  • urethral stricture
  • urinary retention

Interactions

  • Abiraterone
  • Acetaminophen; Butalbital
  • Acetaminophen; Butalbital; Caffeine
  • Acetaminophen; Butalbital; Caffeine; Codeine
  • Acetaminophen; Caffeine; Dihydrocodeine
  • Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine
  • Acetaminophen; Chlorpheniramine; Dextromethorphan; Pseudoephedrine
  • Acetaminophen; Codeine
  • Acetaminophen; Dextromethorphan
  • Acetaminophen; Dextromethorphan; Doxylamine
  • Acetaminophen; Dextromethorphan; Guaifenesin; Phenylephrine
  • Acetaminophen; Dextromethorphan; Phenylephrine
  • Acetaminophen; Dextromethorphan; Pseudoephedrine
  • Acetaminophen; Dichloralphenazone; Isometheptene
  • Acetaminophen; Diphenhydramine
  • Acetaminophen; Hydrocodone
  • Acetaminophen; Oxycodone
  • Acetaminophen; Pentazocine
  • Acetaminophen; Propoxyphene
  • Acetaminophen; Tramadol
  • Acrivastine; Pseudoephedrine
  • Aldesleukin, IL-2
  • Alfentanil
  • Aliskiren; Amlodipine
  • Aliskiren; Amlodipine; Hydrochlorothiazide, HCTZ
  • Aliskiren; Hydrochlorothiazide, HCTZ
  • Almotriptan
  • Alosetron
  • Alprazolam
  • Alvimopan
  • Amantadine
  • Ambenonium Chloride
  • Amide local anesthetics
  • Amifampridine
  • Amikacin
  • Amiloride
  • Amiloride; Hydrochlorothiazide, HCTZ
  • Aminoglycosides
  • Amiodarone
  • Amitriptyline
  • Amitriptyline; Chlordiazepoxide
  • Amlodipine
  • Amlodipine; Atorvastatin
  • Amlodipine; Benazepril
  • Amlodipine; Celecoxib
  • Amlodipine; Hydrochlorothiazide, HCTZ; Olmesartan
  • Amlodipine; Hydrochlorothiazide, HCTZ; Valsartan
  • Amlodipine; Olmesartan
  • Amlodipine; Telmisartan
  • Amlodipine; Valsartan
  • Amobarbital
  • Amoxapine
  • Amoxicillin; Clarithromycin; Lansoprazole
  • Amoxicillin; Clarithromycin; Omeprazole
  • Amphetamine
  • Amphetamine; Dextroamphetamine
  • Amphetamine; Dextroamphetamine Salts
  • Anticholinergics
  • Apalutamide
  • Apomorphine
  • Apraclonidine
  • Aprepitant, Fosaprepitant
  • Aripiprazole
  • Artemether; Lumefantrine
  • Articaine; Epinephrine
  • Asenapine
  • Aspirin, ASA; Butalbital; Caffeine
  • Aspirin, ASA; Butalbital; Caffeine; Codeine
  • Aspirin, ASA; Caffeine; Dihydrocodeine
  • Aspirin, ASA; Caffeine; Orphenadrine
  • Aspirin, ASA; Carisoprodol
  • Aspirin, ASA; Carisoprodol; Codeine
  • Aspirin, ASA; Oxycodone
  • Atazanavir
  • Atazanavir; Cobicistat
  • Atenolol; Chlorthalidone
  • Atropine; Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
  • Atropine; Difenoxin
  • Atropine; Diphenoxylate
  • Atropine; Hyoscyamine; Phenobarbital; Scopolamine
  • Azelastine
  • Azelastine; Fluticasone
  • Azilsartan; Chlorthalidone
  • Baclofen
  • Barbiturates
  • Belladonna Alkaloids; Ergotamine; Phenobarbital
  • Belladonna; Opium
  • Benazepril; Hydrochlorothiazide, HCTZ
  • Bendroflumethiazide; Nadolol
  • Benzhydrocodone; Acetaminophen
  • Benzodiazepines
  • Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
  • Benzonatate
  • Benzphetamine
  • Bethanechol
  • Bexarotene
  • Bismuth Subcitrate Potassium; Metronidazole; Tetracycline
  • Bismuth Subsalicylate
  • Bismuth Subsalicylate; Metronidazole; Tetracycline
  • Bisoprolol; Hydrochlorothiazide, HCTZ
  • Bosentan
  • Brexpiprazole
  • Brigatinib
  • Brimonidine
  • Brimonidine; Brinzolamide
  • Brimonidine; Timolol
  • Brompheniramine
  • Brompheniramine; Carbetapentane; Phenylephrine
  • Brompheniramine; Dextromethorphan; Guaifenesin
  • Brompheniramine; Guaifenesin; Hydrocodone
  • Brompheniramine; Hydrocodone; Pseudoephedrine
  • Brompheniramine; Pseudoephedrine
  • Bumetanide
  • Bupivacaine
  • Bupivacaine Liposomal
  • Bupivacaine; Lidocaine
  • Buprenorphine
  • Buprenorphine; Naloxone
  • Bupropion
  • Bupropion; Naltrexone
  • Buspirone
  • Butabarbital
  • Butorphanol
  • Candesartan; Hydrochlorothiazide, HCTZ
  • Cannabidiol
  • Capsaicin; Metaxalone
  • Captopril; Hydrochlorothiazide, HCTZ
  • Carbamazepine
  • Carbetapentane; Chlorpheniramine
  • Carbetapentane; Chlorpheniramine; Phenylephrine
  • Carbetapentane; Diphenhydramine; Phenylephrine
  • Carbetapentane; Guaifenesin
  • Carbetapentane; Guaifenesin; Phenylephrine
  • Carbetapentane; Phenylephrine
  • Carbetapentane; Phenylephrine; Pyrilamine
  • Carbetapentane; Pseudoephedrine
  • Carbetapentane; Pyrilamine
  • Carbidopa; Levodopa; Entacapone
  • Carbinoxamine
  • Carbinoxamine; Dextromethorphan; Pseudoephedrine
  • Carbinoxamine; Hydrocodone; Phenylephrine
  • Carbinoxamine; Hydrocodone; Pseudoephedrine
  • Carbinoxamine; Phenylephrine
  • Carbinoxamine; Pseudoephedrine
  • Cariprazine
  • Carisoprodol
  • Celecoxib
  • Cenobamate
  • Ceritinib
  • Cetirizine
  • Cetirizine; Pseudoephedrine
  • Chlophedianol; Dexbrompheniramine
  • Chlophedianol; Dexchlorpheniramine; Pseudoephedrine
  • Chloral Hydrate
  • Chloramphenicol
  • Chlorcyclizine
  • Chlordiazepoxide
  • Chlordiazepoxide; Clidinium
  • Chloroprocaine
  • Chlorothiazide
  • Chlorpheniramine; Dextromethorphan
  • Chlorpheniramine; Dextromethorphan; Phenylephrine
  • Chlorpheniramine; Dihydrocodeine; Phenylephrine
  • Chlorpheniramine; Dihydrocodeine; Pseudoephedrine
  • Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine
  • Chlorpheniramine; Hydrocodone
  • Chlorpheniramine; Hydrocodone; Phenylephrine
  • Chlorpheniramine; Hydrocodone; Pseudoephedrine
  • Chlorpromazine
  • Chlorthalidone
  • Chlorthalidone; Clonidine
  • Chlorzoxazone
  • Cimetidine
  • Cinacalcet
  • Ciprofloxacin
  • Citalopram
  • Clarithromycin
  • Clemastine
  • Clobazam
  • Clomipramine
  • Clonazepam
  • Clonidine
  • Clopidogrel
  • Clorazepate
  • Clozapine
  • Cobicistat
  • Codeine
  • Codeine; Guaifenesin
  • Codeine; Phenylephrine; Promethazine
  • Codeine; Promethazine
  • COMT inhibitors
  • Conivaptan
  • Crizotinib
  • Crofelemer
  • Cyclizine
  • Cyclobenzaprine
  • Cyclosporine
  • Cyproheptadine
  • Dabrafenib
  • Dacomitinib
  • Dalfopristin; Quinupristin
  • Danazol
  • Dantrolene
  • Daratumumab; Hyaluronidase
  • Darifenacin
  • Darunavir
  • Darunavir; Cobicistat
  • Darunavir; Cobicistat; Emtricitabine; Tenofovir alafenamide
  • Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir
  • Delavirdine
  • Desflurane
  • Desipramine
  • Desloratadine
  • Desloratadine; Pseudoephedrine
  • Desmopressin
  • Desvenlafaxine
  • Deutetrabenazine
  • Dexamethasone
  • Dexchlorpheniramine
  • Dexchlorpheniramine; Dextromethorphan; Pseudoephedrine
  • Dexmedetomidine
  • Dexpanthenol
  • Dextroamphetamine
  • Dextromethorphan
  • Dextromethorphan; Diphenhydramine; Phenylephrine
  • Dextromethorphan; Guaifenesin
  • Dextromethorphan; Guaifenesin; Phenylephrine
  • Dextromethorphan; Guaifenesin; Potassium Guaiacolsulfonate
  • Dextromethorphan; Guaifenesin; Pseudoephedrine
  • Dextromethorphan; Promethazine
  • Dextromethorphan; Quinidine
  • Diazepam
  • Dihydrocodeine; Guaifenesin; Pseudoephedrine
  • Diltiazem
  • Dimenhydrinate
  • Diphenhydramine
  • Diphenhydramine; Hydrocodone; Phenylephrine
  • Diphenhydramine; Ibuprofen
  • Diphenhydramine; Naproxen
  • Diphenhydramine; Phenylephrine
  • Disopyramide
  • Dolasetron
  • Donepezil
  • Donepezil; Memantine
  • Doxepin
  • Doxorubicin
  • Doxylamine
  • Doxylamine; Pyridoxine
  • Dronabinol
  • Dronedarone
  • Droperidol
  • Duloxetine
  • Dutasteride; Tamsulosin
  • Efavirenz
  • Efavirenz; Emtricitabine; Tenofovir
  • Efavirenz; Lamivudine; Tenofovir Disoproxil Fumarate
  • Elagolix
  • Elagolix; Estradiol; Norethindrone acetate
  • Elbasvir; Grazoprevir
  • Eletriptan
  • Eliglustat
  • Eltrombopag
  • Eluxadoline
  • Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Alafenamide
  • Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate
  • Enalapril; Hydrochlorothiazide, HCTZ
  • Enflurane
  • Entacapone
  • Enzalutamide
  • Eprosartan; Hydrochlorothiazide, HCTZ
  • Erythromycin
  • Erythromycin; Sulfisoxazole
  • Escitalopram
  • Esketamine
  • Eslicarbazepine
  • Estazolam
  • Eszopiclone
  • Ethacrynic Acid
  • Ethanol
  • Ethotoin
  • Etomidate
  • Etravirine
  • Everolimus
  • Ezogabine
  • Fedratinib
  • Fentanyl
  • Fesoterodine
  • Flibanserin
  • Fluconazole
  • Fluoxetine
  • Fluoxetine; Olanzapine
  • Fluphenazine
  • Flurazepam
  • Fluvoxamine
  • Fosamprenavir
  • Fosinopril; Hydrochlorothiazide, HCTZ
  • Fosphenytoin
  • Fospropofol
  • Fostamatinib
  • Frovatriptan
  • Furosemide
  • Gabapentin
  • Galantamine
  • General anesthetics
  • Gentamicin
  • Givosiran
  • Granisetron
  • grapefruit juice
  • Guaifenesin; Hydrocodone
  • Guaifenesin; Hydrocodone; Pseudoephedrine
  • Guanabenz
  • Guanfacine
  • Halogenated Anesthetics
  • Haloperidol
  • Halothane
  • Heparin
  • Homatropine; Hydrocodone
  • Hyaluronidase
  • Hyaluronidase, Recombinant; Immune Globulin
  • Hydantoins
  • Hydralazine; Hydrochlorothiazide, HCTZ
  • Hydrochlorothiazide, HCTZ
  • Hydrochlorothiazide, HCTZ; Irbesartan
  • Hydrochlorothiazide, HCTZ; Lisinopril
  • Hydrochlorothiazide, HCTZ; Losartan
  • Hydrochlorothiazide, HCTZ; Methyldopa
  • Hydrochlorothiazide, HCTZ; Metoprolol
  • Hydrochlorothiazide, HCTZ; Moexipril
  • Hydrochlorothiazide, HCTZ; Olmesartan
  • Hydrochlorothiazide, HCTZ; Propranolol
  • Hydrochlorothiazide, HCTZ; Quinapril
  • Hydrochlorothiazide, HCTZ; Spironolactone
  • Hydrochlorothiazide, HCTZ; Telmisartan
  • Hydrochlorothiazide, HCTZ; Triamterene
  • Hydrochlorothiazide, HCTZ; Valsartan
  • Hydrocodone
  • Hydrocodone; Ibuprofen
  • Hydrocodone; Phenylephrine
  • Hydrocodone; Potassium Guaiacolsulfonate
  • Hydrocodone; Potassium Guaiacolsulfonate; Pseudoephedrine
  • Hydrocodone; Pseudoephedrine
  • Hydromorphone
  • Hydroxyzine
  • Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate; Sodium Biphosphate
  • Ibuprofen; Oxycodone
  • Idelalisib
  • Iloperidone
  • Imatinib
  • Imipramine
  • Indapamide
  • Indinavir
  • Isavuconazonium
  • Isocarboxazid
  • Isoflurane
  • Isoniazid, INH
  • Isoniazid, INH; Pyrazinamide, PZA; Rifampin
  • Isoniazid, INH; Rifampin
  • Istradefylline
  • Itraconazole
  • Kanamycin
  • Ketamine
  • Ketoconazole
  • Lapatinib
  • Larotrectinib
  • Lasmiditan
  • Lefamulin
  • Lemborexant
  • Letermovir
  • Levobupivacaine
  • Levocetirizine
  • Levomethadyl
  • Levomilnacipran
  • Levorphanol
  • Lidocaine
  • Lidocaine; Prilocaine
  • Lincosamides
  • Linezolid
  • Lithium
  • Lofexidine
  • Loop diuretics
  • Loperamide
  • Loperamide; Simethicone
  • Lopinavir; Ritonavir
  • Loratadine
  • Loratadine; Pseudoephedrine
  • Lorazepam
  • Lorlatinib
  • Loxapine
  • Lumacaftor; Ivacaftor
  • Lumateperone
  • Lurasidone
  • Magnesium Salts
  • Maprotiline
  • Meclizine
  • Melatonin
  • Meperidine
  • Meperidine; Promethazine
  • Mephobarbital
  • Mepivacaine
  • Mepivacaine; Levonordefrin
  • Meprobamate
  • Metaxalone
  • Methadone
  • Methamphetamine
  • Methenamine; Sodium Acid Phosphate; Methylene Blue; Hyoscyamine
  • Methocarbamol
  • Methohexital
  • Methyclothiazide
  • Methyldopa
  • Methylene Blue
  • Metoclopramide
  • Metolazone
  • Metyrapone
  • Metyrosine
  • Midazolam
  • Mifepristone
  • Milnacipran
  • Minocycline
  • Mirabegron
  • Mirtazapine
  • Mitotane
  • Modafinil
  • Molindone
  • Monoamine oxidase inhibitors
  • Morphine
  • Morphine; Naltrexone
  • Nabilone
  • Nafcillin
  • Nalbuphine
  • Naloxone
  • Naltrexone
  • Naproxen; Sumatriptan
  • Naratriptan
  • Nebivolol
  • Nebivolol; Valsartan
  • Nefazodone
  • Nelfinavir
  • Nesiritide, BNP
  • Netupitant, Fosnetupitant; Palonosetron
  • Nevirapine
  • Nilotinib
  • Nitroglycerin
  • Nortriptyline
  • Octreotide
  • Olanzapine
  • Ombitasvir; Paritaprevir; Ritonavir
  • Omeprazole; Amoxicillin; Rifabutin
  • Ondansetron
  • Opiate Agonists
  • Oritavancin
  • Orphenadrine
  • Osilodrostat
  • Oxazepam
  • Oxycodone
  • Oxymorphone
  • Ozanimod
  • Palbociclib
  • Paliperidone
  • Palonosetron
  • Panobinostat
  • Papaverine
  • Paromomycin
  • Paroxetine
  • Peginterferon Alfa-2b
  • Pegvisomant
  • Pentazocine
  • Pentazocine; Naloxone
  • Pentobarbital
  • Perampanel
  • Perindopril; Amlodipine
  • Perphenazine
  • Perphenazine; Amitriptyline
  • Phenelzine
  • Phenobarbital
  • Phenylephrine; Promethazine
  • Phenytoin
  • Pimozide
  • Pitolisant
  • Plazomicin
  • Posaconazole
  • Potassium-sparing diuretics
  • Pramipexole
  • Pramlintide
  • Prasugrel
  • Pregabalin
  • Prilocaine
  • Prilocaine; Epinephrine
  • Primidone
  • Procarbazine
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  • Promethazine
  • Propafenone
  • Propofol
  • Propoxyphene
  • Protriptyline
  • Quazepam
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  • Quinidine
  • Quinine
  • Ramelteon
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  • Rasagiline
  • Remifentanil
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  • Rifapentine
  • Rifaximin
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  • Rituximab; Hyaluronidase
  • Rivastigmine
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  • Rolapitant
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  • Rotigotine
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  • Solifenacin
  • Spironolactone
  • St. John’s Wort, Hypericum perforatum
  • Streptogramins
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  • Sumatriptan
  • Suvorexant
  • Tacrine
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  • Tapentadol
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  • Vilazodone
  • Voriconazole
  • Vortioxetine
  • Voxelotor
  • Zaleplon
  • Ziconotide
  • Ziprasidone
  • Zolmitriptan
  • Zolpidem

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