Codeine Promethazine Brand Name– Pentazine with Codeine
What is Codeine Promethazine
Codeine and promethazine are used together in an oral preparation to temporarily relieve cough and upper respiratory symptoms associated with allergy or the common cold.
Promethazine has a phenothiazine-related chemical structure and is a sedating antihistamine (H-1 blocker) with anticholinergic activity that dries the nasal and sinus passages.
Codeine is an opiate agent with antitussive activity. 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.
Codeine promethazine is also contraindicated in adolescent pediatric patients 12 to 18 years of age after tonsillectomy or adenoidectomy.
Indications
- common cold
- cough
For the temporary relief of cough and upper respiratory symptoms associated with allergy or the common cold
Side Effects
- agranulocytosis
- akathisia
- aplastic anemia
- apnea
- blurred vision
- cholestasis
- coma
- confusion
- constipation
- contact dermatitis
- corneal opacification
- cyanosis
- dizziness
- drowsiness
- dyspnea
- dystonic reaction
- eosinophilia
- fever
- headache
- hemolytic anemia
- hepatitis
- hyperthermia
- hypothermia
- ileus
- impaired cognition
- impotence (erectile dysfunction)
- insomnia
- jaundice
- leukopenia
- miosis
- mydriasis
- nausea
- neonatal opioid withdrawal syndrome
- neonatal respiratory depression
- neuroleptic malignant syndrome
- neutropenia
- orthostatic hypotension
- palpitations
- pancytopenia
- photosensitivity
- physiological dependence
- platelet dysfunction
- pseudoparkinsonism
- psychological dependence
- pulmonary edema
- purpura
- rash
- respiratory arrest
- respiratory depression
- restlessness
- retinopathy
- seizures
- skin hyperpigmentation
- tardive dyskinesia
- thrombocytopenia
- urinary retention
- visual impairment
- vomiting
- withdrawal
- xerophthalmia
- xerostomia
Monitoring Parameters
- laboratory monitoring not necessary
Contraindications
- abrupt discontinuation
- accidental exposure
- acute abdomen
- adenoidectomy
- adrenal insufficiency
- agranulocytosis
- alcoholism
- Asian patients
- asthma
- biliary tract disease
- Black patients
- bladder obstruction
- bone marrow suppression
- 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
- dementia
- depression
- diabetes mellitus
- diarrhea
- driving or operating machinery
- dyskinesia
- 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
- jaundice
- labor
- laboratory test interference
- MAOI therapy
- myxedema
- neonatal opioid withdrawal syndrome
- neonates
- neuromuscular disease
- obesity
- obstetric delivery
- opiate agonist hypersensitivity
- orthostatic hypotension
- pancreatitis
- phenothiazine hypersensitivity
- poor metabolizers
- potential for overdose or poisoning
- pregnancy
- prostatic hypertrophy
- pulmonary disease
- radiographic contrast administration
- renal failure
- renal impairment
- respiratory depression
- respiratory infection
- respiratory insufficiency
- Reye’s syndrome
- scoliosis
- seizure disorder
- seizures
- shock
- sleep apnea
- status asthmaticus
- substance abuse
- syncope
- tonsillectomy
- ulcerative colitis
- urethral stricture
- urinary retention
Interactions
- Abarelix
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- Spironolactone
- St. John’s Wort, Hypericum perforatum
- Streptogramins
- Streptomycin
- Sufentanil
- Sulfonylureas
- Sumatriptan
- Sunitinib
- Suvorexant
- Tacrolimus
- Tamoxifen
- Tamsulosin
- Tapentadol
- Tasimelteon
- Tazarotene
- Tazemetostat
- Telavancin
- Telithromycin
- Telotristat Ethyl
- Temazepam
- Teniposide
- Terbinafine
- Tetrabenazine
- Tetracaine
- Thalidomide
- Thiazide diuretics
- Thiazolidinediones
- Thiopental
- Thioridazine
- Thiothixene
- Tiagabine
- Ticagrelor
- Timolol
- Tipranavir
- Tizanidine
- tobacco
- Tobramycin
- Tolazamide
- Tolbutamide
- Tolterodine
- Topiramate
- Toremifene
- Torsemide
- Tramadol
- Trandolapril; Verapamil
- Tranylcypromine
- Trazodone
- Tretinoin, ATRA
- Triamterene
- Triazolam
- Tricyclic antidepressants
- Trifluoperazine
- Trihexyphenidyl
- Trimethobenzamide
- Trimipramine
- Triprolidine
- Triptorelin
- Trospium
- Tucatinib
- Valerian, Valeriana officinalis
- Valproic Acid, Divalproex Sodium
- Vandetanib
- Vardenafil
- Vemurafenib
- Venlafaxine
- Verapamil
- Verteporfin
- Vigabatrin
- Vilazodone
- Voriconazole
- Vorinostat
- Vortioxetine
- Voxelotor
- Zaleplon
- Ziconotide
- Ziprasidone
- Zolmitriptan
- Zolpidem
- Zonisamide
