Codeine Promethazine

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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

  1. agranulocytosis
  2. akathisia
  3. aplastic anemia
  4. apnea
  5. blurred vision
  6. cholestasis
  7. coma
  8. confusion
  9. constipation
  10. contact dermatitis
  11. corneal opacification
  12. cyanosis
  13. dizziness
  14. drowsiness
  15. dyspnea
  16. dystonic reaction
  17. eosinophilia
  18. fever
  19. headache
  20. hemolytic anemia
  21. hepatitis
  22. hyperthermia
  23. hypothermia
  24. ileus
  25. impaired cognition
  26. impotence (erectile dysfunction)
  27. insomnia
  28. jaundice
  29. leukopenia
  30. miosis
  31. mydriasis
  32. nausea
  33. neonatal opioid withdrawal syndrome
  34. neonatal respiratory depression
  35. neuroleptic malignant syndrome
  36. neutropenia
  37. orthostatic hypotension
  38. palpitations
  39. pancytopenia
  40. photosensitivity
  41. physiological dependence
  42. platelet dysfunction
  43. pseudoparkinsonism
  44. psychological dependence
  45. pulmonary edema
  46. purpura
  47. rash
  48. respiratory arrest
  49. respiratory depression
  50. restlessness
  51. retinopathy
  52. seizures
  53. skin hyperpigmentation
  54. tardive dyskinesia
  55. thrombocytopenia
  56. urinary retention
  57. visual impairment
  58. vomiting
  59. withdrawal
  60. xerophthalmia
  61. 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

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  • Acetaminophen; Butalbital; Caffeine
  • Acetaminophen; Butalbital; Caffeine; Codeine
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  • Acetaminophen; Chlorpheniramine; Phenylephrine; Phenyltoloxamine
  • Acetaminophen; Codeine
  • Acetaminophen; Dextromethorphan
  • Acetaminophen; Dextromethorphan; Doxylamine
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  • Acetaminophen; Dextromethorphan; Phenylephrine
  • Acetaminophen; Dextromethorphan; Pseudoephedrine
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  • Acetaminophen; Guaifenesin; Phenylephrine
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  • Oxycodone
  • Oxymorphone
  • Ozanimod
  • Palbociclib
  • Paliperidone
  • Palonosetron
  • Panobinostat
  • Papaverine
  • Paromomycin
  • Paroxetine
  • Pasireotide
  • Pazopanib
  • Peginterferon Alfa-2b
  • Pegvisomant
  • Pemoline
  • Pentamidine
  • Pentazocine
  • Pentazocine; Naloxone
  • Pentobarbital
  • Perampanel
  • Pergolide
  • Perindopril; Amlodipine
  • Perphenazine
  • Perphenazine; Amitriptyline
  • Phenelzine
  • Phenobarbital
  • Phentermine; Topiramate
  • Phenylephrine
  • Phenylephrine; Promethazine
  • Phenytoin
  • Photosensitizing agents (topical)
  • Pilocarpine
  • Pimavanserin
  • Pimozide
  • Pioglitazone
  • Pitolisant
  • Plazomicin
  • Porfimer
  • Posaconazole
  • Potassium-sparing diuretics
  • Pramipexole
  • Pramlintide
  • Prasugrel
  • Pregabalin
  • Prilocaine
  • Prilocaine; Epinephrine
  • Primaquine
  • Primidone
  • Procainamide
  • Procarbazine
  • Prochlorperazine
  • Propafenone
  • Propantheline
  • Propofol
  • Propoxyphene
  • Protriptyline
  • Quazepam
  • Quetiapine
  • Quinidine
  • Quinine
  • Ramelteon
  • Ranolazine
  • Rasagiline
  • Remifentanil
  • Ribociclib
  • Ribociclib; Letrozole
  • Rifabutin
  • Rifampin
  • Rifamycins
  • Rifapentine
  • Rifaximin
  • Rilpivirine
  • Risperidone
  • Ritonavir
  • Rivastigmine
  • Rizatriptan
  • Rolapitant
  • Romidepsin
  • Ropinirole
  • Ropivacaine
  • Rosiglitazone
  • Rotigotine
  • Rucaparib
  • Safinamide
  • Saquinavir
  • Saxagliptin
  • Scopolamine
  • Secobarbital
  • Segesterone Acetate; Ethinyl Estradiol
  • Selegiline
  • Selpercatinib
  • Serotonin-Receptor Agonists
  • Serotonin-Receptor Antagonists
  • Sertraline
  • Sevoflurane
  • SGLT2 Inhibitors
  • Short-acting beta-agonists
  • Sibutramine
  • Sildenafil
  • Simvastatin; Sitagliptin
  • Siponimod
  • Sitagliptin
  • Skeletal Muscle Relaxants
  • Sodium Oxybate
  • Solifenacin
  • Sorafenib
  • Sotalol
  • Sparfloxacin
  • 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

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