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    DEA Class; Rx

    Common Brand Names; Prometh VC with Codeine Syrup

    • Antitussives, Narcotic Combos

    Oral opioid antitussive (codeine), decongestant (phenylephrine), and phenothiazine-related antihistamine (promethazine) combination
    Used for the temporary relief of cough and upper respiratory symptoms associated with allergy or the common cold in adults
    Not indicated in pediatric patients under 18 years of age; contraindicated in neonates, infants and children less than 12 years of age; contraindicated in adolescents 12 to 18 years after tonsillectomy or adenoidectomy

    Temporary relief of cough and upper respiratory tract symptoms associated with allergies or common cold

    For the temporary relief of cough and upper respiratory symptoms (e.g., nasal congestion) associated with allergy or the common cold.


    • Hypersensitivity

    • Children <12 years (risk of potentially fatal respiratory depression)

    • Subcutaneous or intra-arterially administration

    • BPH

    • Narrow angle glaucoma

    • Pyloroduodenal obstruction, stenosing peptic ulcer, bladder neck obstruction

    • Severe CNS depression

    • Coma

    • Severe respiratory depression


    • Children <12 years

    • Absolute: acute abdominal condition, diarrhea associated w/ toxins, pseudomembranous colitis, respiratory depression

    • Postoperative use in children (<18 years) following tonsillectomy and/or adenoidectomy (see Black Box Warnings)

    • Acute or severe bronchial asthma in an unmonitored setting or in the absence of resuscitative equipment

    • Concurrent use of monoamine oxidase inhibitors (MAOIs) or use of MAOIs within the last 14 days

    • Significant respiratory depression

    • Porphyria

    • Treatment of lower respiratory tract symptoms, including asthma

    • Known or suspected gastrointestinal obstruction, including paralytic ileus


    • Hypersensitivity to phenylephrine or sulfites

    • Severe hypertension

    • Ventricular tachycardia

    • Closed angle glaucoma

    • Do not use within 14 days of MAO inhibitors

    • Risk of hypertension

    • Sedation (common)
    • Confusion (common)
    • Disorientation (common)
    • Adverse anticholinergic effects (dry mouth, blurred vision)
    • Photosensitivity
    • Extrapyramidal symptoms
    • Tachycardia
    • Bradycardia Leukopenia (rare)
    • Agranulocytosis (rare)
    • Obstructive jaundice
    • Confusion
    • Dizziness
    • False feeling of well being
    • Headache
    • Lightheadedness
    • Malaise
    • Paradoxical CNS stimulation
    • Restlessness
    • Seizure (with excessive doses)
    • Weakness
    • Blurred vision
    • Hypotension (especially with IV use)
    • Tachycardia
    • Bradycardia
    • Dyspnea
    • Respiratory depression
    • Anorexia
    • Nausea
    • Vomiting
    • Xerostomia
    • Rash
    • Urticaria
    • Ureteral spasm
    • Urination decreased
    • LFT’s increased
    • Histamine release
    • Anaphylactoid reaction (rare)
    • HTN
    • Reflex bardycardia
    • Anxiety
    • Headache
    • Burning
    • Rebound congestion
    • Sneezing
    • Pulmonary edema
    • Extravasation

    Concomitant use of opioids, including promethazine HCl and codeine phosphate oral solution, with benzodiazepines, or other CNS depressants, including alcohol, may result in profound sedation, respiratory depression, coma, and death; because of these risks, avoid use of opioid cough medications in patients taking benzodiazepines, other CNS depressants, or alcohol

    Prolonged use of opioid analgesics during pregnancy may cause neonatal opioid withdrawal syndrome; available data in pregnant women are insufficient to inform a drug-associated risk for major birth defects and miscarriage

    Codeine and its active metabolite, morphine, are present in human milk; there are published studies and cases that have reported excessive sedation, respiratory depression, and death in infants exposed to codeine via breast milk


    5 mL PO q4-6hr, not to exceed 30 mL/24 hr


    <12 years: Contraindicated

    12 years: 2.5-5 mL PO q4-6hr; not to exceed 30 mL/24hr

    >12 years: 5 mL PO q4-6hr, not to exceed 30 mL/24 hr

    Promethazine hydrochloride/codeine phosphate/phenylephrine hydrochloride

    oral liquid: Schedule V

    • promethazine/codeine/phenylephrine
    • (6.25mg/10mg/5mg)/5mL