Sedation (common) Confusion (common) Disorientation (common) Adverse anticholinergic effects (dry mouth, blurred vision) Photosensitivity EPS 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) 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; women who are ultra-rapid metabolizers of codeine achieve higher than expected serum levels of morphine, potentially leading to higher levels of morphine in breast milk that can be dangerous in their breastfed infants; in women with normal codeine metabolism (normal CYP2D6 activity), the amount of codeine secreted into human milk is low and dose-dependent; at least one death was reported in a nursing infant who was exposed to high levels of morphine in breast milk because mother was an ultra-rapid metabolizer of codeine; breastfeeding not recommended There is no information on effects of codeine milk production; because of potential for serious adverse reactions, including excess sedation, respiratory depression, and death in a breastfed infant, breastfeeding is not recommended during treatment Promethazine: Antidopaminergic effect due to blocking mesolimbic dopamine receptors and alpha-adrenergic receptors in the brain; antihistaminic effect due to blocking H1-receptors Codeine: Narcotic agonist analgesic with antitussive activity, mu receptor agonist Onset: 20 min Duration: 4-6 hr Bioavailability: 25% (oral) Protein Bound: 93% Vd: 12.9-17.7 L/hr Metabolism: Hepatic P450 enzyme CYP2D6 Metabolites: Promethazine sulfoxide and glucuronides (inactive) Excretion: Urine, feces Dialyzable: no Half-Life: 3-4 hr Onset: 30-60 min Metabolism: Inactive but metabolized to morphine by CYP2D6 (missing in 5-10% of population) Duration: 4-6 hr Peak Plasma Time: 0.5-1 hr Vd: 3-6 L/kg Bioavailability: 53% Protein Bound: 25% Excretion: Urine (90%), feces 10% of codeine is metabolized to morphine by CYP2D6; the active morphine metabolite has a higher affinity for opioid receptors CYP2D6 poor metabolizers may not achieve adequate analgesia Ultra-rapid metabolizers (up to 7% of Caucasians and up to 30% of Asian and African populations) may have increased toxicity due to rapid conversion The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information. sildenafil pricing It works by preventing the effects of a substance called histamine, which is produced by the body. Histamine can cause itching, sneezing, runny nose, and watery eyes. It can sometimes close up the bronchial tubes (air passages of the lungs) and make breathing difficult. Codeine belongs to the group of medicine called narcotic analgesics (pain medicines). It acts on the central nervous system (CNS) to relieve pain. This medicine is available only with your doctor's prescription. This product is available in the following dosage forms: In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. For this medicine, the following should be considered: Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. 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Promethazine may cause breathing to slow or stop, and may cause death in children. Promethazine should not be given to babies or children who are younger than 2 years old and should be given with caution to children who are 2 years of age or older. Combination products containing promethazine and codeine should not be given to children younger than 16 years old. Promethazine should not routinely be used to treat vomiting in children; it should only be used in specific cases when a doctor decides that it is needed. Tell your child's doctor if your child has any condition that affects his/her breathing such as lung disease, asthma, or sleep apnea (stops breathing for short periods of time during sleep). Tell your doctor or pharmacist about all the medications your child is taking, especially barbiturates such as phenobarbital (Luminal), medications for anxiety, narcotic medications for pain, sedatives, sleeping pills, and tranquilizers. 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