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Promethazine with Codeine is available as an oral syrup with the following composition:
- Standard Formulation:Â Contains 6.25 mg promethazine hydrochloride and 10 mg codeine phosphate per 5 mL
- Available Sizes:Â 4 oz (118 mL), 8 oz (237 mL), and 16 oz (473 mL) bottles
The typical adult dosage is 5 mL (1 teaspoonful) every 4-6 hours, not to exceed 30 mL in 24 hours. For children 6-12 years of age, the dosage is typically 2.5-5 mL every 4-6 hours, not to exceed 30 mL in 24 hours. This medication is not recommended for children under 6 years of age due to the risk of respiratory depression.
Dosing should be individualized based on symptom severity and patient characteristics. The medication is typically taken for a short duration (3-7 days) until symptoms resolve, as prolonged use increases the risk of dependence due to the codeine component.
Important Safety Information
Promethazine with Codeine is a Schedule V controlled substance with potential for abuse and dependence due to the codeine component. Always use as directed by your healthcare provider. Do not combine with alcohol, benzodiazepines, or other central nervous system depressants. Store in a secure location away from children and pets. Dispose of unused medication properly according to local regulations.
Due to the codeine content, Promethazine with Codeine may cause respiratory depression, particularly in children, elderly patients, or when taken in excessive doses. The promethazine component may cause significant sedation and anticholinergic effects.
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Common side effects may include drowsiness, dizziness, sedation, nausea, constipation, and dry mouth. Serious side effects requiring immediate medical attention include difficulty breathing, severe drowsiness, confusion, or allergic reactions. Consult with a healthcare professional before use if you have respiratory conditions, liver or kidney disease, or a history of substance abuse.
For more information about cough medications and respiratory health, please visit these authoritative resources:
- CDC Information on Cough Illness
- FDA Information on Cough and Cold Products
- MedlinePlus Promethazine Information
- MedlinePlus Codeine Information
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- Promethazine Component:Â A first-generation antihistamine that blocks H1 receptors, reducing allergic symptoms and providing sedative effects. It also has anticholinergic and antiemetic properties.
- Codeine Component:Â An opioid that acts on the cough center in the medulla oblongata to suppress the cough reflex. It also provides mild analgesic effects.
- Synergistic Effect:Â The combination provides more effective cough suppression and symptom relief than either component alone.
- Onset of Action:Â 20-30 minutes
- Duration of Action:Â 4-6 hours
- Metabolism:Â Both components are metabolized in the liver; codeine is partially converted to morphine by CYP2D6 enzymes
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- Tylenol #3 (Codeine/Acetaminophen)
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