Cheratussin ac syrup has codeine

List Cheratussin AC side effects by likelihood and severity. Precautions Before taking this medication , tell your doctor or pharmacist if you are allergic to any of its ingredients; or to narcotic pain relievers e. This product may contain inactive ingredients, which can cause allergic reactions or other problems.

Talk to your pharmacist for more details. Before using this medication, tell your doctor or pharmacist your medical history, especially of: This drug may make you dizzy or drowsy. Do not drive, use machinery, or do any activity that requires alertness until you are sure you can perform such activities safely.

To reduce dizziness and lightheadedness , get up slowly when rising from a sitting or lying position. Liquid forms of this medication may contain sugar, alcohol, or aspartame. Consult your doctor or pharmacist about using this medication safely. See also Warning section. Before using this medication, women of childbearing age should talk with their doctor s about the risks and benefits.

Tell your doctor if you are pregnant or if you plan to become pregnant. During pregnancy , this medication should be used only when clearly needed. It may slightly increase the risk of birth defects if used during the first two months of pregnancy. Also, using it for a long time or in high doses near the expected delivery date may harm the unborn baby. To lessen the risk, take the smallest effective dose for the shortest possible time.

This medication passes into breast milk and may rarely have undesirable effects on a nursing infant , such as unusual sleepiness, difficulty feeding, trouble breathing , or unusual limpness. Breast -feeding while using this drug is not recommended. Consult your doctor before breast-feeding. Interactions See also Warning section. Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions.

Do not start, stop, or change the dosage of any medicines without your doctor's approval. Some products that may interact with this drug include: Guaifenesin is available in both prescription and nonprescription products. Medications with the potential to slow GI motility, such as opiate agonists, should be used with caution, if at all, with pramlintide until more data are available from the manufacturer.

Moderate Concomitant use of opiate agonists with other central nervous system CNS depressants can potentiate the effects of the opiate and may lead to additive CNS or respiratory depression, profound sedation, or coma. Examples of drugs associated with CNS depression include pregabalin. Moderate Opiate agonists may cause additive sedation or other CNS effects when given in combination with procarbazine.

Minor Concomitant use of propafenone with codeine-containing products may decrease the metabolism of codeine to morphine by inhibiting cytochrome CYP2D6; varying degrees of analgesia may be seen.

Moderate Concomitant use of codeine with other central nervous system CNS depressants such as quetiapine can potentiate the effects of codeine and may lead to additive CNS or respiratory depression, profound sedation, or coma.

Minor The activity of codeine is due to its conversion to morphine via the cytochrome P 2D6 hepatic isoenzyme. Quinine inhibits CYP2D6 and may decrease the conversion of codeine to morphine; a corresponding decrease in analgesia is seen. Monitor therapeutic response during coadministration. Severe Rasagiline is contraindicated for use with codeine due to the risk of serotonin syndrome. Serotonin syndrome is characterized by the rapid development of hyperthermia, hypertension, myoclonus, rigidity, autonomic instability, mental status changes e.

At least 14 days should elapse between the discontinuation of rasagiline and the initiation of codeine. Moderate Use caution if coadministration of ribociclib with codeine is necessary, as the systemic exposure of codeine may be increased resulting in an increase in treatment-related adverse reactions including sedation and respiratory depression; adjust the dose of codeine if necessary. Ribociclib is a moderate CYP3A4 inhibitor. Moderate Concomitant use of codeine with other central nervous system CNS depressants, such as risperidone, can potentiate the effects of codeine and may lead to additive CNS or respiratory depression, profound sedation, or coma.

Major Use caution if codeine and rolapitant are used concurrently, and monitor for decreased efficacy of codeine. The inhibitory effect of rolapitant lasts for at least 7 days, and may last longer after single dose administration. Moderate Concomitant use of opiate agonists with other central nervous system CNS depressants such as ropinirole can potentiate the effects of the opiate and may lead to additive CNS or respiratory depression, profound sedation, or coma.

Severe Safinamide is contraindicated for use with codeine due to the risk of serotonin syndrome. At least 14 days should elapse between the discontinuation of safinamide and the initiation of codeine.

Moderate Concomitant use of codeine with sedating H1 blockers can potentiate respiratory depression and sedation. In addition, chlorpheniramine and diphenhydramine inhibit CYP2D6, an enzyme responsible for the metabolism of codeine. Monitor patients on these combinations closely. The analgesic activity of codeine may be reduced when it is combined with drugs that inhibit CYP2D6, such as sertraline. Moderate Concurrent use of sevoflurane with opiate agonists such as codeine can reduce the minimal alveolar concentration MAC and increase the CNS depression, hypotension, and respiratory depression associated with sevoflurane administration.

However, concurrent use of sevoflurane is compatible with opioids is common in surgical practice. Moderate Prolonged erections have been reported in two patients taking sildenafil with dihydrocodeine. Although more data are needed, use caution when prescribing opiate agonists and sildenafil concomitantly.

Major Additive CNS depressant effects may be possible when sodium oxybate is used concurrently with opiate agonists. Moderate Monitor patients for signs of urinary retention or reduced gastric motility when codeine is used concomitantly with an anticholinergic drug, such as solifenacin. Moderate CNS depressant drugs may have cumulative effects when administered concurrently and they should be used cautiously with suvorexant. A reduction in dose of the CNS depressant may be needed in some cases.

Major Additive CNS depressive effects are expected if tapentadol is used in conjunction with other CNS depressants, including other opiate agonists. Severe hypotension, profound sedation, coma, or respiratory depression may occur. Prior to concurrent use of tapentadol in patients taking a CNS depressant, assess the level of tolerance to CNS depression that has developed, the duration of use, and the patient's overall response to treatment.

If the extended-release tapentadol tablets are used concurrently with a CNS depressant, it is recommended to use an initial tapentadol dose of 50 mg PO every 12 hours. Moderate Use caution if coadministration of telotristat ethyl and codeine is necessary, as the systemic exposure of codeine and resultant morphine may be decreased resulting in reduced efficacy or onset of a withdrawal syndrome in patients who have developed physical dependence.

If these drugs are used together, monitor patients for suboptimal efficacy of codeine or withdrawal; consider increasing the dose of codeine if necessary. After stopping telotristat ethyl, monitor for sedation and respiratory depression at frequent intervals and consider a codeine dose reduction if necessary.

Codeine is a CYP3A4 substrate. The concomitant use of codeine with CYP3A4 inducers can decrease codeine levels, increase norcodeine levels, and decrease metabolism via 2D6, subsequently resulting in lower morphine levels.

Terbinafine may interfere with the conversion of codeine to morphine; a corresponding decrease in analgesia may be seen. Moderate Additive effects are possible when tetrabenazine is combined with other drugs that cause CNS depression.

Concurrent use of tetrabenazine and drugs that can cause CNS depression, such as opiate agonists, can increase both the frequency and the intensity of adverse effects such as drowsiness, sedation, dizziness, and orthostatic hypotension. Major Due to the central nervous system depression potential of all local anesthetics, they should be used with caution with other agents that can cause respiratory depression, such as opiate agonists.

Restlessness, anxiety, tinnitus, dizziness, blurred vision, tremors, depression, or drowsiness may be early warning signs of CNS toxicity. After each local anesthetic injection, careful and constant monitoring of ventilation adequacy, cardiovascular vital signs, and the patient's state of consciousness is advised. Major Avoid the concomitant use of thalidomide with opiate agonists; antihistamines; antipsychotics; anxiolytics, sedatives, and hypnotics; and other central nervous system depressants due to the potential for additive sedative effects.

Moderate Thiothixene can potentiate the CNS-depressant action of other drugs such as opiate agonists. Caution should be exercised during simultaneous use of these agents due to potential excessive CNS effects or additive hypotension.

Moderate Monitor patients for signs of urinary retention or reduced gastric motility when codeine is used concomitantly with an anticholinergic drug, such as tolterodine. Moderate CNS depressants such as opiate agonists should be used cautiously in patients receiving trazodone because of additive CNS-depressant effects, including possible respiratory depression or hypotension. Moderate The concurrent use of trimethobenzamide with other medications that cause CNS depression, like opiate agonists, may potentiate the effects of either trimethobenzamide or the opiate agonist.

Moderate Monitor patients for signs of urinary retention or reduced gastric motility when opiate agonists are used concomitantly with an anticholinergic drug, such as trospium. Moderate Any substances that act on the CNS may theoretically interact with valerian, Valeriana officinalis.

The valerian derivative, dihydrovaltrate, binds at barbiturate binding sites; valerenic acid has been shown to inhibit enzyme-induced breakdown of GABA in the brain; the non-volatile monoterpenes valepotriates have sedative activity. The sedative effect may be additive to other drugs with sedative actions, such as the opiate agonists. If valerian is used concurrently with a CNS depressant, a reduced dosage of the CNS depressant may be required, or, the valerian supplement may be discontinued.

Moderate Vigabatrin may cause somnolence and fatigue. Drugs that can cause CNS depression, if used concomitantly with vigabatrin, may increase both the frequency and the intensity of adverse effects such as drowsiness, sedation, and dizziness. Caution should be used when vigabatrin is given with opiate agonists.

Moderate Due to the CNS effects of vilazodone, caution should be used when vilazodone is given in combination with other centrally acting medications such as opiate agonists. Moderate Concomitant use of zaleplon can potentiate the effects of codeine, which may potentially lead to respiratory depression, CNS depression, sedation, or hypotensive responses.

Moderate Concurrent use of ziconotide and opiate agonists may result in an increased incidence of dizziness and confusion. Ziconotide neither interacts with opiate receptors nor potentiates opiate-induced respiratory depression. However, in animal models, ziconotide did potentiate gastrointestinal motility reduction by opioid agonists.

Moderate Ziprasidone has the potential to impair cognitive and motor skills. Additive CNS depressant effects are possible when ziprasidone is used concurrently with any CNS depressant, including codeine. Moderate Concomitant use of zolpidem can potentiate the effects of codeine, which may potentially lead to respiratory depression, CNS depression, sedation, or hypotensive responses. In addition, sleep-related behaviors, such as sleep-driving, are more likely to occur during concurrent use of zolpidem and other CNS depressants than with zolpidem alone.

For Intermezzo brand of sublingual zolpidem tablets, reduce the dose to 1. It is not known if guaifenesin is excreted into breast milk, but codeine is distributed into breast milk in varying degrees depending upon the dose. Codeine is metabolized to morphine, which is also distributed into breast milk.

Breast-fed infants of women who quickly metabolize codeine ultra-rapid metabolizer may ingest dangerous amounts of morphine. The mother was taking codeine 30 mg and acetaminophen mg tablets. The mother initially took 2 tablets every 12 hours for episiotomy pain, but she took half of this dose from day 2 to 14 because of somnolence and constipation.

Ultra-rapid metabolizers have a specific CYP2D6 genotype and may change codeine to morphine more rapidly and completely than other people. Ultra-rapid metabolizers are more likely to have higher than normal blood and breast milk morphine concentrations after taking codeine.

Ultra-rapid metabolism has only been reported as a problem with codeine, although ultra-rapid metabolism has the potential to affect other narcotics. Too much of any narcotic in breast milk can be fatal to a nursing infant. The estimated number of ultra-rapid metabolizers varies among different population groups from less than 1 per people up to 28 per people. Although a genetic test to identify ultra-metabolizers is available, the risk of having an adverse event when taking codeine is not known.

The test result alone may not correctly predict if a mother's milk will have too much morphine if she ingests codeine. According to the manufacturer, because of the risk of adverse effects in the infant, a decision whether to discontinue breast-feeding the infant or to discontinue codeine; guaifenesin should be made.

Although data in breast-feeding women are not available, some experts state that the maternal use of usual doses of dextromethorphan and guaifenesin is unlikely to be harmful to a nursing infant; therefore, dextromethorphan; guaifenesin may represent a reasonable alternative in some patients.

However, care should be taken to avoid preparations with a high alcohol content. The antitussive effects of codeine are mediated through direct action on receptors in the cough center of the medulla in the brain.

Codeine also has a drying effect on the respiratory tract and increases the viscosity of bronchial secretions. Cough suppression can be achieved at lower doses than those required to produce analgesia. Guaifenesin is an expectorant which increases the output of phlegm sputum and bronchial secretions by reducing adhesiveness and surface tension. The increased flow of less viscous secretions promotes ciliary action and changes a dry, unproductive cough to one that is more productive and less frequent.

By reducing the viscosity and adhesiveness of secretions, guaifenesin increases the efficacy of the mucociliary mechanism in removing accumulated secretions from the upper and lower airway. The expectorant effect can reduce cough frequency. Guaifenesin can also be beneficial for irritating, nonproductive coughs and for conditions in which thick mucous secretions are produced.

The metabolism of codeine is primarily by glucuronidation with a minor amount of codeine metabolized to morphine via O-demethylation. The metabolism to morphine is mediated by CYP2D6. Elimination half-life ranges from 3—4 hours for codeine and is 2 hours for morphine.

Elimination occurs renally as the unchanged drug, norcodeine, and free and conjugated morphine. Negligible amounts are excreted in the feces. Excessive use of guaifenesin may result in urolithiasis; renal stones have been documented to contain beta- 2-methoxyphenoxy -lactic acid and other guaifenesin metabolites. Additional pharmacokinetic information is not known. Codeine is well absorbed after oral administration. Peak antitussive activity is achieved within 1—2 hours of oral administration and can last for 4—6 hours.

Protein binding is negligible. Guaifenesin is rapidly absorbed from the GI tract and has a plasma half-life of about 1 hour. Call your doctor if your symptoms do not improve after 7 days of treatment, or if you also have a fever, headache, or skin rash. This medication can cause unusual results with certain medical tests. Tell any doctor who treats you that you are using codeine and guaifenesin.

Do not stop using this medication suddenly after long-term use or you could have unpleasant withdrawal symptoms. Ask your doctor how to avoid withdrawal symptoms when you stop using the medication.

Store at room temperature away from moisture, heat, and light. Keep the bottle tightly closed when not in use. Keep track of the amount of medicine used from each new bottle. Codeine is a drug of abuse and you should be aware if anyone is using your medicine improperly or without a prescription.

What happens if I miss a dose? Since cough medicine is taken when needed, you may not be on a dosing schedule. If you are taking the medication regularly, take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose. Codeine and guaifenesin will not treat a cough that is caused by smoking, asthma, or emphysema. Codeine and guaifenesin may also be used for other purposes not listed in this medication guide.

What are the possible side effects of codeine and guaifenesin? Get emergency medical help if you have any of these signs of an allergic reaction: Stop taking this medication and call your doctor at once if you have any of these serious side effects: Less serious side effects include:

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