Health Library

Codeine/phenylephrine/promethazine (By mouth)

Codeine Phosphate (KOE-deen FOS-fate), Phenylephrine Hydrochloride (fen-il-EF-rin hye-droe-KLOR-ide), Promethazine Hydrochloride (proe-METH-a-zeen hye-droe-KLOR-ide)

Relieves cough and stuffy nose caused by allergies. This medicine contains a narcotic.

Brand Name(s):

Promethazine VC w/Codeine

When This Medicine Should Not Be Used:

How to Use This Medicine:

Liquid, Syrup

• Your doctor will tell you how much medicine to use. Do not use more than directed.
• An overdose can be dangerous. Follow directions carefully so you do not get too much medicine at one time.
• Oral liquid: Measure the oral liquid medicine with a marked measuring spoon, oral syringe, or medicine cup.
• Drink plenty of liquids to help avoid constipation.
• This medicine is not for long-term use.
• This medicine should come with a Medication Guide. Ask your pharmacist for a copy if you do not have one.
• Missed dose: Take a dose as soon as you remember. If it is almost time for your next dose, wait until then and take a regular dose. Do not take extra medicine to make up for a missed dose.
• Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Drop off any unused narcotic medicine at a drug take-back location right away. If you do not have a drug take-back location near you, flush any unused narcotic medicine down the toilet. Check your local drug store and clinics for take-back locations. You can also check the DEA website for locations. Here is the link to the FDA safe disposal of medicines website: www.fda.gov/drugs/resourcesforyou/consumers/buyingusingmedicinesafely/ensuringsafeuseofmedicine/safedisposalofmedicines/ucm186187.htm

Drugs and Foods to Avoid:

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Do not use this medicine together with a MAO inhibitor.
• Some medicines can affect how codeine/phenylephrine/promethazine works. Tell your doctor if you are using the following:
  • Amiodarone, atomoxetine, atropine, bupropion, carbamazepine, erythromycin, fluoxetine, hydrocortisone, ketoconazole, paroxetine, phenylpropanolamine, phenytoin, propranolol, quinidine, rifampin, ritonavir
  • Amphetamine medicine
  • Blood pressure medicine (including guanfacine, nifedipine, phentolamine, reserpine)
  • Diuretic (water pill)
  • Ergot medicines
  • Medicine to treat depression, anxiety, and mental health problems (including benzodiazepine medicine, TCAs)
• Do not drink alcohol while you are using this medicine.
• Tell your doctor if you use anything else that makes you sleepy. Some examples are allergy medicine, narcotic pain medicine, and alcohol. Tell your doctor if you are also using butorphanol, nalbuphine, pentazocine, or a muscle relaxer.

Warnings While Using This Medicine:

• Tell your doctor if you are pregnant or breastfeeding, or if you have kidney disease, liver disease, Addison disease, bone marrow problems, breathing problems (including asthma, COPD, sleep apnea), diabetes, glaucoma, enlarged prostate, heart or blood vessel problems (including high blood pressure), stomach or bowel problems (including ulcers, ulcerative colitis), pancreas problems, thyroid problems, or a history of head injury, seizures, or drug or alcohol addiction. Tell your doctor if you have recently had a stomach or urinary tract surgery.
• This medicine may cause the following problems:
  • Respiratory depression (serious breathing problem that can be life-threatening)
  • Increased risk of overdose, which can lead to death
  • Neuroleptic malignant syndrome (a nerve disorder that could be life-threatening)
  • Increased risk of seizures
  • Low blood pressure
  • Adrenal gland problems
• This medicine may make you dizzy, drowsy, or lightheaded. Do not drive or do anything else that could be dangerous until you know how this medicine affects you. Sit or lie down if you feel dizzy. Stand up carefully.
• This medicine may make you bleed, bruise, or get infections more easily. Take precautions to prevent illness and injury. Wash your hands often.
• This medicine may make your skin more sensitive to sunlight. Wear sunscreen. Do not use sunlamps or tanning beds.
• This medicine can be habit-forming. Do not use more than your prescribed dose. Call your doctor if you think your medicine is not working.
• This medicine may cause constipation, especially with long-term use. Ask your doctor if you should use a laxative to prevent and treat constipation.
• Do not stop using this medicine suddenly. Your doctor will need to slowly decrease your dose before you stop it completely.
• This medicine could cause infertility. Talk with your doctor before using this medicine if you plan to have children.
• Tell any doctor or dentist who treats you that you are using this medicine. This medicine may affect certain medical test results.
• Your doctor will check your progress and the effects of this medicine at regular visits. Keep all appointments. Call your doctor if your cough does not improve or if it gets worse within 5 days.
• Keep all medicine out of the reach of children. Never share your medicine with anyone.

Possible Side Effects While Using This Medicine:

Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Changes in skin color, dark freckles
• Dark urine or pale stools, nausea, vomiting, loss of appetite, or yellow skin or eyes
• Extreme dizziness, drowsiness, or weakness, shallow breathing, slow or uneven heartbeat, sweating, cold or clammy skin, seizures
• Fever, confusion, muscle stiffness
• Inability to move the eyes, increased blinking or spasms of the eyelid, sticking out of the tongue, trouble with breathing, speaking, or swallowing
• Lightheadedness, dizziness, fainting
• Severe constipation or stomach pain
• Uncontrolled twisting movements of the neck, trunk, arms, or legs
• Unusual bleeding, bruising, or weakness

If you notice these less serious side effects, talk with your doctor:

• Mild constipation
• Sleepiness

If you notice other side effects that you think are caused by this medicine, tell your doctor

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088

Last Updated: 9/6/2024