Physician reviewed Cheratussin AC patient information Allfen CD, Cheracol with Codeine, Cheratussin AC, Codar GF Keep track of the amount of medicine used.

This medication is not usually used for ongoing coughs from smoking , asthma , other long-term breathing problems e. Do not use this product in children younger than 18 years. There is a risk of serious rarely fatal side effects, such as breathing problems. Cough -and-cold products do not cure colds. Cough due to a common cold often does not need to be treated with medicine.

Moderate Concomitant use of CNS depressants can potentiate the effects of codeine, which may potentially lead to respiratory depression, CNS depression, sedation, or hypotensive responses. Moderate Monitor for reduced efficacy of codeine and signs of opioid withdrawal if coadministration with enzalutamide is necessary; consider increasing the dose of codeine as needed.

If enzalutamide is discontinued, consider a dose reduction of codeine and frequently monitor for signs or respiratory depression and sedation.

The CYP3A4 pathway is an important metabolic clearance route for codeine, and inhibition of this metabolic pathway by CYP3A4 inhibitors, such as erythromycin, may lead to elevated codeine concentrations that are available for conversion to morphine by CYP2D6. Escitalopram modestly inhibits metabolism via the CYP2D6 pathway. Moderate Concomitant use of eszopiclone with codeine can potentiate the effects of codeine, which may potentially lead to respiratory depression, CNS depression, sedation, or hypotensive responses.

In addition, the risk of next-day psychomotor impairment is increased during co-administration of eszopiclone and other CNS depressants, which may decrease the ability to perform tasks requiring full mental alertness such as driving.

Prior to concurrent use, assess the level of tolerance to CNS depression that has developed, the duration of use, and the patient's overall response to treatment. Major Alcohol is associated with CNS depression. The combined use of alcohol and CNS depressants can lead to additive CNS depression, which could be dangerous in tasks requiring mental alertness and fatal in overdose.

Alcohol taken with other CNS depressants can lead to additive respiratory depression, hypotension, profound sedation, or coma. Consider the patient's use of alcohol or illicit drugs when prescribing CNS depressant medications.

In many cases, the patient should receive a lower dose of the CNS depressant initially if the patient is not likely to be compliant with avoiding alcohol. Moderate Additive CNS depression could be seen with the combined use of the hydantoin and opiate agonists. Major Concomitant use of CNS depressants can potentiate the effects of codeine, which may potentially lead to respiratory depression, CNS depression, sedation, or hypotensive responses. Moderate Monitor for signs and symptoms of respiratory depression or sedation and analgesic response if coadministration of codeine and everolimus is necessary, particularly if everolimus is added after a stable dose of codeine is achieved.

If concurrent use is necessary, use the lowest effective dose of codeine and carefully titrate to desired clinical effect. Concurrent use of a CYP3A4 inhibitor may shift codeine metabolism away from the CYP3A4 pathway such that more codeine is metabolized by CYP2D6, resulting in a higher rate of conversion to morphine and subsequent adverse events including respiratory depression, hypotension, profound sedation, and death. Discontinuation of a CYP3A4 inhibitor in a patient stabilized on codeine may decrease opioid efficacy and lead to withdrawal symptoms.

Alternatively, CYP2D6 inhibitors can increase the plasma concentration of codeine, but decrease exposure to morphine resulting in decreased analgesia or opioid withdrawal. Discontinuation of a CYP2D6 inhibitor results in decreased codeine concentrations as the effect of the inhibitor declines but increased morphine plasma concentrations which may result in increased or prolonged opioid-related adverse reactions and potentially fatal respiratory depression.

Moderate Monitor patients for signs of urinary retention or reduced gastric motility when fesoterodine, an anticholinergic drug for overactive bladder. Patients should avoid activities requiring full alertness e. Moderate The activity of codeine is due to its conversion to morphine via the CYP2D6 hepatic isoenzyme and therefore its analgesic effectiveness may vary greatly when combined with drugs that potently inhibit CYP2D6, such as fluoxetine.

Moderate In vitro studies have shown no effect of carbamazepine and phenytoin on the conversion of codeine to morphine. However, CYP inducers e. If co-administration with codeine is necessary, caution is advised when initiating therapy with, currently taking, or discontinuing any potent CYP3A4 inducers. Evaluate these patients at frequent intervals and consider dose adjustments until stable drug effects are achieved. When using barbiturates with codeine, additive sedation and respiratory depression will be expected to occur.

Moderate Monitor for codeine toxicities that may require codeine dose reduction if given concurrently with fostamatinib. Moderate Pain medications that contain opiate agonists may intensify CNS depressive adverse effects seen with gabapentin use, such as drowsiness or dizziness.

Patients should limit activity until they are aware of how coadministration affects them. Moderate Monitor for decreased efficacy of codeine if gefitinib and codeine are used concomitantly. At high concentrations, gefitinib is an inhibitor of CYP2D6, which is partially responsible for the metabolism of codeine to morphine. Moderate Guanabenz is associated with sedative effects. Guanabenz can potentiate the effects of CNS depressants such as opiate agonists, when administered concomitantly.

Moderate Central-acting adrenergic agonists like guanfacine have CNS depressive effects and can potentiate the actions of other CNS depressants including opiate agonists. Moderate Clinically relevant drug interactions may occur when guselkumab is administered with sensitive substrates of CYP2D6, such as codeine.

Monitor codeine concentrations if guselkumab is initiated or discontinued; the codeine dose may need to be adjusted. During chronic inflammation, increased levels of certain cytokines can alter the formation of CYP enzymes.

Thus, the formation of CYP2D6 could be normalized during guselkumab administration. Moderate Haloperidol inhibits CYP2D6 and may decrease the conversion of codeine to morphine, decreasing its effectiveness.

Moderate Methyldopa is associated with sedative effects. Methyldopa can potentiate the effects of CNS depressants, such as opiate agonists, when administered concomitantly. Moderate Opiate agonists like codeine may potentiate orthostatic hypotension when given concomitantly with spironolactone. Hydrocodone; Potassium Guaiacolsulfonate; Pseudoephedrine: Major Concomitant use of hydromorphone with other central nervous system CNS depressants, such as other opiate agonists, can potentiate the effects of hydromorphone and may lead to additive CNS or respiratory depression, profound sedation, or coma.

Prior to concurrent use of hydromorphone 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. Moderate Concomitant use of iloperidone with other centrally-acting medications such as opiate agonists, may increase both the frequency and the intensity of adverse effects including drowsiness, sedation, and dizziness. Moderate The activity of codeine is due to its conversion to morphine via the cytochrome P 2D6 hepatic isoenzyme.

Codeine has a low affinity for CYP2D6; therefore, its analgesic activity may vary greatly when it is combined with any other drugs that inhibit CYP2D6 including imatinib. Moderate CYP inducers e. Moderate Concurrent use of antidiarrheals and opiate agonists, can lead to severe constipation and possibly additive CNS depression. Moderate Monitor for an increase in codeine-related adverse reactions including sedation and respiratory depression if coadministration with letermovir is necessary; adjust the dose of codeine if necessary.

The magnitude of this interaction may be increased in patients also receiving cyclosporine. Moderate Lincosamides, which have been shown to exhibit neuromuscular blocking action, can enhance the effects of opiate agonists if used concomitantly, enhancing respiratory depressant effects. They should be used together with caution and the patient carefully monitored.

Linezolid is a reversible, non-selective inhibitor of MAO. Moderate Monitor for excessive hypotension and sedation during coadministration of lofexidine and codeine.

Lofexidine can potentiate the effects of CNS depressants. Concurrent use of selected antidiarrheals e. Moderate Loxapine can potentiate the actions of other CNS depressants such as opiate agonists. Caution should be exercised with simultaneous use of these agents due to potential excessive CNS effects. Minor Concomitant use of codeine and lumacaftor; ivacaftor may alter the response to codeine; if used together, monitor analgesic activity and adverse drug reactions.

Lumacaftor is a strong CYP3A inducer. Induction of codeine through the CYP3A pathway may increase plasma concentrations of norcodeine. Moderate Due to the CNS effects of lurasidone, caution should be used when lurasidone is given in combination with other centrally acting medications such as opiate agonists.

Minor Because of the CNS-depressant effects of magnesium sulfate, additive central-depressant effects can occur following concurrent administration with CNS depressants such as opiate agonists. Caution should be exercised when using these agents concurrently. Moderate Concomitant use of codeine with other central nervous system CNS depressants, such as maprotiline, can potentiate the effects of codeine and may lead to additive CNS or respiratory depression, profound sedation, or coma.

Prior to concurrent use of codeine 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.

Moderate Concomitant use of meprobamate with codeine can potentiate the effects of codeine, which may potentially lead to respiratory depression, CNS depression, sedation, or hypotensive responses. Major Concomitant use of methadone with another CNS depressant can lead to additive respiratory depression, hypotension, profound sedation, or coma. Prior to concurrent use of methadone 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.

Methadone should be used with caution and in reduced dosages if used concurrently with a CNS depressant; also consider a using a lower dose of the CNS depressant. Moderate Opiate agonists antagonize GI motility and can decrease the gastroprokinetic effects of metoclopramide. Other drugs that may also cause drowsiness, such as opiate agonists, should be used with caution.

Moderate The concomitant administration of metyrosine with opiate agonists can result in additive sedative effects. Minor Injectable minocycline contains magnesium sulfate heptahydrate. Because of the CNS-depressant effects of magnesium sulfate, additive central-depressant effects can occur following concurrent administration with CNS depressants such as opiate agonists. Moderate Concurrent use of codeine with mirabegron may increase the risk of increased opioid-related adverse reactions, such as fatal respiratory depression.

Consider a dose reduction of codeine until stable drug effects are achieved. Monitor patients for respiratory depression and sedation at frequent intervals. Mirabegron is a moderate inhibitor of CYP2D6. Discontinuation of mirabegron in a patient taking codeine chronically may decrease codeine plasma concentrations, decrease opioid efficacy, and potentially lead to a withdrawal syndrome in those with physical dependence to opioid agonists.

If mirabegron is discontinued, monitor the patient carefully and consider increasing the opioid dosage if appropriate. Moderate Concomitant use of CNS depressants, such as mirtazapine, can potentiate the effects of codeine, potentially leading to respiratory depression, CNS depression, sedation, or hypotensive responses.

In some cases, a dose reduction of codeine or the second agent may be warranted. Major Use caution if mitotane and codeine are used concomitantly, and monitor for decreased efficacy of codeine and a possible change in dosage requirements.

What happens if I miss a dose? Since Cheratussin AC is used when needed, you may not be on a dosing schedule. If you are on a schedule, use the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not use extra medicine to make up the missed dose. What happens if I overdose? Seek emergency medical attention or call the Poison Help line at A codeine overdose can be fatal, especially in a child or other person using the medicine without a prescription.

Overdose symptoms may include slow breathing and heart rate, severe drowsiness, muscle weakness, cold and clammy skin, pinpoint pupils, and fainting. What should I avoid while taking Cheratussin AC? This medicine may impair your thinking or reactions. Avoid driving or operating machinery until you know how this medicine will affect you. Dizziness or severe drowsiness can cause falls or other accidents. Keep the liquid form of this medicine from freezing.

Do not refrigerate the syrup. Allergies TOP Tell your doctor if you have ever had any unusual or allergic reaction to medicines in this group or any other medicines. Also tell your health care professional if you have any other types of allergies , such as to foods dyes, preservatives, or animals.

For non-prescription products, read the label or package ingredients carefully. Pediatric TOP Very young children are usually more sensitive to the effects of this medicine. Before giving any of these combination medicines to a child, check the package label very carefully. Some of these medicines are too strong for use in children. If you are not certain whether a specific product can be given to a child, or if you have any questions about the amount to give, check with your health care professional, especially if it contains: Antihistamines—Nightmares, unusual excitement, nervousness, restlessness, or irritability may be more likely to occur in children taking antihistamines.

Also, unusual excitement or restlessness may be more likely to occur in children receiving these medicines. This is very important because salicylates may cause a serious illness called Reye's syndrome in children with fever caused by a virus infection, especially flu or chickenpox.

Also, children may be more sensitive to the aspirin or other salicylates contained in some of these medicines, especially if they have a fever or have lost large amounts of body fluid because of vomiting, diarrhea , or sweating.

Geriatric TOP The elderly are usually more sensitive to the effects of this medicine, especially if it contains: Antihistamines—Confusion, difficult or painful urination , dizziness, drowsiness, feeling faint, or dryness of mouth, nose, or throat may be more likely to occur in elderly patients. Also, nightmares or unusual excitement, nervousness, restlessness, or irritability may be more likely to occur in the elderly taking antihistamines. Also, increases in blood pressure may be more likely to occur in elderly persons taking decongestants.

Check the label to see if a medicine contains an guaifenesin, or an expectorant. Codeine and guaifenesin may impair your thinking or reactions. Avoid driving or operating machinery until you know how this medicine will affect you. Codeine may be habit-forming and should be used only by the person it was prescribed for. This medication should never be shared with another person, especially someone who has a history of drug abuse or addiction.

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