Promethazine with codeine cough syrup online

Convulsions Convulsions have occurred with therapeutic doses and overdoses of promethazine hydrochloride in pediatric patients. Promethazine may lower seizure threshold. It should be used with caution in persons with seizure disorders or in persons who are using concomitant medications, such as narcotics or local anesthetics, which may also affect seizure threshold.

Dystonias Promethazine is a phenothiazine. Phenothiazines are associated with dystonic reactions. In pediatric patients who are acutely ill associated with dehydration, there is an increased susceptibility to dystonias with the use of promethazine hydrochloride. Head Injury and Increased Intracranial Pressure The respiratory-depressant effects of narcotic analgesics and their capacity to elevate cerebrospinal fluid pressure may be markedly exaggerated in the presence of head injury, intracranial lesions, or a pre-existing increase in intracranial pressure.

Narcotics may produce adverse reactions which may obscure the clinical course of patients with head injuries. Clinical manifestations of NMS are hyperpyrexia, muscle rigidity, altered mental status and evidence of autonomic instability irregular pulse or blood pressure, tachycardia, diaphoresis and cardiac dysrhythmias.

The diagnostic evaluation of patients with this syndrome is complicated. In arriving at a diagnosis, it is important to identify cases where the clinical presentation includes both serious medical illness e.

Other important considerations in the differential diagnosis include central anticholinergic toxicity, heat stroke, drug fever and primary central nervous system CNS pathology.

The management of NMS should include 1 immediate discontinuation of promethazine hydrochloride, antipsychotic drugs, if any, and other drugs not essential to concurrent therapy, 2 intensive symptomatic treatment and medical monitoring, and 3 treatment of any concomitant serious medical problems for which specific treatments are available.

There is no general agreement about specific pharmacological treatment regimens for uncomplicated NMS. Unresponsive Cough Dosage of codeine should not be increased if cough fails to respond; an unresponsive cough should be reevaluated in 5 days or sooner for possible underlying pathology, such as foreign body or lower respiratory tract disease.

Cardiovascular Effects Codeine may produce orthostatic hypotension in ambulatory patients. Bone-Marrow Depression Promethazine should be used with caution in patients with bone-marrow depression.

Leukopenia and agranulocytosis have been reported, usually when promethazine hydrochloride has been used in association with other known marrow-toxic agents.

Constipation Codeine may cause or aggravate constipation. Other Considerations Administration of promethazine has been associated with reported cholestatic jaundice. Administration of codeine may be accomplished by histamine release and should be used with caution in atopic children.

Promethazine should be used cautiously in persons with impairment of liver function. Anticholinergic Effects Drugs having anticholinergic properties should be used with caution in patients with narrow-angle glaucoma, prostatic hypertrophy, stenosing peptic ulcer, pyloroduodenal obstruction, and bladder-neck obstruction. Information for Patients Advise patients of the risks of respiratory depression and death with promethazine hydrochloride and codeine phosphate syrup in children younger than 18 years of age.

Ambulatory patients should be told to avoid engaging in such activities until it is known that they do not become drowsy or dizzy from Promethazine and Codeine therapy.

Pediatric patients should be supervised to avoid potential harm in bike riding or in other hazardous activities. Patients should be advised to measure Promethazine hydrochloride and codeine phosphate syrup with an accurate measuring device. A household teaspoon is not an accurate measuring device and could lead to overdosage, especially when a half a teaspoon is measured.

A pharmacist can recommend an appropriate measuring device and can provide instructions for measuring the correct dose. Patients should be advised to report any involuntary muscle movements. Avoid prolonged exposure to the sun.

Codeine, like other narcotic analgesics, may produce orthostatic hypotension in some ambulatory patients. Patients should be cautioned accordingly.

The use of benzodiazepines, opioids, antihistamines, antipsychotics, anti-anxiety agents, or other CNS depressants including alcohol concomitantly with promethazine hydrochloride and codeine phosphate syrup may cause an additive CNS depressant effect, profound sedation, respiratory depression, coma, and death and should be avoided see WARNINGS - Risks from Concomitant Use with Benzodiazepines or Other CNS Depressants. Concomitant use of other agents with anticholinergic properties should be undertaken with caution.

Drug interactions, including an increased incidence of extrapyramidal effects, have been reported when some MAOI and phenothiazines are used concomitantly. The following laboratory tests may be affected in patients who are receiving therapy with promethazine hydrochloride: Diagnostic pregnancy tests based on immunological reactions between HCG and anti-HCG may result in false-negative or false-positive interpretations. An increase in blood glucose has been reported in patients receiving promethazine.

Carcinogenesis, Mutagenesis, Impairment of Fertility Long-term animal studies have not been performed to assess the carcinogenic potential of codeine or of promethazine, nor are there other animal or human data concerning carcinogenicity, mutagenicity, or impairment of fertility with these agents.

Codeine has been reported to show no evidence of carcinogenicity or mutagenicity in a variety of test systems, including the micronucleus and sperm abnormality assays and the Salmonella assay. Promethazine was nonmutagenic in the Salmonella test system of Ames. There are no studies in humans, and the significance of these findings to humans, if any, is not known.

Teratogenic effects have not been demonstrated in rat-feeding studies at doses of 6. These doses are from approximately 2.

Specific studies to test the action of the drug on parturition, lactation, and development of the animal neonate were not done, but a general preliminary study in rats indicated no effect on these parameters. Although antihistamines have been found to produce fetal mortality in rodents, the pharmacological effects of histamine in the rodent do not parallel those in man.

There are no adequate and well-controlled studies of promethazine in pregnant women. Animal reproduction studies have not been conducted with the drug combination — Promethazine and Codeine. It is not known whether this drug combination can cause fetal harm when administered to a pregnant woman or can affect reproduction capacity.

Promethazine hydrochloride and codeine phosphate syrup should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Nonteratogenic Effects Dependence has been reported in newborns whose mothers took opiates regularly during pregnancy. Withdrawal signs include irritability, excessive crying, tremors, hyperreflexia, fever, vomiting, and diarrhea. Signs usually appear during the first few days of life. Promethazine administered to a pregnant woman within two weeks of delivery may inhibit platelet aggregation in the newborn.

Labor and Delivery Narcotic analgesics cross the placental barrier. The closer to the delivery and the larger the dose used, the greater the possibility of respiratory depression in the newborn. Narcotic analgesics should be avoided during labor if delivery of a premature infant is anticipated. If the mother has received narcotic analgesics during labor, newborn infants should be observed closely for signs of respiratory depression.

Limited data suggests that use of promethazine hydrochloride during labor and delivery does not have an appreciable effect on the duration of labor or delivery and does not increase the risk of need for intervention in the newborn.

See also Nonteratogenic Effects. Children younger than 12 years of age. Children younger than 18 years of age who have had surgery removal of tonsils or adenoids. Children 12 to 18 years of age who have a high risk for breathing problems eg, obstructive sleep apnea , obesity , lung disease.

If a nursing mother is an ultra-rapid metabolizer of codeine , it could lead to morphine overdose in the nursing baby and cause very serious side effects.

For nursing mothers taking this medicine: Talk to your doctor if you have any questions about taking codeine or about how this medicine may affect your baby.

Call your doctor if you become extremely tired and have difficulty caring for your baby. Your baby should generally nurse every 2 to 3 hours and should not sleep for more than 4 hours at a time. Check with your doctor or hospital emergency room immediately if your baby shows signs of increased sleepiness more than usual , difficulty breastfeeding, difficulty breathing, or limpness.

These may be symptoms of an overdose and need immediate medical attention. This medicine may be habit-forming. If you feel that the medicine is not working as well, do not use more than your prescribed dose. Call your doctor for instructions. Using narcotics for a long time can cause severe constipation. To prevent this, your doctor may direct you to take laxatives, drink a lot of fluids, or increase the amount of fiber in your diet.

Be sure to follow the directions carefully, because continuing constipation can lead to more serious problems. This medicine may cause some people to become dizzy, drowsy, or less alert than they are normally.

Do not drive or do anything else that could be dangerous until you know how this medicine affects you. 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 Promethazine with Codeine? 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. Do not drink alcohol. Dangerous side effects or death could occur. Avoid exposure to sunlight or tanning beds. Promethazine with Codeine can make you sunburn more easily. Wear protective clothing and use sunscreen SPF 30 or higher when you are outdoors. Promethazine with Codeine side effects Get emergency medical help if you have signs of an allergic reaction:

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