Promethazine + Codeine - Oral

Promethazine and Codeine are combined in this medicine.

Promethazine + Codeine is used for the temporary relief of cough and certain symptoms associated with allergies or common cold.

Take Promethazine + Codeine exactly as directed by your doctor or according to the instructions on the label. Do not take more or less than instructed by your doctor.

Promethazine + Codeine is available as an oral solution.

To take the oral solution, use the measuring device provided to measure or deliver your dose. Your doctor or pharmacist will show you how to properly use the measuring device and administer the dose. Always ask your doctor or pharmacist if you are not sure how to take your medicine.

The dose of this medicine will be decided by your doctor. Your doctor will advise you on the treatment timeframe depending on your condition and your response to the medication.

Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and return to your normal dosing schedule.

DO NOT double a dose under any circumstances.

Alert your doctor if you have the following conditions:

• severe respiratory depression (slow or ineffective breathing)
• acute or severe asthma
• known or suspected obstruction in the stomach or bowel e.g. paralytic ileus (bowel obstruction caused by slow movement or paralysis of the intestines)

as Promethazine + Codeine may not be suitable for you.

Generally, do not give this medicine to children below 12 years old. Additionally, do not give Promethazine + Codeine to children below 18 years who have undergone surgery or removal of tonsils and/or adenoid glands (glands that help protect the body from bacteria and viruses), unless instructed to do so by the doctor.

Some genetic traits can affect level in the blood. Individuals who have increased CYP2D6 activity, also known as ultrarapid metabolisers of CYP2D6 may experience enhanced effects from Promethazine + Codeine, which also increases the risk of causing serious side effects. On the other hand, individuals who are poor metabolisers of CYP2D6 may respond poorer to this medicine. Though not routinely done, your doctor may advise you to undergo genetic testing to check if this medicine is best suited for you. If you know you have either of these gene types, alert your doctor.

Do not take Promethazine + Codeine if you are currently taking or have taken a medicine that is used to treat depression known as a monoamine oxidase inhibitor (MAOI) such as isocarboxazid, phenelzine and tranylcypromine in the last 14 days.

Inform your doctor if you have the following conditions:

• lung disease e.g. chronic obstructive pulmonary disease (a long-term lung disease that causes airflow obstruction making it hard to breathe)
• heart disease e.g. recent heart attack
• hypovolaemia (low volume of circulating fluids in the body)
• low blood pressure
• bone marrow suppression (a condition in which the blood cells are low)
• delirium tremens or alcohol withdrawal delirium (severe tremors, hallucination, and disorientation caused by withdrawal from alcohol)
• mental illness e.g. mood disorder, depression
• history of drug abuse
• epilepsy (fits or seizures) or predisposing conditions to fits or seizures e.g. head injury, brain damage, alcoholism
• myasthenia gravis (muscle weakness disorder)
• sleep apnoea (sleep disorder that causes interrupted breathing during sleep)
• Addison's disease (a rare disorder where the adrenal glands produce insufficient amounts of certain hormones)
• increased pressure in the eye
• stomach or bowel disorder
• biliary tract (group of organs that produce, store, and secrete bile in the body) disorder
• inflammation of the pancreas
• prostate enlargement or difficulty in passing urine
• kidney disease
• liver disease

Let your doctor know if you are pregnant or breastfeeding.

Be sure to check with your doctor or pharmacist before giving Promethazine + Codeine to a child, the elderly, obese, or debilitated individual (a person who is physically or mentally weak usually due to illness or old age). Children, elderly people, obese, or debilitated individuals may be more sensitive to the side effects.

This medicine may affect the ability of your body to maintain its internal temperature within the normal range. Discuss with your doctor if you frequently need to exercise, participate in any activity, or work in a hot environment.

Individuals who have reduced CYP2D6 activity known as intermediate metabolisers of CYP2D6 may respond poorer to this medicine. Although not routinely done, your doctor may advise you to undergo genetic testing to check if this medicine is best suited for you. If you know you have this gene type, inform your doctor.

If you are going to have certain laboratory tests (e.g. pregnancy test, skin test, blood sugar tests, blood tests for certain enzymes called amylase or lipase), inform your doctor that you are taking this medicine.

Why is it important to keep my appointments with the doctor?

Keep your appointments with your doctor. Your doctor needs to monitor your condition and check your response to the medication regularly.

• Routine tests (e.g. lung or bowel function) may be done while you are being treated with this medicine. Your doctor will advise you about how often you need to have these tests.
• Your blood pressure may fall to unsafe levels without you noticing it. Monitor your blood pressure regularly during treatment.
• Regular monitoring of heart rate, mental status, cough relief, and signs and symptoms of substance abuse, misuse, or addiction may also be needed.

Promethazine + Codeine may cause drowsiness or blurred vision. If affected, do not drive or take part in any activity in which you need to be alert or need to see clearly.

This medicine may cause your blood pressure to fall suddenly when you get up from a sitting or lying down position and you may feel giddy. To minimise this problem, stand up slowly.


Other side effects include any of the following: nausea, vomiting, headache, abdominal cramps, abdominal pain, dry mouth, tiredness, weakness, flushing, rashes, and sweating.

Some side effects may need immediate medical help. Alert your doctor quickly if you experience any of the following:

• slow, shallow, or trouble breathing
• high fever, muscle cramps or stiffness, severe headache, fast or abnormal heartbeat, excessive sweating
• problems controlling body movements, change in balance, trouble speaking or swallowing, twitching
• severe stomach pain or constipation
• severe dizziness or passing out, headache or changes in vision
• frequent sore throat, mouth sores, chills
• fits or seizures
• unusual changes in mood or behaviour (being too depressed, agitated, or having compulsive and impulsive behaviour), hallucination (seeing, hearing or feeling things that are not existent)
• difficulty in passing urine
• yellowing of the skin or eyes

Inform your doctor if any of these side effects do not go away or are severe, or if you experience other side effects.

Do not take Promethazine + Codeine if you are currently taking or have taken a medicine to treat depression known as monoamine oxidase inhibitor (MAOI) such as isocarboxazid, phenelzine, and tranylcypromine in the last 14 days.

Inform your doctor and pharmacist if you are taking any of these medicines:

• other medicines that cause drowsiness or affect your concentration
• medicines for HIV infection e.g. ritonavir
• medicines used to treat fungal infection e.g. ketoconazole
• medicines for epilepsy (fits or seizures) e.g. carbamazepine, phenytoin
• medicines for irregular heartbeat e.g. amiodarone, quinidine
• certain antibiotics e.g. erythromycin
• rifampicin (medicine to treat TB, an infection known as tuberculosis)

This list does not include all medicines that may interact with Promethazine + Codeine.

Always notify your doctor and pharmacist if you are taking any other medicines, including herbal tonics such as traditional Chinese medicines, supplements, and medicines that you buy without a prescription.

Avoid alcohol. Alcohol intake may worsen the dizziness and drowsiness caused by Promethazine + Codeine.

Store in a cool, dry place away from the reach of children.

Medicines must not be used past the expiry date.