codeine/guaifenesin (Rx)

  • Print
Brand and Other Names:Mytussin AC, Tussi-Organidin NR, more...Cheratussin AC, Guiatuss AC, Iophen C-NR

Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

codeine/guaifenesin

oral liquid: Schedule V

  • (6.3mg/100mg)/5 mL
  • (7.5mg/225mg)/5 mL
  • (8mg/200mg)/5 mL
  • (10mg/100mg)/5 mL
  • (10mg/300mg)/5 mL

capsule

  • 9mg/200mg

tablets

  • 10mg/400mg
  • 20mg/400mg
more...

Cough

Temporary control of cough caused by minor throat and bronchial irritation

Loosens mucus and thins bronchial secretions

Liquid

  • Codeine/guaifenesin
  • 15 mL [(6.3mg/100mg)/5mL] PO q4-6hr; not to exceed 90 mL/day
  • 5-7.5 mL [(7.5mg/225mg)/5mL] PO q4hr; not to exceed 45 mL/day
  • 10 mL [(8mg-10mg)/100 mg - 200 mg)]/5 mL PO q4hr; not to exceed 60 mL/day
  • 5 mL [(10mg/300mg)/5 mL] PO q4hr; not to exceed 40 mL/day
  • 5 mL [(20 mg/200 mg)/5 mL] PO q4-6hr; not to exceed 30 mL/day

Capsule

  • Codeine/guaifenesin
  • 2 capsules (10-20 mg/400 mg) PO q4hr; not to exceed 12 caps/day

Tablets

  • Codeine/guaifenesin
  • 1 tablet (10-20 mg/400 mg) PO q6hr; not to exceed 6 tabs/day

Administration

Give with food or milk if GI upset

Administer with special measuring device for accurate dose

Dosage Forms & Strengths

codeine/guaifenesin

oral liquid: Schedule V

  • (6.3mg/100mg)/5 mL
  • (7.5mg/225mg)/5 mL
  • (8mg/200mg)/5 mL
  • (10mg/100mg)/5 mL
  • (10mg/300mg)/5 mL

Capsule

  • Codeine/guaifenesin
  • 2 capsules (10-20 mg/400 mg) PO q4hr; not to exceed 12 caps/day

Tablets

  • Codeine/guaifenesin
  • 1 tablet (10-20 mg/400 mg) PO q6hr; not to exceed 6 tabs/day
more...

Cough

Capsule

6-12 years

  • 1 capsule PO q4hr

>12 years

  • 2 capsules (10-20 mg/400 mg) PO q4hr; not to exceed 12 caps/day

Liquid

6-12 years

Guaifenesin/codeine

(100 mg/6.33 mg)/5 mL

  • 7.5 mL PO q4-6hr; not to exceed 45 mL/24hr

[(100 mg-200 mg)/(8-10 mg)/5 mL]

  • 5 mL PO q4hr; not to exceed 30 mL/24hr

(300 mg/10 mg)/5 mL

  • 2.5 mL PO q4-6hr; not to exceed 20 mL/24hr

>12 years

  • 15 mL [(6.3mg/100mg)/5mL] PO q4-6hr; not to exceed 90 mL/day
  • 5-7.5 mL [(7.5mg/225mg)/5mL] PO q4hr; not to exceed 45 mL/day
  • 10 mL [(8mg-10mg)/100 mg - 200 mg)]/5 mL PO q4hr; not to exceed 60 mL/day
  • 5 mL [(10mg/300mg)/5  mL] PO q4hr; not to exceed 40 mL/day
  • 5 mL [(20 mg/200 mg)/5 mL] PO q4-6hr; not to exceed 30 mL/day

Tablet

6-12 years

  • One half tablet PO q4-6hr; not to exceed 3 tab/24hr

>12 years

  • 1 tablet (10-20 mg/400 mg) PO q6hr; not to exceed 6 tabs/day
Next:

Adverse Effects

>10%

Codeine

  • Drowsiness
  • Constipation

1-10%

Codeine

  • Bradycardia, hypotension, tachycardia
  • Confusion, dizziness, false feeling of well being, headache, lightheadedness, malaise, paradoxical CNS stimulation, restlessness, weakness
  • Rash, urticaria
  • Anorexia, nausea, vomiting, xerostomia
  • LFT's increased
  • Ureteral spasm, urination decreased
  • Dyspnea
  • Burning at injection site, blurred vision, histamine release

Frequency Not Defined

Codeine (serious)

  • Hypotension, With IV use
  • Seizure, With excessive doses
  • Anaphylactoid reaction (rare)
  • Respiratory depression

Guaifensesin

  • Headache
  • Rash
  • Nausea
  • Vomiting
Previous
Next:

Warnings

Contraindications

Codeine

  • Absolute: acute abdominal condition, diarrhea associated w/ toxins, pseudomembranous colitis, respiratory depression
  • Relative: asthma (acute), inflammatory bowel disease, respiratory impairment

Guaifenesin

  • Do not use as self-medication in chronic or persistent coughs
  • Hypersensitivity

Cautions

Codeine

  • Cardiac arrhythmias, drug abuse/dependence, emotional lability, gallbladder dz, head injury, hepatic impairment, hypothyroidism, incr ICP, prostatic hypertrophy, renal impairment, seizures w/ epilepsy, urethral stricture, urinary tract surgery
  • Risk of life threatening side effects in nursing babies, especially if mother is an ultra rapid metabolizer of codeine
  • Ibuprofen is more effective than codeine for pain from musculoskeletal injuries in children

Guaifenesin

  • Often comes in combos, check brand name/other constituents
Previous
Next:

Pregnancy & Lactation

Pregnancy category: C; category D if used for prolonged periods or in high doses at term

Lactation: excreted in breast milk; caution advised

Pregnancy Categories

A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

NA:Information not available.

more...
Previous
Next:

Pharmacology

Mechanism of Action

Codeine: Narcotic agonist analgesic with antitussive activity, mu receptor agonist

Guaifenesin: Reduces viscosity of secretions by increasing amount of respiratory tract fluid

Pharmacolinetics

Codeine

  • Half-Life: 3-4 hr
  • Onset: 30-60 min
  • Metabolism: Inactive but metabolized to morphine by CYP2D6 (missing in 5-10% of population)
  • Duration: 4-6 hr
  • Peak Plasma Time: 0.5-1 hr
  • Protein Bound: 25%
  • Excretion: urine, feces

Guaifenesin

  • Half-Life: 1 hr
  • Onset: 30 min
  • Duration: 4-6 hr
  • Metabolism: Liver
  • Metabolite: b-(2-methoxyphenoxy) lactic acid
  • Excretion: Urine
Previous
Next:

Images

Previous
Next:

Formulary

FormularyPatient Discounts

Adding plans allows you to compare formulary status to other drugs in the same class.

To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

Adding plans allows you to:

  • View the formulary and any restrictions for each plan.
  • Manage and view all your plans together – even plans in different states.
  • Compare formulary status to other drugs in the same class.
  • Access your plan list on any device – mobile or desktop.

The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

Tier Description
1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
NC NOT COVERED – Drugs that are not covered by the plan.
Code Definition
PA Prior Authorization
Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
QL Quantity Limits
Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
ST Step Therapy
Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
OR Other Restrictions
Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
Additional Offers
Email to Patient

From:

To:

The recipient will receive more details and instructions to access this offer.

By clicking send, you acknowledge that you have permission to email the recipient with this information.

Email Forms to Patient

From:

To:

The recipient will receive more details and instructions to access this offer.

By clicking send, you acknowledge that you have permission to email the recipient with this information.

Previous