The phosphate salt of codeine occurs as white, needle-shaped crystals or white crystalline powder. Codeine phosphate is freely soluble in drinking water and slightly soluble in Alcoholic beverages. The molecular excess weight is 406.37. Its molecular system is C18H21NO3•H3PO4 • ½ H2O, and it has the following chemical structure.
On the whole, dose selection for an elderly affected individual need to be careful, usually starting off on the very low stop from the dosing array, reflecting the greater frequency of lowered hepatic, renal or cardiac purpose, and of concomitant illness or other drug therapy.
Caution must be exercised when administering promethazine to pediatric individuals 2 yrs of age and older. It is recommended that the bottom productive dose of promethazine be Utilized in pediatric people 2 many years of age and more mature and concomitant administration of other medications with respiratory depressant consequences be averted.
The estimated track record possibility of significant beginning defects and miscarriage for that indicated inhabitants is unknown. All pregnancies Have a very qualifications hazard of birth defect, loss, or other adverse outcomes.
The combination of promethazine hydrochloride and codeine phosphate is contraindicated in pediatric individuals lower than six several years of age. Concomitant administration of promethazine items with other respiratory depressants has an Affiliation with respiratory depression, and in some cases Loss of life, in pediatric sufferers.
Neuroleptic malignant syndrome (NMS) which can result in Demise. Tell you healthcare company at once In case you have any of the subsequent signs and symptoms of NMS:
Sedation This product relieves apprehension and induces a silent snooze from which the individual might be conveniently aroused.
The consequences of concomitant use or discontinuation of cytochrome P450 3A4 inducers, 3A4 inhibitors, or 2D6 inhibitors with codeine are complicated, necessitating thorough thing to consider of the consequences on the mum or dad drug, codeine, plus the Lively metabolite, morphine.
Indications and signs and symptoms of overdosage with Promethazine HCl range between mild melancholy from the central anxious procedure and cardiovascular system to profound hypotension, respiratory depression, unconsciousness, and unexpected Demise.
If your reaction to an opioid antagonist is suboptimal or only temporary in mother nature, administer more antagonist as directed because of the product’s prescribing info. The respiratory depressant results of promethazine are usually not reversed by opioid antagonists, for instance naloxone.
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The opioid antagonists, naloxone and nalmefene, are specific antidotes for respiratory despair resulting from opioid overdose. For clinically important respiratory or circulatory depression secondary to codeine overdose, administer an opioid antagonist. An antagonist shouldn't be administered during the absence of clinically significant respiratory depression. Since the period of opioid reversal is expected to get a lot less than the duration of action of codeine in Promethazine HCl and Codeine Phosphate Oral Remedy, thoroughly keep track of the client right until spontaneous respiration is reliably reestablished.
The concomitant usage of Promethazine HCl and here Codeine Phosphate Oral Solution with all cytochrome P450 3A4 inducers or discontinuation of a cytochrome P450 3A4 inhibitor may cause reduced codeine ranges, greater norcodeine levels, and fewer metabolism through 2D6 with resultant lower morphine ranges.
Bodily dependence, the ailment in which ongoing administration on the drug is needed to stop the appearance of the withdrawal syndrome, assumes clinically major proportions only immediately after a number of weeks of ongoing oral opioid use, Despite the fact that some mild diploma of Actual physical dependence may develop soon after a couple of days of opioid therapy.