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Endacof AC (Generic Codeine)

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Codeine could lead to habit formation. Provide codeine precisely as prescribed. Do not take it in larger amounts, more frequently, or otherwise differently than prescribed by your doctor. Discuss your pain management objectives, course of treatment, and additional pain management options with your healthcare professional while taking codeine. Inform your doctor if you or any family members regularly use significant amounts of alcohol, take street drugs, abuse prescription drugs excessively, experience overdosing, or currently suffer from depression or another mental disorder. If you currently have or have previously had any of these conditions, there is a higher chance that you may abuse codeine. If you suspect an opioid addiction, consult your doctor right away and ask for advice. You can also contact the SAMHSA National Helpline by calling 1-800-662-HELP, which is operated by the U.S. Substance Abuse and Mental Health Services Administration.

Breathing issues brought on by codeine can be significant or even fatal, especially in the first 24 to 72 hours of treatment and whenever the amount is raised. Throughout your therapy, your doctor will keep a close eye on you. If you have asthma or slow breathing, let your doctor know. Most likely, your doctor will advise against using codeine. Moreover, let your physician know if you now have or previously had a lung condition like chronic obstructive pulmonary disease (COPD), a group of illnesses that affect the lungs and airways, a head injury, a brain tumour, or any other condition that raises the pressure inside of your skull. The likelihood that you will experience breathing issues may be increased if you are an older adult, weak, or undernourished as a result of a sickness. Get emergency medical care if you encounter any of the following symptoms, or call your doctor right away: sluggish breathing, protracted breath gaps, or shortness of breath.

Children who used codeine were reported to have serious and perhaps fatal breathing issues, including fatalities and slow or laboured breathing. Children under the age of 18 should never be given codeine to alleviate pain or a cough. See your kid’s doctor about other therapies if your child is currently on a codeine-containing cough and cold medication.

You run a higher chance of developing breathing issues or other severe, life-threatening respiratory issues, drowsiness, or coma if you take certain drugs while receiving codeine therapy. If you now take or intend to take any of the following medications, let your doctor know: some antibiotics, such erythromycin (Erytab, Erythrocin), some antifungal drugs, like ketoconazole; benzodiazepines such carbamazepine (Carbatrol, Epitol, Equetro, Tegretol, Teril), diazepam (Diastat, Valium), lorazepam (Ativan), estazolam (Halcion), flurazepam (Estazolam), and triazolam (Halcion); drugs for mental illness or nausea, such as indinavir (Crixivan), nelfinavir (Viracept), and ritonavir (Norvir, in Kaletra); some HIV treatments; other painkillers, muscle relaxants, phenytoin (Dilantin, Phenytek), rifampin (Rifadin, Rimactane, in Rifamate), sedatives, sleeping aids, or tranquillizers are also acceptable options. The dosages of your medications may need to be adjusted, and your doctor will closely monitor you. Call your doctor right away or go to the hospital for emergency care if you experience any of the following symptoms after taking codeine with any of these drugs: unusual dizziness, lightheadedness, extreme drowsiness, sluggish or laboured breathing, or inability to respond. Make sure your carer or family members are aware of any symptoms that could be significant so they can contact an emergency room or a doctor if you are unable to do so on your own.

You run a higher chance of developing these severe, sometimes fatal side effects if you consume alcohol or other illegal substances while taking codeine. During your treatment, refrain from drinking alcohol, taking alcohol-containing prescription or over-the-counter medications, or using illegal substances.

If you are pregnant or want to become pregnant, let your doctor know. Codeine use during pregnancy increases the risk of your unborn child developing potentially fatal withdrawal symptoms. If your infant exhibits any of the following symptoms, contact your doctor straight away: irritability, hyperactivity, disturbed sleep, high-pitched crying, excessive shaking of a body part, vomiting, diarrhoea, or failure to gain weight.

Do not share your medication with anybody else. Children especially may be harmed or killed by codeine while taking your medication.

The manufacturer’s patient information sheet (Medication Guide) will be provided to you by your doctor or chemist when you start taking codeine and at each time your prescription is renewed. If you have any questions, carefully read the information and ask your doctor or chemist. The Medication Guide is also available on the manufacturer’s website or the Food and Drug Administration (FDA) website (

Why is this medication prescribed?

Mild to moderate pain is treated with codeine. Moreover, it is utilised to lessen coughing, typically in conjunction with other drugs. While codeine can help with symptoms, it cannot treat the underlying cause of symptoms or hasten the healing process. In addition to being an antitussive, codeine is part of the group of drugs known as opiate (narcotic) analgesics. When codeine is used to relieve pain, it alters how the nervous system and brain react to pain. Codeine works by reducing activity in the area of the brain that triggers coughing when used to treat coughing.

Furthermore, codeine is a common constituent in many cough and cold treatments and is also offered in combinations with acetaminophen (Tylenol with Codeine, Capital and Codeine), aspirin, carisoprodol, and promethazine. The usage of codeine is the only topic covered in this monograph. If you are using a product containing codeine and other substances, make sure to read the ingredients list and seek additional advice from your doctor or chemist.

How should this medicine be used?

Codeine is available as a tablet, a capsule, and a solution (liquid) for oral administration (alone or in combination with other drugs). As needed, it is typically taken every 4 to 6 hours. Ask your doctor or chemist to explain any instructions on your prescription label that you are unsure about following. Provide codeine precisely as prescribed.

Do not discontinue taking codeine if you have been doing it for several weeks or longer without first consulting your doctor. Your dosage may progressively be reduced by your doctor. If you suddenly stop taking codeine, you might experience withdrawal symptoms like agitation, widened pupils (black circles in the centre of the eyes), teary eyes, irritability, anxiety, runny nose, difficulty falling or staying asleep, yawning, sweating, rapid breathing, rapid heartbeat, chills, hair standing on end on your arms, nausea, loss of appetite, vomiting, diarrhoea, stomach cramps, muscle aches, or backaches.

Before each usage, thoroughly shake the mixture to combine the medication. Don’t measure your dose with a regular spoon. Use a spoon made specifically for measuring medication, the measuring cup that came with the medicine, or both.

Other uses for this medicine

Ask your doctor or chemist for more details if you’re interested in using this medication for any other conditions.

What special precautions should I follow?

Before taking codeine,

  • If you have any allergies, including to codeine, other medications, or any of the substances in the codeine product you want to take, let your doctor and chemist know right away. For a list of the ingredients, ask your doctor or chemist.
  • Inform your doctor or chemist if you are taking or receiving any of the following monoamine oxidase (MAO) inhibitors, or if you have stopped taking them within the previous two weeks: isocarboxazid (Marplan), linezolid (Zyvox), methylene blue, phenelzine (Nardil), selegiline (Eldepryl, Emsam, Zelapar), or tranylcypromine (Parnate). If you are now taking any of these drugs or have recently taken them, your doctor will probably advise against taking codeine.
  • Inform your doctor and chemist about any vitamins, nutritional supplements, herbal items, and prescription and over-the-counter medicines you are now taking or intend to take. Any of the following should be mentioned: medication for a cough, cold, or allergies; lithium (Lithobid); bupropion (Aplenzin, Wellbutrin, Zyban); cyclobenzaprine (Amrix); diuretics (‘water pills’); drugs for migraine headaches, including zolmitriptan (Zomig), sumatriptan (Imitrex), eletriptan (Relpax), naratriptan (Amerge), frovatriptan (Frova), and rizatriptan (Maxalt); pharmaceuticals for anxiety or seizures; 5HT3 serotonin blockers like alosetron (Lotronex), dolasetron (Anzemet), granisetron (Kytril), ondansetron (Zofran, Zuplenz), or palonosetron (Aloxi); mirtazapine (Remeron); selective serotonin-reuptake inhibitors such fluoxetine (Prozac, Sarafem, in Symbyax), citalopram (Celexa), escitalopram (Lexapro), fluvoxamine (Luvox), paroxetine (Brisdelle, Prozac, Pexeva), and sertraline (Zoloft); tramadol (Conzip), trazodone (Oleptro), and serotonin and norepinephrine reuptake inhibitors including desvenlafaxine (Khedezla, Pristiq), milnacipran (Savella), and venlafaxine (Effexor); includes tricyclic antidepressants (often known as “mood lifters”), which include amitriptyline, clomipramine (Anafranil), and desipramine (Norpramin), nortriptyline (Pamelor), protriptyline (Vivactil), doxepin (Silenor), imipramine (Tofranil), and trimipramine (Surmontil). Codeine may also interact with many other drugs, so be sure to let your doctor know about all the drugs you’re taking, even if they don’t appear on this list. Your doctor might need to adjust your medication doses or keep a close eye out for any negative side effects.
  • Inform your doctor about the herbal supplements you are taking, especially if you take St. John’s wort or tryptophan.
  • Inform your doctor if you have paralytic ileus, a blockage or constriction of your stomach or intestines, or any of the disorders listed in the IMPORTANT WARNING section (condition in which digested food does not move through the intestines). You could be advised by your doctor not to use codeine.
  • If you drink or have just had surgery on your urinary or abdominal tract, let your doctor know. If you have or have ever had seizures, mental illness, prostatic hypertrophy (enlargement of a male reproductive gland), urinary issues, low blood pressure, Addison’s disease (condition in which the body does not produce enough of certain natural substances), thyroid, pancreatic, intestinal, gallbladder, liver, or kidney disease, be sure to let your doctor know as well.
  • You should be aware that both men and women who use this medicine may have decreased fertility. Discuss the dangers of taking codeine with your doctor.
  • If you are breastfeeding, let your doctor know. While using codeine, you shouldn’t breastfeed. Codeine can result in shallow breathing, noisy breathing, disorientation, excessive drowsiness, nursing difficulties, or limpness in breastfed newborns.
  • Inform the surgeon or dentist that you are taking codeine if you are having surgery, including dental surgery.
  • You should be aware that this medicine may cause you to feel sleepy. Prior to understanding how this drug affects you, avoid using machinery or driving a car.
  • You should be aware that if you get out of a laying position too rapidly while taking codeine, you could have dizziness, lightheadedness, and fainting. When you initially start taking codeine, this happens more frequently. Get out of bed gradually, resting your feet on the floor for a few minutes before standing up, to avoid this issue.
  • It’s important to be aware that codeine might cause constipation. To treat or prevent constipation, discuss with your doctor modifying your diet and taking additional drugs.

What special dietary instructions should I follow?

Keep eating normally unless your doctor instructs you otherwise.

What should I do if I forget a dose?

Usually, codeine is consumed as needed. Take the missing dose as soon as you remember it if your doctor has instructed you to take codeine on a regular basis. If the next dose is soon due, skip the missed one and carry on with your regular dosing plan. To make up for a missing dose, do not take a second one.

What side effects can this medication cause?

Possible negative consequences of codeine. If any of these symptoms are severe or do not go away, let your doctor know right once:

  • Headache
  • Abdominal pain
  • Having trouble urinating

Some adverse effects may be severe. Call your doctor right away or seek emergency medical help if you notice any of the following symptoms or any of those mentioned in the IMPORTANT WARNINGS section.

  • Agitation, hallucinations (seeing objects or hearing voices that are not there), fever, sweating, confusion, rapid heartbeat, shivering, extreme muscle stiffness or twitching, loss of coordination, nausea, vomiting, or diarrhoea
  • Nausea, vomiting, weight loss, anorexia, or lightheadedness
  • Failure to achieve or maintain erection
  • Irregular periods of time
  • Less sexual arousal
  • Loud or irregular breathing
  • Breathing or swallowing challenges
  • Alterations in heartbeat
  • Rash
  • Itching
  • Hives
  • Alterations to vision
  • Seizures

Further negative effects of codeine are possible. If you have any strange side effects while taking this medicine, contact your doctor right once.

You or your doctor can submit a report to the Food and Drug Administration’s (FDA) MedWatch Adverse Event Reporting programme online or by phone if you have a serious side event (1-800-332-1088).

What should I know about storage and disposal of this medication?

Keep this medication tightly closed in the original container and out of the reach of children. Keep it away from excessive heat and moisture at room temperature (not in the bathroom).

Although many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and are simple for young children to open, it is crucial to keep all medications out of sight and out of reach of children. Always lock safety caps and promptly stash medication up and away from young children where it is out of their sight and reach to prevent poisoning.

Unused prescriptions must be disposed of carefully to prevent pets, kids, and other people from ingesting them. You should not, however, dispose of this medication in the toilet. Instead, utilising a medicine take-back programme is the easiest approach to get rid of your medication. To find out about take-back programmes in your area, speak with your chemist or the garbage/recycling agency in your city. If you do not have access to a take-back programme, see the FDA’s Safe Disposal of Medications website at for additional information.

In case of emergency/overdose

Call the poison control hotline at 1-800-222-1222 in the event of an overdose. Moreover, information can be found online at Call 911 right once if the person has collapsed, experienced a seizure, is having difficulty breathing, or cannot be roused.

You should consult your doctor about keeping naloxone, a life-saving drug, on hand while taking codeine (e.g., home, office). Naloxone is used to undo an overdose’s potentially fatal consequences. To treat harmful symptoms brought on by excessive levels of opiates in the blood, it functions by inhibiting the effects of opiates. If you live with young children or someone who has abused prescription or illicit drugs, your doctor could also advise you to get naloxone. Make sure you, your family, your caretakers, and anyone else who spends time with you are aware of the signs of an overdose, how to administer naloxone, and what to do until emergency assistance arrives. You and your family members will be shown how to use the medication by your doctor or chemist. For the directions, speak to your chemist or go to the manufacturer’s website. If you start to experience overdose symptoms, a friend or family member should administer the first dose of naloxone, contact 911 right away, and stay by your side while keeping a careful eye on you until emergency medical assistance comes. After receiving naloxone, your symptoms can come back a short while later. The person should administer you another dose of naloxone if your symptoms come back. If symptoms reappear before receiving medical attention, more doses may be given every 2 to 3 minutes.

Overdose signs could include the following:

  • Having trouble breathing
  • Weak or sluggish breathing
  • Extreme tiredness or drowsiness
  • Not able to speak or awaken
  • Decline in muscular tone
  • Clammy, frigid skin
  • Fainting
  • Dizziness
  • Sluggish heartbeat

What other information should I know?

Keep all of your appointments with your physician and the lab. To determine how your body reacts to codeine, your doctor will request specific lab tests.

Inform your doctor and the lab staff that you are taking codeine prior to any laboratory test (particularly one that uses methylene blue).

It is against the law to sell or give away this drug because doing so could result in death or harm to others. It’s possible that your prescription won’t be refilled. Any queries you may have regarding prescription refills should be directed to your chemist.

You should keep a written record of every medication you take, including any over-the-counter (OTC) items, prescription drugs, and dietary supplements like vitamins and minerals. This list should be brought with you whenever you see a doctor or are admitted to the hospital. You should always have this information with you in case of emergencies.

Brand names

  • Tuzistra XR® (as a combination product containing Chlorpheniramine, Codeine)
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