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RESPIRATORY SYSTEM › COUGH AND COLD PREPARATIONS › COUGH SUPPRESSANTS, EXCL. COMBINATIONS WITH EXPECTORANTS › Opium alkaloids and derivatives
pholcodine
R05DA08
Forms & Strengths
- Oral syrup: 5 mg/5 mL
- Oral solution: 10 mg/5 mL
Adult Dosing
- 5 mg to 10 mg orally every 4 to 6 hours as needed
- Maximum daily dose: 30 mg to 40 mg daily
Pediatric Dosing
- Children 6 to 12 years: 2.5 mg to 5 mg orally every 6 hours; maximum 15 mg daily
- Children under 6 years: Not recommended due to safety concerns
Indications
- Symptomatic treatment of non-productive (dry) cough
Mechanism of Action
- Acts centrally on the cough center in the medulla oblongata to elevate the threshold for coughing
- Morphine derivative with minimal analgesic and sedative properties compared to codeine
Contraindications
- Known hypersensitivity to pholcodine or other opioids
- Asthmatic cough or acute asthma attack
- Respiratory depression or chronic obstructive pulmonary disease (COPD)
- Severe hepatic impairment
- Concomitant use with monoamine oxidase inhibitors (MAOIs) or within 14 days of cessation
- Children under 6 years of age
Adverse Reactions
- Drowsiness and sedation
- Nausea and vomiting
- Constipation
- Dizziness
- Allergic skin reactions (rash, pruritus)
- Anaphylaxis and cross-sensitization with neuromuscular blocking agents (NMBAs)
Drug Interactions
- Central nervous system (CNS) depressants (alcohol, sedatives, hypnotics, anxiolytics): May cause additive CNS depression and respiratory depression
- Monoamine oxidase inhibitors (MAOIs): Risk of severe excitation, hypertension, or hyperpyrexic coma
- Neuromuscular blocking agents (NMBAs): Prior use of pholcodine can increase the risk of perioperative anaphylactic reactions to NMBAs
Curated Content: Needs Vetting Before Put to Clinical Use