Pholcodine


Generic Medicine Info
Indications and Dosage
Oral
Acute non-productive cough
Adult: 5-10 mg 3 or 4 times daily.
Child: 6-12 years 2-5 mg 3 or 4 times daily. >12 years Same as adult dose.
Renal Impairment
Severe: Contraindicated.
Hepatic Impairment
Severe: Contraindicated.
Administration
May be taken with or without food.
Contraindications
Respiratory failure (including patients who are at risk of developing respiratory failure), during an asthma attack, bronchiectasis, bronchiolitis, chronic bronchitis, COPD. Hepatic or renal failure. Children <6 years. Concomitant use during or within 14 days of MAOI therapy.
Special Precautions
Chronic or persistent cough, history of asthma, history of drug abuse. Mild to moderate hepatic or renal impairment. Treatment with a cough medicine in children should be considered carefully due to potential risks and limited evidence on efficacy. Pregnancy and lactation.
Adverse Reactions
Significant: Drowsiness, sputum retention.
Gastrointestinal disorders: Constipation, nausea, vomiting.
Immune system disorders: Hypersensitivity reactions, anaphylaxis.
Nervous system disorders: Dizziness.
Psychiatric disorders: Excitation, confusion.
Skin and subcutaneous tissue disorders: Rash.
Patient Counseling Information
This drug may cause drowsiness and dizziness, if affected, do not drive or operate machinery.
Overdosage
Symptoms: Respiratory or CNS depression, nausea, drowsiness, excitement, ataxia, restlessness. Management: Symptomatic and supportive treatment. Employ gastric lavage with airway protection. Administration of narcotic antagonist (e.g. naloxone) may be given in severe cases. Activated charcoal (1 g/kg body weight) may be administered if >4 mg/kg has been ingested, provided airway is protected and ingestion is recent (within 1 hr).
Drug Interactions
Increased CNS effects with other CNS depressants (e.g. barbiturates, narcotic analgesics). May potentiate the hypotensive effects of antihypertensives and diuretics. Concomitant use with neuromuscular blocking agents may result in anaphylaxis.
Potentially Fatal: Concurrent use of MAOIs (or within 14 days of stopping treatment) may result in hypotension, psychosis, or bizarre behaviour.
Food Interaction
Increased CNS effects with alcohol.
Lab Interference
May interfere with opiate immunoassays.
Action
Description: Pholcodine is an antitussive agent that acts primarily on the CNS, causing depression of the medullary cough centre. It has mild sedative effect with little or no analgesic action.
Pharmacokinetics:
Absorption: Time to peak plasma concentration: 4-8 hours.
Distribution: Volume of distribution: 30-49 L/kg. Plasma protein binding: 23.5%.
Metabolism: Metabolised in the liver, with little conjugation. No transformation to morphine.
Excretion: Elimination half-life: 32-43 hours.
Storage
Store below 25°C. Protect from light.
ATC Classification
R05DA08 - pholcodine ; Belongs to the class of opium alkaloids and derivatives. Used as cough suppressant.
References
Anon. Pholcodine. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 14/08/2018.

Buckingham R (ed). Pholcodine. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 14/08/2018.

Joint Formulary Committee. Pholcodine. British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 14/08/2018.

Preston CL (ed). Pholcodine Interactions. Stockley’s Drug Interactions [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 16/08/2018.

Disclaimer: This information is independently developed by MIMS based on Pholcodine from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to MIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, MIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2021 MIMS. All rights reserved. Powered by MIMS.com
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