Pronunciation:

(gwye FEN e sin & KOE deen)

U.S. Brand Names:

Synonyms:

Generic Available:

Use:

Restrictions:

Pregnancy Risk Factor:

Lactation:

Contraindications:

Based on guaifenesin component: Hypersensitivity to guaifenesin or any component of the formulation

Based on codeine component: Hypersensitivity to codeine or any component of the formulation

Warnings/Precautions:

Based on guaifenesin component: Not for persistent cough such as occurs with smoking, asthma, or emphysema or cough accompanied by excessive secretions

Based on codeine component: Use with caution in patients with hypersensitivity reactions to other phenanthrene derivative opioid agonists (morphine, hydrocodone, hydromorphone, levorphanol, oxycodone, oxymorphone); respiratory diseases including asthma, emphysema, COPD, or severe liver or renal insufficiency; some preparations contain sulfites which may cause allergic reactions; tolerance or drug dependence may result from extended use

Not recommended for use for cough control in patients with a productive cough; not recommended as an antitussive for children <2 years of age; the elderly may be particularly susceptible to the CNS depressant and confusion as well as constipating effects of narcotics

Adverse Reactions:

Based on guaifenesin component:

Central nervous system: Drowsiness, headache

Dermatologic: Rash

Gastrointestinal: Nausea, vomiting, stomach pain

Based on codeine component:

>10%:

Central nervous system: Drowsiness

Gastrointestinal: Constipation

1% to 10%:

Cardiovascular: Tachycardia or bradycardia, hypotension

Central nervous system: Dizziness, lightheadedness, false feeling of well being, malaise, headache, restlessness, paradoxical CNS stimulation, confusion

Dermatologic: Rash, urticaria

Gastrointestinal: Xerostomia, anorexia, nausea, vomiting,

Genitourinary: Decreased urination, ureteral spasm

Hepatic: Increased LFTs

Local: Burning at injection site

Neuromuscular & skeletal: Weakness

Ocular: Blurred vision

Respiratory: Dyspnea

Miscellaneous: Histamine release

<1%: Convulsions, hallucinations, mental depression, nightmares, insomnia, paralytic ileus, biliary spasm, stomach cramps, muscle rigidity, trembling

Percentage unknown: Increased AST, ALT

Drug Interactions:

Ethanol/Nutrition/Herb Interactions:

Mechanism of Action:

Guaifenesin is thought to act as an expectorant by irritating the gastric mucosa and stimulating respiratory tract secretions, thereby increasing respiratory fluid volumes and decreasing phlegm viscosity

Codeine is an antitussive that controls cough by depressing the medullary cough center

Pharmacodynamics/Kinetics:

Dosage:

Children:

2-6 years: 1-1.5 mg/kg codeine/day divided into 4 doses administered every 4-6 hours (maximum: 30 mg/24 hours)

6-12 years: 5 mL every 4 hours, not to exceed 30 mL/24 hours

Children >12 years and Adults: 5-10 mL every 6 hours not to exceed 60 mL/24 hours

Dietary Considerations:

Patient Education:

Nursing Implications:

Dental Health: Effects on Dental Treatment:

Dental Health: Vasoconstrictor/Local Anesthetic Precautions:

Mental Health: Effects on Mental Status:

Mental Health: Effects on Psychiatric Treatment:

Dosage Forms:

Liquid:

Brontex®: Guaifenesin 75 mg and codeine phosphate 2.5 mg per 5 mL (480 mL) [alcohol free; strawberry mint flavor]

Diabetic Tussin C®: Guaifenesin 200 mg and codeine phosphate 10 mg per 5 mL (480 mL) [contains phenylalanine 0.03 mcg/5 mL; cherry vanilla flavor]

Gani-Tuss® NR: Guaifenesin 100 mg and codeine phosphate 10 mg per 5 mL (480 mL) [raspberry flavor]

Guaifen-C: Guaifenesin 75 mg and codeine phosphate 2.5 mg per 5 mL (480 mL) [cherry flavor]

Guaifenesin AC: Guaifenesin 100 mg and codeine phosphate 10 mg per 5 mL (120 mL, 480 mL) [alcohol free, sugar free; raspberry flavor]

Iophen-C NR: Guaifenesin 100 mg and codeine phosphate 10 mg per 5 mL (480 mL) [raspberry flavor]

Kolephrin® #1: Guaifenesin 100 mg and codeine phosphate 10 mg per 5 mL (120 mL) [contains sodium 1.1 mg/5 mL and sodium benzoate]

Tussi-Organidin® NR: Guaifenesin 100 mg and codeine phosphate 10 mg per 5 mL (480 mL) [contains sodium benzoate; raspberry flavor]

Tussi-Organidin® S-NR: Guaifenesin 100 mg and codeine phosphate 10 mg per 5 mL (120 mL) [contains sodium benzoate; raspberry flavor]

Syrup:

Cheracol®: Guaifenesin 100 mg and codeine phosphate 10 mg per 5 mL (120 mL) [contains alcohol 4.75% and benzoic acid]

Cheratussin AC: Guaifenesin 100 mg and codeine phosphate 10 mg per 5 mL (120 mL, 240 mL, 480 mL)

Guaituss AC®: Guaifenesin 100 mg and codeine phosphate 10 mg per 5 mL (120 mL, 480 mL) [contains alcohol; sugar free; fruit-mint flavor]

Mytussin® AC: Guaifenesin 100 mg and codeine phosphate 10 mg per 5 mL (120 mL, 480 mL) [contains alcohol; sugar free; fruit flavor]

Robafen AC: Guaifenesin 100 mg and codeine phosphate 10 mg per 5 mL (120 mL, 480 mL)

Romilar® AC: Guaifenesin 100 mg and codeine phosphate 10 mg per 5 mL (480 mL) [contains benzoic acid and phenylalanine; alcohol free, sugar free, dye free; grape flavor]

Tablet (Brontex®): Guaifenesin 300 mg and codeine phosphate 10 mg