What should I Know Regarding Pregnancy, Nursing and Administering Phenyleph-Dihydrocodeine-Guaif Liquid to Children or the Elderly?

If you are PREGNANT

  • Only When Necessary: NEONATAL WITHDRAWAL/RESP.DEPRESS. W/CHRONIC OR HIGH DOSE
  • Only When Necessary: EVIDENCE FOR MALFORMATIONS; CAN REDUCE UTERINE BLOOD FLOW CAUSING FETAL HYPOXIA
  • Only When Necessary:

If you are NURSING

  • Absolute Contraindication: MONITOR NURSING INFANT FOR RESPIRATORY DEPRESSION
  • Precaution: ORAL BIOAVAILABILITY LOW; INFANT EXPOSURE MAY BE MINIMAL
  • Precaution: INSUFFICIENT DATA AVAILABLE

If you are an adult over 60

  • management or monitoring precaution: Cardiovascular-Elderly are more sensitive to tachycardia and hypertensive effects. May exacerbate symptomatic coronary insufficiency. Genitourinary-May cause urinary retention. Neuro/Psych-May worsen cognitive impairment in some elderly with dementia. Insomnia risk.
  • management or monitoring precaution: Pulmonary-Life threatening respiratory depression is more likely to occur with high doses, SR products, cachexia, or debilitation due to altered pharmacokinetics with poor fat stores, muscle wasting, or altered clearance. Monitor closely at initiation and with dose titration. Neuro/Psych-Risk for increased confusion and delirium. May increase fall risk. Avoid treatment with 3 or more CNS active drugs. Gastrointestinal-Constipation risk. Urogenital-Urinary retention risk.

Giving Phenyleph-Dihydrocodeine-Guaif Liquid to a child under 12

  • Severe Precaution: No established efficacy for cough and cold products age < 2 years. Do not use unless directed by clinician consultation.
  • Severe Precaution: Contraindicated for pain management post-surgical tonsillectomy and or adenoidectomy. Respiratory depression and death reported in CYP2D6 ultra-rapid metabolizer patients post tonsillectomy or adenoidectomy. Avoid in patient with obesity, obstructive sleep apnea, asthma or other underlying breathing problem.
  • Contraindication: Increased risk of CNS and respiratory depression. Contraindicated age < 12 years. Respiratory depression and death reported in CYP2D6 ultra-rapid metabolizers post tonsillectomy or adenoidectomy. Risk increases with obesity, asthma, obstructive sleep apnea or other underlying lung or breathing problem.
  • Contraindication: Risk of CNS excitation. Do not use age <6 years without clinician consult.