What should I Know Regarding Pregnancy, Nursing and Administering Promethazine-phenyleph-codeine to Children or the Elderly?
If you are pregnant Not Recommended: Not Recommended: Not Recommended:
If you are nursing Precaution: LIMITED AMOUNT MAY BE EXCRETED DUE TO LOW MW; MONITOR INFANT FOR RESP DEPRESS Precaution: CNS/RESPIRATORY DEPRESSION,APNEA POSSIBLE;CAUTION W/ FAST CYP2D6 METABOLIZER Precaution: ORAL BIOAVAILABILITY LOW; INFANT EXPOSURE MAY BE MINIMAL
If you are an adult over 60 management or monitoring precaution: General-Consider adding naloxone Rx. Pulmonary-Life threatening respiratory depression risk with high doses, cachexia, or debilitation due to altered pharmacokinetics (poor fat stores, muscle wasting, or altered clearance). Monitor closely at initiation and 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. management or monitoring precaution: Neuro/Psych-Anticholinergic effects may cause sedation, worsen cognitive impairment and increase fall risk. Gastrointestinal-May cause or worsen pre-existing constipation. Genitourinary-Best avoided in patients with urinary retention from any cause. 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.
Pediatric use Severe Precaution: Risk of life-threatening respiratory depression, death. Contraindicated post-tonsillectomy and post-adenoidectomy. Avoid in patients with obesity, obstructive sleep apnea, asthma or other underlying breathing problems. Avoid in CYP2D6 ultra-rapid metabolizers. Analgesic use not recommended without prior CYP2D6 testing. Not recommended for cough because benefit does not outweigh risk. With any opioid, access to naloxone for emergency reversal can mitigate risk from accidental ingestion/overdose. Severe Precaution: 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. With any opioid, access to naloxone for emergency reversal can mitigate risk from accidental ingestion/overdose. Severe Precaution: Risk of CNS excitation. Do not use age <6 years without clinician consult. Severe Precaution: Potential for fatal respiratory depression age < 2 years. Avoid use. Severe Precaution: Caution:use the lowest effective dose due to risk of respiratory depression.
CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.