PROMETHAZINE-CODEINE

Promethazine Hydrochloride 6.25mg/5mL, Codeine Phosphate 10mg/5mL, Oral solution

Alcohol

· Severity: Major

· Notes for Consumers: Avoid alcohol-containing drinks while taking this medicine. Using this drug along with alcohol can lead to serious side effects. You may feel drowsy or more tired when taking these drugs together. Do not drive or operate machinery until you know how this drug affects you, and especially if you are drinking alcohol-containing beverages. If you notice slurred speech, confusion, severe weakness, or difficulty breathing, contact your health care provider immediately.

· Notes for Professionals: Alcohol is associated with CNS depression. The combined use of alcohol and CNS depressants can lead to additive CNS depression, which could be dangerous in tasks requiring mental alertness and fatal in overdose. Alcohol taken with other CNS depressants can lead to additive respiratory depression, hypotension, profound sedation, or coma. Consider the patient's use of alcohol or illicit drugs when prescribing CNS depressant medications. In many cases, the patient should receive a lower dose of the CNS depressant initially if the patient is not likely to be compliant with avoiding alcohol.

Promethazine Hydrochloride 6.25mg/5mL, Codeine Phosphate 10mg/5mL, Oral solution

Grapefruit juice

· Severity: Moderate

· Notes for Consumers: It is recommended that you limit and do not significantly alter your intake of grapefruit or grapefruit juice while taking codeine. Side effects from codeine may get worse if you increase your intake of grapefruit juice. Talk to your doctor first. Contact your doctor right away if you have symptoms of codeine side effects such as slurred speech, confusion, weakness, or trouble breathing. Do not drive or operate machinery until you know how codeine affects you.

· Notes for Professionals: Patients should not significantly alter their intake of grapefruit or grapefruit juice during therapy with codeine. Grapefruit juice, a CYP3A4 inhibitor, may increase plasma concentrations of codeine, a CYP3A4 substrate. This may increase or prolong codeine-related toxicities including respiratory depression. Advise patients accordingly; patient monitoring and dosage adjustments may be necessary if grapefruit is consumed regularly.

Promethazine Hydrochloride 6.25mg/5mL, Codeine Phosphate 10mg/5mL, Oral solution

Tobacco

· Severity: Moderate

· Notes for Consumers: Tobacco smoking may reduce the effectiveness of this drug in treating your condition; Tobacco smoke contains substances that speed the removal of this drug from the body. Alternatively, if you take this drug and suddenly stop Tobacco smoking, you may feel more drowsy or tired, or may experience confusion, dizziness, difficulty in movement or other side effects. If you will stop smoking, use care in driving or operating machinery until you know how this drug will affect you. Make sure your prescriber is aware that you smoke Tobacco or if you plan to stop smoking. Report any unusual side effects promptly.

· Notes for Professionals: Tobacco smoke may accelerate the metabolism of phenothiazines. Because the effect on hepatic microsomal enzymes is not related to the nicotine component of tobacco, the sudden cessation of tobacco smoking may result in a reduced clearance of these antipsychotics, despite the initiation of a nicotine replacement product. Monitor patients carefully when changes in smoking status occur.

Promethazine Hydrochloride 6.25mg/5mL, Codeine Phosphate 10mg/5mL, Oral solution

Marijuana

· Severity: Major

· Notes for Consumers: Avoid combining Phenothiazines and marijuana. This combination may cause your condition to get worse. Marijuana may also decrease the efficacy of this medicine, making it not work as well for you. Do not drive or operate machinery until you know how this combination will affect you. Contact your health care provider right away if you notice unusual changes in moods or behaviors of any type.

· Notes for Professionals: It is recommended that patients avoid the use of marijuana, by any route, if they are treated for a psychiatric history, including psychosis and bipolar disorder, as the cannabinoids (the psychoactive ingredients, such as THC) in marijuana can produce psychotoxic effects and may exacerbate psychiatric disorders. A high frequency of use and use of products with high-potency of THC are potential risk factors for psychiatric effects. Additionally, additive CNS effects, such as sedation or CNS depression are possible. Clinical studies suggest that cannabis use may reduce the efficacy of some antipsychotic drugs. In addition, several cannabinoids in marijuana appear to influence the activity of CYP enzymes and P-glycoprotein, which may alter the concentrations of antipsychotics and influence either safety or efficacy.

<b>DISCLAIMER:</b><em> This drug information content is provided for informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Patients should always consult their physician with any questions regarding a medical condition and to obtain medical advice and treatment. Drug information is sourced from GSDD (Gold Standard Drug Database ) provided by Elsevier.</em>