Classes
DEA Class; Rx
Common Brand Names; Zyrtec D
- Antitussives, Narcotic Combos
Description
Codeine: Narcotic agonist analgesic with antitussive activity, mu receptor agonist
Triprolidine: First generation antihistamine, proplamine-derivative
Pseudoephedrine: Alpha adrenergic agonist
Indications
Indicated for the treatment of Allergic Rhinitis, Cough, Sinus Congestion
Contraindications
Codeine
Absolute: acute abdominal condition, diarrhea associated w/ toxins, pseudomembranous colitis, respiratory depression
Relative: asthma (acute), inflammatory bowel disease, respiratory impairment
Pseudoephedrine
Hypsesensitivity
Severe HTN, severe CAD
Nonselective MAO inhibitors: risk of hypertensive reaction
Newborns, preemies
Triprolidine
Hypersensitivity, acute asthma, sleep apnea
Adverse Effects
Codeine
Drowsiness
Constipation
Bradycardia, hypotension, tachycardia
Confusion, dizziness, false feeling of well being, headache, lightheadedness, malaise, paradoxical CNS stimulation, restlessness, weakness
Rash, urticaria
Anorexia, nausea, vomiting, xerostomia
LFT’s increased
Ureteral spasm, urination decreased
Dyspnea
Burning at injection site, blurred vision, histamine release
Hypotension, With IV use
Seizure, With excessive doses
Anaphylactoid reaction (rare)
Respiratory depression
Pseudoephedrine
CNS (tremor, restlessness, etc)
Insomnia
Nausea
Vomiting
Triprolidine
Anti-cholinergic
Dizziness
Drowsiness
Warnings
Do not use more than directed
Adrenergic agent, pseudoephedrine, component may cause arrhythmias, dizziness, insomnia, tremor, weakness
May cause sedation; caution with tasks requiring cognitive abilities (eg, driving, operating machinery)
Alcohol may exacerbate sedation and cognitive abilities
Ask healthcare professional if taking tranquilizers or sedatives as it may exacerbate CNS effects
Caution with history of diabetes mellitus, hypertension, thyroid disease, increased IOP, heart disease, prostatic hypertrophy, or renal function impairment
Ask healthcare professional if experience nervousness, dizziness, insomnia
If hypersensitivity reaction occurs, seek medical help immediately
Pregnancy and Lactation
Pregnancy category: C
Lactation: codeine, triprolidine, pseudoephedrine excreted in breast milk, use caution
Maximum Dosage
Syrup: 20 mg/4 mg/60 mg (10 mL) PO q4-6hr, up to 40 mL/24 hr
Tablet: 1 tab PO q6hr
Nonanticholinergic antihistamines should be considered first when treating allergic reactions (Beers Criteria)
Clearance reduced with advanced age, greater risk of confusion, dry mouth, constipation, and other anticholinergic effects and toxicity
May exacerbate existing lower urinary conditions or benign prostatic hyperplasia
Pediatric
<6 years
- Not recommended
6-12 years
- 5 mL PO q4-6hr, up to 20 mL/24 hr
>12 years
- Syrup: 10 mL PO q4-6hr, up to 40 mL/24 hr
- Tablet: 1 tab PO q6hr
How supplied
Codeine/triprolidine/pseudoephedrine
oral syrup: schedule V
- (10mg/2mg/30mg)/5mL
tablet: schedule V
- 20mg/4mg/60mg
