Pholcodine


Generic Medicine Info
Indications and Dosage
Oral
Acute non-productive cough
Adult: 5-10 mg 3 or 4 times daily. Alternatively, 10-15 mg 8-10 hourly. Dosage recommendations may vary among countries or individual products. Refer to specific product guidelines.
Child: 6-12 years 4 mg tid. Max treatment duration: 5 days; >12 years Same as adult dose. Dosage recommendations may vary among countries or individual products. Refer to specific product guidelines.
Administration
May be taken with or without food.
Contraindications
Patient at risk of developing respiratory failure. Asthma attack, chronic bronchitis, COPD, bronchiolitis or bronchiectasis. Hepatic failure. Children <6 years. Concomitant use with or within 14 days of stopping MAOI therapy.
Special Precautions
Patient with decreased respiratory reserve, history of asthma, chronic or persistent cough, history of drug abuse. Concomitant use with benzodiazepines and other CNS depressants. Renal and hepatic impairment. Treatment with a cough medicine in children should be considered carefully due to potential risks and limited evidence on efficacy. Pregnancy and lactation.
Adverse Reactions
Significant: Sputum retention; adrenal insufficiency, infertility (long-term use).
Gastrointestinal disorders: Nausea, vomiting, constipation.
Immune system disorders: Hypersensitivity reactions (including anaphylaxis).
Nervous system disorders: Occasional drowsiness, dizziness; ataxia (large dose).
Psychiatric disorders: Excitation, confusion; restlessness (large dose).
Respiratory, thoracic and mediastinal disorders: Respiratory depression (large dose).
Skin and subcutaneous tissue disorders: Rash.
Potentially Fatal: Severe cutaneous adverse reactions (SCARs) including acute generalised exanthematous pustulosis (AGEP).
Patient Counseling Information
This drug may cause drowsiness and dizziness, if affected, do not drive or operate machinery.
Monitoring Parameters
Monitor respiratory function (in patients with reduced respiratory reserve); signs and symptoms of skin reactions.
Overdosage
Symptoms: Restlessness, excitement, ataxia, drowsiness, nausea, and respiratory depression. Management: Symptomatic and supportive treatment. Gastric emptying may be done by aspiration and lavage. Naloxone may be given in cases of acute poisoning. Administration of activated charcoal (1 g/kg) may also be considered if ingestion is >4 mg/kg, provided the airway is protected and ingestion is recent (within 1 hour).
Drug Interactions
Antihypertensives and diuretics may potentiate the hypotensive effect of pholcodine. Concomitant use with neuromuscular blocking agents may result in anaphylaxis.
Potentially Fatal: Concurrent use with MAOIs (or within 14 days of stopping treatment) may result in serotonin syndrome. Concomitant use with benzodiazepines and other CNS depressants may result in sedation, respiratory depression, and coma.
Food Interaction
May enhance the CNS depressant effects of alcohol.
Action
Description: Pholcodine is a centrally acting cough suppressant that causes depression of the cough reflex, partly due to its direct effect on the cough centre in the medulla. It has a mild sedative effect with little or no analgesic action.
Pharmacokinetics:
Absorption: Readily absorbed from the gastrointestinal tract. Time to peak plasma concentration: 4-8 hours.
Distribution: Enters breast milk. Volume of distribution: 30-49 L/kg. Plasma protein binding: 24%.
Metabolism: Metabolised in the liver via hydrolysis followed by conjugation and N-dealkylation.
Excretion: Elimination half-life: 32-43 hours.
Chemical Structure

Chemical Structure Image
Pholcodine

Storage
Store below 30°C. Protect from light.
MIMS Class
Cough & Cold Preparations
ATC Classification
R05DA08 - pholcodine ; Belongs to the class of opium alkaloids and derivatives. Used as cough suppressant.
References
Anon. Pholcodine. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 23/06/2022.

Buckingham R (ed). Pholcodine. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 23/06/2022.

Ducodin Forte Linctus 15 mg/5 mL (Hovid Bhd.). National Pharmaceutical Regulatory Agency - Ministry of Health Malaysia. https://www.npra.gov.my. Accessed 23/06/2022.

Ducodin Linctus 5 mg/5 mL (Hovid Bhd.). National Pharmaceutical Regulatory Agency - Ministry of Health Malaysia. https://www.npra.gov.my. Accessed 23/06/2022.

Duro-Tuss Cough Linctus (iNova Pharmaceuticals Pte Ltd, Malaysia Branch). MIMS Malaysia. http://www.mims.com/malaysia. Accessed 23/06/2022.

Galenphol Paediatric Linctus (Thornton & Ross Limited). MHRA. https://products.mhra.gov.uk. Accessed 23/06/2022.

Joint Formulary Committee. Pholcodine. British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 23/06/2022.

Pholcodine Linctus (L.C.M. Ltd.). MHRA. https://products.mhra.gov.uk. Accessed 23/06/2022.

Disclaimer: This information is independently developed by MIMS based on Pholcodine from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to MIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, MIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2024 MIMS. All rights reserved. Powered by MIMS.com
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