From the Guidelines
The recommended adult dose of promethazine with codeine is 5 mL (containing 6.25 mg promethazine and 10 mg codeine) taken by mouth every 4-6 hours as needed, not to exceed 30 mL in 24 hours, based on the general guidelines for cough management in patients with lung cancer 1.
Key Considerations
- The medication should only be taken as prescribed by a healthcare provider and for the shortest duration necessary to control symptoms, usually for acute cough and upper respiratory symptoms.
- It's essential to use the measuring device provided with the medication for accurate dosing.
- This combination medication works because promethazine helps reduce coughing by suppressing the cough reflex in the brain, while also providing antihistamine effects, and codeine acts as both a cough suppressant and mild pain reliever.
Important Safety Information
- Due to its codeine content, this medication carries risks of dependence, respiratory depression, and other serious side effects 1.
- It should not be combined with alcohol or other central nervous system depressants.
- Patients should avoid driving or operating machinery while taking it due to sedative effects.
Dosage and Administration
- The typical dosage is 5 mL every 4-6 hours as needed, with a maximum of 30 mL in 24 hours.
- The patient’s previous exposure to opioids will dictate the initial starting dose, as suggested in the study 1.
- For patients with lung cancer who are experiencing nonspecific cough and who are in the palliative stage of their illness, a bedtime dose of codeine may be helpful in suppressing cough and inducing an undisturbed sleep 1.
From the Research
Dosage Information
- The provided studies do not specify the exact dosage of promethazine with codeine that an adult can take 2, 3, 4, 5.
General Safety Precautions
- It is known that opioids, including codeine, can cause respiratory depression, which can be fatal 2, 4, 5.
- The combined use of opioids and other substances, such as benzodiazepines, can increase the risk of respiratory depression and other adverse events 4.
Opioid-Related Risks
- Opioid drugs, including morphine, oxycodone, heroin, and fentanyl, can cause respiratory depression and brain hypoxia, which can be dangerous and even lethal 5.
- The development of tolerance and the degree of respiratory depression can vary depending on the specific opioid agonist and the individual's response to it 2.