Common Brand Names of Codeine-Containing Cough Syrups
Codeine-containing cough syrups are typically formulated as combination products with guaifenesin (an expectorant) or other ingredients, with the most common FDA-approved formulation containing codeine phosphate 10 mg per 5 mL teaspoonful combined with guaifenesin 100 mg. 1
Typical Formulations
- The standard FDA-approved formulation contains codeine phosphate 10 mg per 5 mL combined with guaifenesin as an expectorant 1
- Codeine is classified as an antitussive (cough suppressant) in these preparations 1
- These products are typically dispensed as prescription syrups rather than specific brand names in most countries 2
Important Clinical Context
However, codeine should NOT be your first-line choice for cough suppression. The evidence strongly favors alternatives:
Why Codeine Is Not Preferred
- Codeine has no greater efficacy than dextromethorphan but carries a significantly worse adverse effect profile, including drowsiness, nausea, constipation, and risk of physical dependence 3, 4
- When opioids are necessary, pholcodine, hydrocodone, or dihydrocodeine are explicitly preferred over codeine due to better side effect profiles 2, 3
- Codeine showed no significant benefit over placebo in controlled trials for acute upper respiratory tract infection cough 5
Recommended Alternatives
- Dextromethorphan at 60 mg is the preferred first-line pharmacologic option, though most over-the-counter preparations contain subtherapeutic doses 3, 4
- Glycerol-based cough syrups (such as Sinecod, Benylin, Robitussin for dry coughs) offer low cost with favorable safety profiles 2
- Simple honey and lemon is recommended as the initial approach for acute viral cough before any pharmacologic treatment 3, 4
When Codeine Might Be Considered
- The recommended dosing when codeine is used is 30-60 mg four times daily 2, 6
- It may have a role in refractory cough in lung cancer patients or palliative care settings where other options have failed 2
- A bedtime dose may suppress cough and induce sleep in palliative patients 3
Critical Caveat
- Codeine-containing cough syrups have significant abuse potential, particularly in regions where they are easily accessible, with reports of dependence developing rapidly (within 1 month in 54% of users in one study) 7