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Z-Tuss AC

Generic Name: chlorpheniramine and codeine (KLOR fen IR a meed and KOE deen)Brand Names: Cotab A, Cotab AX, Notuss-AC, Z-Tuss AC, Zodryl AC 25, Zodryl AC 30, Zodryl AC 35, Zodryl AC 40, Zodryl AC 50, Zodryl AC 60, Zodryl AC 80

What is Z-Tuss AC (chlorpheniramine and codeine)?

Chlorpheniramine is an antihistamine that reduces the natural chemical histamine in the body. Histamine can produce symptoms of sneezing, itching, watery eyes, and runny nose.

Codeine is a narcotic cough suppressant. It affects the signals in the brain that trigger cough reflex.

The combination of chlorpheniramine and codeine is used to treat runny or stuffy nose, sneezing, watery eyes, and cough caused by allergies or the common cold.

Chlorpheniramine and codeine will not treat a cough that is caused by smoking, asthma, or emphysema.

Chlorpheniramine and codeine may also be used for other purposes not listed in this medication guide.

What is the most important information I should know about Z-Tuss AC (chlorpheniramine and codeine)?

Do not take a cough and cold if you have used an MAO inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate) within the past 14 days. Serious, life-threatening side effects can occur if you take a cough and cold medicine before the MAO inhibitor has cleared from your body. You should not take this medication if you are allergic to chlorpheniramine or codeine, or if you have severe high blood pressure or coronary artery disease, ischemic heart disease, a stomach ulcer, narrow-angle glaucoma, if you are having an asthma attack, if you are pregnant or breast-feeding, or if you are unable to urinate.

Before taking this medication, tell your doctor if you have asthma or other breathing disorder, glaucoma, heart disease, high blood pressure, seizures, a thyroid disorder, diabetes, urination problems, stomach problems, liver or kidney disease, Addison's disease, mental illness, or a history of drug or alcohol addiction.

Codeine may be habit-forming and should be used only by the person it was prescribed for. This medication should never be shared with another person, especially someone who has a history of drug abuse or addiction. Keep the medication in a secure place where others cannot get to it. Do not give this medicine to a child younger than 6 years old.

What should I discuss with my healthcare provider before taking Z-Tuss AC (chlorpheniramine and codeine)?

Do not take a cough and cold if you have used an MAO inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate) within the past 14 days. Serious, life-threatening side effects can occur if you take a cough and cold medicine before the MAO inhibitor has cleared from your body. You should not take this medication if you are allergic to chlorpheniramine or codeine, or if you have:

  • severe or uncontrolled high blood pressure;

  • severe coronary artery disease;

  • ischemic heart disease;

  • a stomach ulcer;

  • narrow-angle glaucoma;

  • if you are having an asthma attack;

  • if you are unable to urinate; or

  • if you are pregnant or breast-feeding.

If you have any of these other conditions, you may need a dose adjustment or special tests to safely use this medication:

  • asthma, COPD, emphysema, or other breathing disorder;

  • glaucoma;

  • heart disease, high blood pressure;

  • a history of head injury or brain tumor;

  • epilepsy or other seizure disorder;

  • a thyroid disorder;

  • diabetes;

  • enlarged prostate or urination problems;

  • stomach or intestinal problems;

  • liver or kidney disease;

  • Addison's disease;

  • mental illness; or

  • a history of drug or alcohol addiction.

FDA pregnancy category C. It is not known whether chlorpheniramine and codeine is harmful to an unborn baby. Codeine can cause breathing problems or addiction/withdrawal symptoms in a newborn. Tell your doctor if you are pregnant or plan to become pregnant during treatment. Codeine can pass into breast milk and may harm a nursing baby. The use of codeine by some nursing mothers may lead to life-threatening side effects in the baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

Older adults are more likely to have side effects from this medicine.

Do not give chlorpheniramine and codeine to a child younger than 6 years old. Codeine may be habit-forming and should be used only by the person it was prescribed for. This medication should never be shared with another person, especially someone who has a history of drug abuse or addiction. Keep the medication in a secure place where others cannot get to it.

How should I take Z-Tuss AC (chlorpheniramine and codeine)?

Take this medication exactly as prescribed by your doctor. Do not take it in larger amounts or for longer than recommended. Follow the directions on your prescription label.

Do not take this medication more often than you doctor has prescribed. An overdose of chlorpheniramine and codeine can cause life-threatening side effects. Take chlorpheniramine and codeine with a full glass of water.

Measure liquid medicine with a special dose-measuring spoon or cup, not a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist for one.

Chlorpheniramine and codeine can be taken with food if it upsets your stomach.

Call your doctor if your symptoms do not improve after 7 days of treatment, or if you also have a fever, headache, or skin rash.

Store chlorpheniramine and codeine at room temperature away from moisture and heat. Keep track of how much of this medicine has been used from each new bottle. Codeine is a drug of abuse and you should be aware if any person in the household is using this medicine improperly or without a prescription.

What happens if I miss a dose?

Cough or cold medicine is usually taken only as needed, so you may not be on a dosing schedule. If you are taking the medication regularly, take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the medicine at your next regularly scheduled time. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention if you think you have used too much of this medicine. An overdose of chlorpheniramine and codeine can be fatal, especially to a child.

Overdose symptoms may include feeling restless or nervous, sleep problems, extreme drowsiness, weak or limp feeling, confusion, hallucinations, chest pain, shortness of breath, uneven heartbeats, pinpoint pupils, cold and clammy skin, fainting, seizure (convulsions), weak pulse, shallow breathing, or breathing that stops.

What should I avoid while taking Z-Tuss AC (chlorpheniramine and codeine)?

This medication can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.

Avoid getting up too fast from a sitting or lying position, or you may feel dizzy. Get up slowly and steady yourself to prevent a fall.

Avoid drinking alcohol while using chlorpheniramine and codeine. Alcohol may increase drowsiness and dizziness.

Z-Tuss AC (chlorpheniramine and codeine) side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Call your doctor at once if you have any of these serious side effects:

  • weak or shallow breathing;

  • chest tightness, fast heart rate;

  • painful urination;

  • urinating less than usual or not at all; or

  • confusion, hallucinations, or unusual behavior.

Less serious side effects may include:

  • feeling restless or excited (especially in children);

  • dizziness, drowsiness, loss of coordination;

  • ringing in your ears;

  • constipation or diarrhea;

  • nausea, vomiting, loss of appetite;

  • dry mouth, nose, or throat; or

  • mild itching or skin rash.

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect Z-Tuss AC (chlorpheniramine and codeine)?

Narcotic pain medicine, sleeping pills, muscle relaxers, and medicine for seizures, depression or anxiety can add to sleepiness caused by chlorpheniramine and codeine. Tell your doctor if you regularly use any of these medicines, or any other cold or allergy medicine.

Tell your doctor about all other medications you use, especially:

  • atropine (Donnatal, and others), benztropine (Cogentin), dimenhydrinate (Dramamine), methscopolamine (Pamine), or scopolamine (Transderm-Scop);

  • bronchodilators such as ipratroprium (Atrovent) or tiotropium (Spiriva);

  • glycopyrrolate (Robinul);

  • mepenzolate (Cantil);

  • bladder or urinary medications such as darifenacin (Enablex), flavoxate (Urispas), oxybutynin (Ditropan, Oxytrol), tolterodine (Detrol), or solifenacin (Vesicare);

  • irritable bowel medications such as dicyclomine (Bentyl), hyoscyamine (Anaspaz, Cystospaz, Levsin, and others), or propantheline (Pro-Banthine); or

  • an MAO inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate).

This list is not complete and there may be other drugs that can interact with chlorpheniramine and codeine. Tell your doctor about all your prescription and over-the-counter medications, vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start a new medication without telling your doctor.

Where can I get more information?

  • Your pharmacist can provide more information about chlorpheniramine and codeine.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.
Copyright 1996-2006 Cerner Multum, Inc. Version: 3.01. Revision Date: 07/07/2009 9:17:46 AM.
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