Codeine/Triprolidine/Pseudoephedrine

Codeine/Triprolidine/Pseudoephedrine
No Brand

DEA Class;  Rx

Common Brand Names; Zyrtec D

  • Antitussives, Narcotic Combos

Codeine: Narcotic agonist analgesic with antitussive activity, mu receptor agonist

Triprolidine: First generation antihistamine, proplamine-derivative

Pseudoephedrine: Alpha adrenergic agonist

Indicated for the treatment of Allergic Rhinitis, Cough, Sinus Congestion

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

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

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 category: C

Lactation: codeine, triprolidine, pseudoephedrine excreted in breast milk, use caution

Adults

Syrup: 20 mg/4 mg/60 mg (10 mL) PO q4-6hr, up to 40 mL/24 hr

Tablet: 1 tab PO q6hr

Geriatric

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

Codeine/triprolidine/pseudoephedrine

oral syrup: schedule V

  • (10mg/2mg/30mg)/5mL

tablet: schedule V

  • 20mg/4mg/60mg
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