Some serious health problems can be caused by codeine/promethazine. For certain groups, the risk could be higher. Talk to your pharmacist if you are concerned about this.

POTENTIAL FOR ADDICTIONS, ABUSE AND MISUSE

• History of mental illness

Promethazine/codeine, like other opioid-containing drugs, can be misused or abused, which could lead to overdose and even death. Even if the medication is being taken at the prescribed dosage, this can still happen. Promethazine/codeine should be taken at the lowest dose possible for as short a time as possible. You should consult your doctor if you feel unwell after 5 days of taking this medication.

TROUBLE BREATHING

• History of breathing problems (COPD, sleep apnea, asthma)

Promethazine/codeine is not recommended for children younger than 18 years. Children may experience difficulty breathing if they take promethazine / codeine. This could be fatal. This can be life-threatening for people who have breathing issues such as asthma, sleep apnea or chronic obstructive lung disease (COPD), and are also taking medications that affect breathing (opioids, sleep medications), which could increase their risk. Before you start promethazine/codeine, please discuss with your doctor if it is the best option for you.

EXTREME DROWSINESS

• Warnings: Do not take promethazine/codeine with benzodiazepines or alcohol

 Being extremely sleepy can be caused by taking promethazine/codeine along with benzodiazepines and alcohol. This could be dangerous and can even cause death. Take promethazine/codeine with alcohol. Talk to your doctor about alternatives if you are taking benzodiazepines frequently. There are safer ways to treat a cough.

MULTIPLE DRUG INTEACTIONS

Promethazine/codeine has been shown to interact with many other medications. These interactions could be life-threatening or dangerous. Before you begin promethazine/codeine, tell your doctor and pharmacist about any medications or over-the-counter drugs you take. This is true even if they are only used occasionally.

WITHDRAWAL IN NEWBORNS

• Health factors: Promethazine/codeine use during pregnancy

Codeine and promethazine are not safe to be used during pregnancy. Babies can experience withdrawal symptoms from promethazine/codeine. This is dangerous for them. Do not take this medication if you are pregnant. There are safer options.

LOW BLOOD PRISE

• Risk Factors: History with certain heart conditions

Your blood pressure can drop to dangerous levels when you take codeine or promethazine. This could cause you to fall or pass out. This side effect is more common in people with heart conditions. Before you take promethazine/codeine, make sure that your doctor is aware of all medical conditions.

ADDISON’S DISEASE (ADRENAL INSUFFICIENCY)

• Safety factors: HTML1 _____ HTML1­ Using codeine or promethazine for more than one month

Your adrenal glands can stop releasing the normal amount of your natural stress hormones, such as codeine or promethazine. Your body won’t be able to fight infections effectively if it doesn’t have the proper amount of these hormones. This is Addison’s Disease or adrenal insufficiency. Although this is rare, it can be caused by promethazine or codeine. If you experience nausea, vomiting, weight loss, dizziness, weakness, dizziness or other symptoms, talk to your doctor immediately.

SEIZURES

• Seizures History

Promethazine/codeine may increase the likelihood of seizures in those who have had seizures before or have epilepsy. Before you begin taking this medication, make sure you let your healthcare provider know if you have had seizures in the past.

NEUROLEPTIC MALIGNANTSYNDROME

• Factors that could lead to taking antipsychotics

Neuroleptic Malignant syndrome (NMS) can be caused by Promethazine/codeine. Although rare, it is important to be treated immediately. This is more common in people who are taking standard or unusual antipsychotic medication. Before you start promethazine/codeine, make sure your pharmacist and provider are aware of all medications that you have taken. NMS symptoms include high fever, muscle stiffness and confusion, as well as increased blood pressure and heart rate changes. You should seek immediate medical attention if you experience any of these symptoms.

UNCONTROLABLE BODY MOVEMENTS

Rarely, promethazine/codeine causes uncontrollable movements in your face, tongue and other body parts. Extrapyramidal symptoms (EPS) are the name for this condition. Extrapyramidal symptoms (EPS) include tremors, jerky movements in your arms and legs while walking, difficulty swallowing or speaking, tongue thrusting, and trouble talking. If you notice unusual body movements, tell your provider immediately.

LOW WHITE CELL COUNT

• The risk factors for undergoing certain chemotherapies

Your body’s number of white blood cell can be decreased by taking codeine or promethazine. This is the cell that fights off infection. If you don’t have enough, you may get sicker and have a harder time getting well. Although rare, this side effect can be fatal. This side effect is more common if you are taking chemotherapy that affects bone marrow. If you take promethazine/codeine regularly, blood tests may be required to ensure that your white blood cells are normal.

Certain medications and supplements may interact with Promethazine/codeine. Your doctor should be notified of any other medication or supplements, including prescription and over-the counter medications, vitamins and dietary supplements. This list does not contain all possible drug interactions with codeine/promethazine. The list below only lists the generic name for each medication.