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TUXARIN ER (chlorpheniramine maleate/codeine phosphate)
- cold symptoms
- cough
- inflammation of the nose due to an allergy
- runny nose
- stuffy nose
8 mg-54.3 mg tablet,extended release
- 1 tablet by oral route every 12 hours
Allergic rhinitis
- 1 tablet by oral route every 12 hours
Cold symptoms
- 1 tablet by oral route every 12 hours
Cough
- 1 tablet by oral route every 12 hours
Nasal congestion
- 1 tablet by oral route every 12 hours
Rhinorrhea
- 1 tablet by oral route every 12 hours
- Azilect
- Depade
- Eldepryl
- isocarboxazid
- linezolid
- Marplan
- Matulane
- methylene blue (antidote)
- naltrexone
- naltrexone microspheres
- Nardil
- Parnate
- phenelzine
- procarbazine
- rasagiline
- Revia
- selegiline HCl
- tranylcypromine
- Vivitrol
- Zelapar
- Zyvox
Contraindicated
- K-tab
- Klor-con
- Klor-con 10
- Klor-con M10
- Klor-con M15
- Klor-con M20
- Medi-lyte
- potassium chloride
- potassium citrate
- potassium Cl-calcium phos-mag
- sodium Cl-potassium chloride
- Thermotabs
- Urocit-k 10
- Urocit-k 15
- Urocit-k 5
Severe
Moderate
- Aplenzin
- Brisdelle
- Buprenex
- buprenorphine
- buprenorphine-naloxone
- Buproban
- bupropion HBr
- bupropion HCl
- butorphanol tartrate
- Butrans
- dextromethorphan-quinidine
- fluoxetine
- Forfivo Xl
- nalbuphine
- Nuedexta
- olanzapine-fluoxetine
- paroxetine HCl
- paroxetine mesylate
- Paxil
- Paxil Cr
- Pexeva
- Prozac
- Prozac Weekly
- quinidine gluconate
- quinidine sulfate
- Sarafem
- Suboxone
- Symbyax
- Wellbutrin
- Wellbutrin Sr
- Wellbutrin Xl
- Zubsolv
- Zyban
- Acute asthma attack
- Adenoidectomy in pediatric patient
- Tonsillectomy in pediatric patient
Contraindicated
- Acute pancreatitis
- Angle-closure glaucoma
- Benign prostatic hyperplasia
- Bladder outflow obstruction
- Chronic idiopathic constipation
- Chronic kidney disease stage 5 (failure) GFr<15 ml/min
- COPD exacerbation
- CYp2d6 poor metabolizer
- CYp2d6 ultrarapid metabolizer
- Drug abuse
- Familial dysautonomia
- Gastrointestinal obstruction
- History of opioid overdose
- Intracranial hypertension
- Kidney disease with likely reduction in GFR
- Respiratory depression
- Shock
- Sleep apnea
- Stenosing peptic ulcer
- Systemic mastocytosis
- Urinary retention
Severe
Moderate
- Adrenocortical insufficiency
- Alcohol intoxication
- Biliary tract disorder
- Chronic obstructive pulmonary disease
- Constipation
- Cor pulmonale
- Debilitation
- Hypertension
- Hyperthyroidism
- Hypotension
- Seizure disorder
- Severe hepatic disease
- Untreated hypothyroidism
- Urinary retention
TUXARIN ER (chlorpheniramine maleate/codeine phosphate)
- cold symptoms
- cough
- inflammation of the nose due to an allergy
- runny nose
- stuffy nose
- None
- Abdominal pain with cramps
- Constipation
- Dizziness
- Drowsy
- Hyperhidrosis
- Nausea
- Sedation
- Thick bronchial secretions
- Vomiting
More Frequent
Severe
Less Severe
- Atelectasis
- CNS depression
- Dyspnea
- Hypotension
- Orthostatic hypotension
- Respiratory depression
- Acute confusion
- Anorexia
- Dizziness
- Dysphoric mood
- General weakness
- Headache disorder
- Nervousness
- Oliguria
- Palpitations
- Pruritus of skin
- Sedation
- Skin rash
- Syncope
- Urticaria
- Visual changes
- Xerostomia
Less Frequent
Severe
Less Severe
Rare / Very Rare
Severe
- Accidental fall
- Acute respiratory failure
- Adrenocortical insufficiency
- Anaphylaxis
- Androgen deficiency
- Blood dyscrasias
- Bradycardia
- Cardiac arrest
- Drug dependence
- Extrasystoles
- Hallucinations
- Hemolytic anemia
- Hypersensitivity drug reaction
- Hypotension
- Ileus
- Opioid dependence
- Pancreatitis
- Seizure disorder
- Shock
- Sleep apnea
Less Severe
- Abdominal distension
- Acute abdominal pain
- Acute confusion
- Anorexia
- Ataxia
- Biliary spasm
- Blurred vision
- Chest discomfort
- Chills
- Constipation
- Depression
- Diarrhea
- Diplopia
- Dry nose
- Dry throat
- Dyspnea
- Dysuria
- Erectile dysfunction
- Euphoria
- Excitement
- Fatigue
- Flushing
- Gastrointestinal irritation
- Headache disorder
- Hyperhidrosis
- Increased urinary frequency
- Infertility
- Insomnia
- Irritability
- Libido changes
- Maculopapular rash
- Malaise
- Migraine
- Nervousness
- Nightmares
- Palpitations
- Paresthesia
- Pruritus of skin
- Skin photosensitivity
- Skin rash
- Symptoms of anxiety
- Tachycardia
- Tinnitus
- Tremor
- Urinary retention
- Urticaria
- Vasodilation of blood vessels
- Vertigo
- Visual changes
- Vomiting
- Wheezing
- Xerostomia
Contraindicated
Chlorpheniramine
Risk of serious and life-threatening adverse effects of CNS depression or excitation. Not recommended age <2 years. Avoid using with underlying asthma.
Possible paradoxical CNS excitation. Seizure risk in newborns.
Not indicated for symptoms of cough and cold in pediatrics. Risk of slowed or difficult breathing and respiratory depression. Death reported in CYP2D6 ultra-rapid metabolizers post tonsillectomy or adenoidectomy.
- 30 Days – 2 Years
- 1 Risk of serious and life-threatening adverse effects of CNS depression or excitation. Not recommended age <2 years. Avoid using with underlying asthma.
- 1 Day – 29 Days
- 1 Risk of serious and life-threatening adverse effects of CNS depression or excitation. Not recommended age <2 years. Avoid using with underlying asthma.
- 1 Day – 18 Years
- 1 Risk of serious and life-threatening adverse effects of CNS depression or excitation. Not recommended age <2 years. Avoid using with underlying asthma.
Chlorpheniramine (Oral)
Risk of serious and life-threatening adverse effects of CNS depression or excitation. Not recommended age <2 years. Avoid using with underlying asthma.
Possible paradoxical CNS excitation. Seizure risk in newborns.
Not indicated for symptoms of cough and cold in pediatrics. Risk of slowed or difficult breathing and respiratory depression. Death reported in CYP2D6 ultra-rapid metabolizers post tonsillectomy or adenoidectomy.
- 30 Days – 2 Years
- 1 Possible paradoxical CNS excitation. Seizure risk in newborns.
- 1 Day – 29 Days
- 1 Possible paradoxical CNS excitation. Seizure risk in newborns.
- 1 Day – 18 Years
- 1 Possible paradoxical CNS excitation. Seizure risk in newborns.
Codeine (cough_cold)
Risk of serious and life-threatening adverse effects of CNS depression or excitation. Not recommended age <2 years. Avoid using with underlying asthma.
Possible paradoxical CNS excitation. Seizure risk in newborns.
Not indicated for symptoms of cough and cold in pediatrics. Risk of slowed or difficult breathing and respiratory depression. Death reported in CYP2D6 ultra-rapid metabolizers post tonsillectomy or adenoidectomy.
- 30 Days – 2 Years
- 1 Not indicated for symptoms of cough and cold in pediatrics. Risk of slowed or difficult breathing and respiratory depression. Death reported in CYP2D6 ultra-rapid metabolizers post tonsillectomy or adenoidectomy.
- 1 Day – 29 Days
- 1 Not indicated for symptoms of cough and cold in pediatrics. Risk of slowed or difficult breathing and respiratory depression. Death reported in CYP2D6 ultra-rapid metabolizers post tonsillectomy or adenoidectomy.
- 1 Day – 18 Years
- 1 Not indicated for symptoms of cough and cold in pediatrics. Risk of slowed or difficult breathing and respiratory depression. Death reported in CYP2D6 ultra-rapid metabolizers post tonsillectomy or adenoidectomy.
Severe Precaution
Chlorpheniramine (Ext. Release)
Not recommended in children under 12 years unless clinician consultation.
- 2 Years – 12 Years
- Not recommended in children under 12 years unless clinician consultation.
Management or Monitoring Precaution
None
Chlorpheniramine
- Severity Level:
2
- Additional Notes: Low risk, premature infant at risk of retrolental fibroplasia
Codeine
- Severity Level:
2
- Additional Notes: Neonatal withdrawal/resp.depression w/chronic or high dose
Contraindicated
None
| General | Excretion Potential | Effect on Infant | Notes |
| None |
Precaution Exists
Chlorpheniramine
Insufficient data available; may cause sedation and inhibit lactation
Resp dep poss in infant,non-opioid alt rec, or use low dose shortest duration
| General | Excretion Potential | Effect on Infant | Notes |
| Evaluate use carefully | Unknown | Not known; no or inclusive data | Insufficient data available; may cause sedation and inhibit lactation |
Codeine
Insufficient data available; may cause sedation and inhibit lactation
Resp dep poss in infant,non-opioid alt rec, or use low dose shortest duration
| General | Excretion Potential | Effect on Infant | Notes |
| Evaluate use carefully | Excreted | Drug shown to have adverse effect | Resp dep poss in infant,non-opioid alt rec, or use low dose shortest duration |
No Known Risk
None
| General | Excretion Potential | Effect on Infant | Notes |
| None |
Contraindicated
None
Precaution Exists
Chlorpheniramine
Neuro/Psych-Anticholinergic effects may cause sedation, worsen cognitive impairment and increase fall risk. Non-sedating antihistamine preferred. Gastrointestinal-May cause or worsen pre-existing constipation. Genitourinary-Best avoided in patients with urinary retention from any cause.
General-Consider adding naloxone Rx. Pulmonary-Life threatening respiratory depression risk with high doses, cachexia, or debilitation due to altered pharmacokinetics (poor fat stores, muscle wasting, or altered clearance). Monitor closely at initiation and dose titration. Neuro/Psych-Risk for increased confusion and delirium. May increase fall risk. Avoid treatment with 3 or more CNS active drugs. Gastrointestinal-Constipation risk. Urogenital-Urinary retention risk.
| Organ / System | HEP | REN | CARD | ENDO | NEURO / PSYCH | PULM |
| Increased Risk / Adverse Effects | N | N | N | Y | N | N |
BEERS: Y HEDIS: Y STOPP: Y
Codeine
Neuro/Psych-Anticholinergic effects may cause sedation, worsen cognitive impairment and increase fall risk. Non-sedating antihistamine preferred. Gastrointestinal-May cause or worsen pre-existing constipation. Genitourinary-Best avoided in patients with urinary retention from any cause.
General-Consider adding naloxone Rx. Pulmonary-Life threatening respiratory depression risk with high doses, cachexia, or debilitation due to altered pharmacokinetics (poor fat stores, muscle wasting, or altered clearance). Monitor closely at initiation and dose titration. Neuro/Psych-Risk for increased confusion and delirium. May increase fall risk. Avoid treatment with 3 or more CNS active drugs. Gastrointestinal-Constipation risk. Urogenital-Urinary retention risk.
| Organ / System | HEP | REN | CARD | ENDO | NEURO / PSYCH | PULM |
| Increased Risk / Adverse Effects | N | Y | Y | Y | Y | N |
BEERS: Y HEDIS: N STOPP: Y
No Known Risk
None
- This medication has a risk for abuse and addiction, which can lead to overdose and death. This medication may also cause severe, possibly fatal, breathing problems. To lower your risk, your doctor should have you take the smallest dose that works, and take it for the shortest possible time.<br /><br />See also How to Use section for more information about addiction. The risk for severe breathing problems is higher when you start this medication, or if you take the wrong dose or take more of this medication than prescribed. Taking this medication with alcohol or other drugs that can cause drowsiness or breathing problems may cause very serious side effects, including death.<br /><br /> Also, other medications can affect the removal of this product from your body, which may affect how it works. Be sure you know how to take this product and what other drugs you should avoid taking with it. See also Drug Interactions section.<br /><br />Get medical help right away if any of these very serious side effects occur: slow/shallow breathing, unusual lightheadedness, severe drowsiness/dizziness, difficulty waking up. Keep this medicine in a safe place to prevent theft, misuse, or abuse. If someone accidentally swallows this drug, get medical help right away.<br /><br /> Before using this medication, women of childbearing age should talk with their doctor(s) about the risks and benefits. Tell your doctor if you are pregnant or think you may be pregnant. During pregnancy, this medication is not recommended.<br /><br />It may slightly increase the risk of birth defects if used during the first two months of pregnancy. Also, using it for a long time or in high doses near the expected delivery date may harm the unborn baby. To lessen the risk, take the smallest effective dose for the shortest possible time.<br /><br />Babies born to mothers who use this drug for a long time may develop severe (possibly fatal) withdrawal symptoms. Tell the doctor right away if you notice any symptoms in your newborn baby such as crying that doesn't stop, slow/shallow breathing, irritability, shaking, vomiting, diarrhea, poor feeding, or difficulty gaining weight.
| Allergic rhinitis | |
| J30.1 | Allergic rhinitis due to pollen |
| J30.2 | Other seasonal allergic rhinitis |
| J30.5 | Allergic rhinitis due to food |
| J30.8 | Other allergic rhinitis |
| J30.81 | Allergic rhinitis due to animal (cat) (dog) hair and dander |
| J30.89 | Other allergic rhinitis |
| J30.9 | Allergic rhinitis, unspecified |
| Cold symptoms | |
| J00 | Acute nasopharyngitis [common cold] |
| Cough | |
| R05 | Cough |
| R05.1 | Acute cough |
| R05.2 | Subacute cough |
| R05.3 | Chronic cough |
| R05.9 | Cough, unspecified |
| Nasal congestion | |
| R09.81 | Nasal congestion |
| Rhinorrhea | |
| R09.82 | Postnasal drip |
| 0-9 | A-Z |
|---|---|
| J00 | Acute nasopharyngitis [common cold] |
| J30.1 | Allergic rhinitis due to pollen |
| J30.2 | Other seasonal allergic rhinitis |
| J30.5 | Allergic rhinitis due to food |
| J30.8 | Other allergic rhinitis |
| J30.81 | Allergic rhinitis due to animal (cat) (dog) hair and dander |
| J30.89 | Other allergic rhinitis |
| J30.9 | Allergic rhinitis, unspecified |
| R05 | Cough |
| R05.1 | Acute cough |
| R05.2 | Subacute cough |
| R05.3 | Chronic cough |
| R05.9 | Cough, unspecified |
| R09.81 | Nasal congestion |
| R09.82 | Postnasal drip |
Formulary Reference Tool