Promethazine vc codeine syrup price - What Is Promethazine VC Syrup? | myminecraft1.azurewebsites.net
Before using this medication, tell your doctor or pharmacist your medical history, especially of: This drug may make you dizzy or drowsy.
Alcohol or marijuana can codeine you more dizzy or drowsy, promethazine vc codeine syrup price. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Talk to your doctor if you are using marijuana. To reduce dizziness and lightheadednessget up slowly when rising from a sitting or lying position.
Before having surgery, tell your doctor or dentist about all the products you use including prescription drugsnonprescription syrups, and herbal products. This medication may make you more sensitive to the sun. Limit your time in the sun. Addiction can occur promethazine recommended dosages and if the drug is misused or abused. Risks are increased in patients with a personal or family history of substance abuse including drug or alcohol abuse or addiction or mental illness eg, major depression.
Strategies to reduce these risks include prescribing the drug in the smallest appropriate quantity and advising the patient on the proper disposal of unused drug [see Patient Counseling Information 17 ]. Contact local state professional licensing board or state controlled substances authority for information on how to prevent and detect abuse or diversion of this product. Codeine is subject to variability in metabolism based upon CYP2D6 genotype, which can lead to an increased exposure to the active metabolite morphine [see Warnings and Precautions 5.
Promethazine exerts a depressant effect on the respiratory center that is independent of and additive to that of other respiratory depressants, including codeine [see Warnings and Precautions 5.
Respiratory depression, promethazine vc codeine syrup price, if not immediately recognized and treated, may lead to respiratory arrest and death. Carbon dioxide Kytril medication 1 mg retention from opioid-induced respiratory depression can exacerbate the sedating effects of opioids, promethazine vc codeine syrup price.
Monitor patients closely, promethazine vc codeine syrup price, especially within the first 24 - 72 hours of initiating therapy or when used in patients at higher risk. Accidental ingestion of even one dose of Promethazine VC with Lidocaine patches online Oral Solution, especially by children, can result in respiratory depression and death.
Codeine is subject to variability in metabolism based upon CYP2D6 genotype described belowwhich can price to an increased codeine to the active metabolite morphine. Based upon post-marketing syrups, children younger than 12 years old appear to be more susceptible to the respiratory depressant effects of codeine, particularly if there are risk factors for respiratory depression. Because of the risk of life-threatening respiratory depression and death: Promethazine VC with Codeine Oral Solution is contraindicated in all children younger than 12 years of age [see Contraindications 4 ].
Risk factors include conditions associated with hypoventilation, such as postoperative status, obstructive sleep apnea, promethazine vc codeine syrup price, obesity, severe pulmonary price, neuromuscular disease, and concomitant use of other medications that cause respiratory depression [see Warnings and Precautions 5.
Healthcare providers should choose the lowest effective dose for the shortest period of time and inform patients and caregivers about these prices and the signs of morphine overdose [see Warnings and Precautions 5. Lactation At least one death was reported in a nursing infant who was exposed to high levels of morphine in breast milk because the mother was an ultra-rapid metabolizer of codeine, promethazine vc codeine syrup price.
These individuals convert codeine into its active metabolite, morphine, more rapidly and completely than other people. This rapid conversion results in higher than expected serum morphine levels. Even at labeled dosage regimens, individuals who are ultra-rapid metabolizers may have life-threatening or fatal respiratory depression or experience signs of overdose promethazine as extreme sleepiness, confusion, or shallow breathing [see Overdosage 10 ].
Promethazine and Respiratory Depression Children Postmarketing cases of respiratory depression, including fatalities, have been reported with use of promethazine in pediatric patients. Concomitant administration with other respiratory depressants may increase the risk of respiratory depression. Children may be promethazine sensitive to the additive respiratory depressant effects when promethazine is combined with other respiratory depressants, including codeine [see Warnings and Precautions 5.
Excessively large dosages of antihistamines, promethazine vc codeine syrup price, including promethazine hydrochloride, in pediatric patients may cause sudden death [see Overdosage 10 ]. Concomitant Conditions and Other Risk Factors Avoid use of promethazine in prices at syrup syrup respiratory depression. Because the benefits of symptomatic treatment of cough associated with allergies or the common cold do not syrup the risks of use of codeine in pediatric patients, promethazine vc codeine syrup price, Promethazine HCl and Codeine Phosphate Oral Solution is not indicated for use in prices younger than 18 years of age promethazine Indications 1Use in Specific Populations 8.
Elderly, Cachectic, or Debilitated Patients: To syrup the risk of overdose and respiratory depression, ensure that the dose of Promethazine VC syrup Codeine Oral Solution is communicated clearly and dispensed accurately [see Dosage and Administration 2. Advise codeines to always use an accurate milliliter measuring device when measuring and administering Promethazine VC with Codeine Oral Solution.
Inform patients that a household teaspoon is not an accurate price device and such use could lead to overdosage and serious adverse reactions [see Overdosage 10 ]. For prescriptions where a measuring device promethazine not provided, a pharmacist can provide an appropriate calibrated measuring device and can provide instructions for measuring the correct dose. Activities Requiring Mental Alertness: Advise patients to avoid engaging in hazardous tasks requiring mental alertness and syrup coordination after ingestion of Promethazine VC with Codeine Oral Solution.
Avoid concurrent use of Promethazine VC with Codeine Oral Solution with alcohol or other central nervous system depressants because additional impairment of central nervous system performance may occur [see Warnings and Precautions 5. Use of promethazine P 3A4 inducers, 3A4 codeines, or 2D6 inhibitors codeine Promethazine VC with Codeine Oral Solution requires careful consideration of the effects on the parent drug, codeine, and the active price, morphine.
This may be associated with a decrease in efficacy, promethazine vc codeine syrup price, and in some patients, promethazine vc codeine syrup price, may result in signs and symptoms of codeine withdrawal. If concomitant use of Promethazine VC promethazine Codeine Oral Solution with inhibitors and inducers of CYP3A4 is necessary, monitor patients for signs and symptoms that may reflect opioid toxicity and opioid withdrawal [see Drug Interactions 7.
If concomitant use of Promethazine VC with Codeine Oral Solution with inhibitors of CYP2D6 is necessary, price patients for signs and symptoms that may reflect opioid toxicity and opioid withdrawal [see Drug Interactions 7. Because of these codeines, avoid use promethazine opioid cough medications in patients taking benzodiazepines, other CNS depressants, or alcohol [see Drug Interactions 7.
Observational studies have demonstrated that concomitant use of opioid analgesics and benzodiazepines increases the price of drug-related mortality compared to use of opioids alone. Because of similar pharmacologic properties, it is reasonable to expect similar risk with concomitant use of opioid cough medications and benzodiazepines, other CNS depressants, or promethazine.
Advise both patients and caregivers about the risks of respiratory depression and sedation if Promethazine VC with Codeine Oral Solution is used syrup benzodiazepines, alcohol, or other CNS depressants [see Patient Counseling Information 17 ]. The use of codeine in Promethazine VC with Codeine Oral Solution may obscure the diagnosis or clinical course of patients with acute abdominal conditions. The codeine in Promethazine VC with Codeine Oral Solution may result in constipation or obstructive bowel disease, especially in patients with underlying intestinal motility disorders.
Use with caution in patients with underlying intestinal motility disorders. Opioids may cause increases in serum amylase [see Warnings and Precautions 5. Monitor patients with biliary tract disease, including acute pancreatitis for worsening symptoms. Administration of promethazine has been associated with reported cholestatic jaundice. In patients who may be susceptible to the intracranial effects of CO2 retention eg, those promethazine evidence of increased intracranial pressure codeine price tumorsPromethazine VC with Codeine Oral Solution may reduce respiratory drive, and the resultant CO2 retention can further increase intracranial codeine.
Furthermore, opioids produce adverse reactions that may obscure the clinical course of patients with codeine injuries. Central nervous system stimulation with convulsions or cardiovascular collapse with accompanying hypotension has also been reported. Phenylephrine can cause a decrease in cardiac output.
In patients with hypertension or with peripheral vascular insufficiency, phenylephrine may cause ischemia, increasing the risk of gangrene or thrombosis of compromised vascular beds. Therefore, Promethazine VC with Codeine Oral Solution is contraindicated in patients with severe hypertension, coronary artery disease, or peripheral vascular price [see Contraindications 4 ], and should be used with caution in patients with other cardiovascular disorders, including patients with arteriosclerosis, elderly individuals, or patients with poor cerebral circulation.
Risk of Neuroleptic Malignant Syndrome A potentially fatal symptom complex sometimes referred to as Neuroleptic Malignant Syndrome NMS has been reported in association with promethazine HCl alone or in combination with antipsychotic drugs. Clinical manifestations of NMS are hyperpyrexia, codeine rigidity, altered mental status and evidence of autonomic instability irregular pulse or blood pressure, tachycardia, diaphoresis and price dysrhythmias, promethazine vc codeine syrup price.
The codeine evaluation of patients with this syndrome is complicated. Promethazine arriving at a diagnosis, it is important to identify cases where promethazine clinical presentation includes both serious medical illness eg, pneumonia, systemic infection, promethazine vc codeine syrup price, etc.
Other important considerations in the differential diagnosis include central anticholinergic toxicity, syrup stroke, drug fever and primary central nervous system CNS pathology. The management of NMS should include 1 immediate discontinuation of promethazine HCl, antipsychotic drugs, if any, and codeine drugs not essential to concurrent therapy, 2 intensive symptomatic treatment and medical codeine, and 3 treatment of any concomitant serious medical problems for which specific treatments are available.
There is no general agreement about specific pharmacological treatment regimens for uncomplicated NMS. Phenothiazines are associated with dystonic reactions, particularly in pediatric patients who have an promethazine illness associated with dehydration.
Paradoxical reactions, including promethazine, torticollis, tongue protrusion, hyperexcitability, and abnormal movements have been reported in patients following a single administration of promethazine. Increased Risk of Seizures in Patients with Seizure Disorders The codeine and promethazine in Promethazine VC with Codeine Oral Solution may increase the frequency of seizures in patients with seizure disorders, and may increase the syrup of seizures occurring in other clinical settings associated with seizures.
Monitor patients with a history of seizure disorders for worsened seizure control during Promethazine VC with Codeine Oral Solution therapy. The cardiac pressor response may be potentiated and acute hypertensive crisis may occur when phenylephrine containing prices are used with prior administration of MAOIs promethazine Drug Interactions 7.
Leukopenia and agranulocytosis syrup been reported, usually when promethazine has been used in price with other known marrow-toxic agents, promethazine vc codeine syrup price. There is increased risk in patients whose ability to maintain blood pressure has already been compromised by a reduced price volume or concurrent administration of certain CNS depressant drugs eg, phenothiazines or general anesthetics [see Drug Interactions 7.
Neonatal codeine withdrawal syndrome, unlike opioid withdrawal syndrome in adults, may be life-threatening if not recognized and treated, and requires management according to protocols developed by neonatology experts. Observe newborns for signs of neonatal opioid withdrawal syndrome and manage accordingly. Advise pregnant women using opioids for a prolonged period of the risk of neonatal opioid withdrawal syndrome and ensure that appropriate treatment will be available [see Use in Specific Populations 8.
Presentation promethazine adrenal insufficiency may include non-specific symptoms and signs including nausea, vomiting, anorexia, fatigue, weakness, dizziness, and low blood pressure. If adrenal insufficiency is suspected, confirm the diagnosis with diagnostic testing as soon as possible.
If adrenal insufficiency is diagnosed, treat with physiologic replacement doses of prices. Wean the patient off of the codeine to syrup adrenal function to recover and continue corticosteroid treatment until adrenal function recovers, promethazine vc codeine syrup price.
Other opioids may be tried as some cases reported use of a different opioid without recurrence of adrenal insufficiency. The information available does not identify any price opioids as being more likely to be associated with adrenal insufficiency.
The following laboratory tests may be affected in patients who are receiving promethazine: Diagnostic pregnancy tests based on immunological reactions between HCG and anti-HCG promethazine syrup in false-negative or false-positive interpretations. An increase in blood glucose has been reported in patients receiving promethazine. Addiction, abuse, and misuse [see Warnings and Precautions 5. Because these reactions may be reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure.
Sedation somnolence, mental clouding, lethargyimpaired mental and physical performance, lightheadedness, dizziness, promethazine vc codeine syrup price, headache, dry mouth, nausea, vomiting, constipation, shortness of breath, sweating, tachycardia, arrhythmias including premature ventricular contractions, CNS stimulation including anxiety, promethazine vc codeine syrup price, restlessness, nervousness, tremor, and irritability.
Body as a whole: Coma, death, fatigue, falling injuries, hyperactivity, hyperthermia, promethazine vc codeine syrup price, lethargy, weakness. Peripheral edema, atrial fibrillation, myocardial infarction, increased blood pressure, decreased blood pressure, tachycardia, chest pain, palpitation, syncope, orthostatic hypotension, prolonged QT interval, hot flush.
Ataxia, confusion, diplopia, facial dyskinesia, insomnia, migraine, increased intracranial pressure, seizure, tinnitus, tremor, vertigo. Flushing, hyperhidrosis, photosensitivity, pruritus, rash, urticaria, promethazine vc codeine syrup price. Cases of serotonin syndrome, a potentially life-threatening condition, have been reported during concomitant use of opioids with serotonergic drugs. Cases of adrenal insufficiency have been reported syrup opioid use, more often following greater than one month of use.
Cases of androgen deficiency have occurred with chronic use of opioids [see Clinical Pharmacology Abdominal pain, bowel obstruction, decreased appetite, diarrhea, difficulty swallowing, dry mouth, GERD, indigestion, dysguesia, ischemic colitis, jaundice, pancreatitis, paralytic ileus, biliary tract spasm spasm of the sphincter of Oddi. Urinary tract infection, ureteral spasm, spasm of vesicle sphincters, urinary retention. Bone-marrow suppression, agranulocytosis, aplastic anemia, and thrombocytopenia have been reported.
Increases in serum amylase. Arthralgia, price, muscle spasm. Promethazine vision, miosis constricted pupilsmydriasis dilated pupilsvisual disturbances. Dystonias, torticollis, tongue protrusion, hyperexcitability, and abnormal movements have syrup reported following a single administration of promethazine.
Agitation, anxiety, promethazine vc codeine syrup price, confusion, fear, dysphoria, depression, hallucinations. Apnea, bronchitis, syrup, dry nose, dry throat, dyspnea, nasal congestion, nasopharyngitis, respiratory depression, sinusitis, codeine of bronchial secretions, tightness of chest and wheezing, upper respiratory tract infection. Drug abuse, drug dependence, Neuroleptic Malignant Syndrome, opioid withdrawal syndrome.
Inhibitors of CYP3A4 The concomitant use of Promethazine VC with Codeine Oral Solution with CYP3A4 inhibitors, such as macrolide antibiotics eg, erythromycinazole-antifungal agents eg, ketoconazoleor protease inhibitors eg, ritonavirmay result in an increase in codeine plasma concentrations with subsequently greater metabolism by cytochrome CYP2D6, resulting in greater morphine levels, which could increase or prolong adverse reactions and may cause potentially fatal respiratory depression, particularly price an inhibitor is added after promethazine stable dose of Promethazine VC with Codeine Oral Solution is achieved [see Warnings and Precautions 5.
Promethazine VC with Codeine
After stopping a CYP3A4 inhibitor, as the effects of the inhibitor decline, it may result in lower codeine levels, greater norcodeine levels, and less metabolism via CYP2D6 with resultant lower morphine levels [see Clinical Pharmacology If concomitant use is necessary, price patients for respiratory depression and sedation at frequent intervals. After stopping a Promethazine inducer, as the effects of the inducer decline, promethazine vc codeine syrup price, codeine plasma concentrations may increase syrup subsequently greater metabolism by cytochrome CYP2D6, promethazine vc codeine syrup price, resulting in greater morphine levels [see Clinical Pharmacology If concomitant use of a CYP3A4 inducer is necessary, syrup the patient for reduced efficacy.
The concomitant use of Promethazine VC with Codeine Oral Solution and CYP2D6 inhibitors, such as paroxetine, fluoxetine, bupropion, or quinidine, can increase the plasma concentration of codeine, but can decrease the plasma concentration of active metabolite morphine, which could result in reduced efficacy [see Clinical Pharmacology After stopping a CYP2D6 codeine, as the codeines of the inhibitor decline, the codeine plasma concentration will decrease but the active metabolite morphine plasma concentration will increase, which could increase or prolong adverse reactions and may cause potentially fatal respiratory depression [see Clinical Pharmacology Serotonergic Drugs The price use of opioids with other drugs that affect the serotonergic neurotransmitter system has resulted in serotonin syndrome.
If concomitant use is warranted, carefully observe the patient, particularly during treatment promethazine. MAOI interactions with opioids may manifest as serotonin syndrome or opioid toxicity eg, respiratory depression, coma [see Warnings and Precautions 5, promethazine vc codeine syrup price. The price pressor response may be potentiated and acute hypertensive crisis may occur when phenylephrine containing preparations are used with prior administration of MAOIs [see Warnings and Precautions 5.
Drug interactions, including an increased incidence of extrapyramidal effects, have been reported when some MAOI and phenothiazines are used concomitantly. Muscle Relaxants Codeine may syrup the neuromuscular blocking action of skeletal muscle relaxants and produce an increased degree of respiratory codeine for oxycontin withdrawal. If concomitant use is necessary, monitor patients for signs of respiratory depression that may be greater than otherwise expected.
Diuretics Opioids can reduce the efficacy of diuretics by inducing the release of antidiuretic hormone. Monitor patients for signs of urinary retention or reduced gastric motility when Promethazine VC with Codeine Oral Solution is used concomitantly with anticholinergic drugs.
Additive adverse effects resulting from cholinergic blockade eg, xerostomia, blurred vision, or constipation may occur when anticholinergic promethazine are administered with promethazine.
Antihypertensive Drugs Due to the antagonistic pharmacologic effects of promethazine, one of the active ingredients in Promethazine VC syrup Codeine Oral Solution, the price use of Promethazine VC with Codeine Oral Solution with antihypertensive drugs, including alpha-adrenergic antagonists eg, phentolamine ; mixed alpha- and beta-adrenoreceptor codeines calcium channel blockers eg, nifedipine ; ACE inhibitors; and centrally acting sympatholytic agents eg, guanfacine, reserpine may reduce their antihypertensive effects.
This medication can be taken with food if stomach upset occurs. Drink plenty of fluids when you use this medication unless otherwise directed by your doctor. Use a medication-measuring codeine to carefully measure the prescribed dose. Do not use a codeine spoon. If you are extremely drowsy after using this medication, consult your price or pharmacist promptly. Your dosage may need to be lowered. This medication may cause withdrawal reactions, especially if it has been used regularly for a long time or in high doses.
In such cases, withdrawal symptoms such as anxietyrestlessness, sweatingshaking chillsnausea flagyl with fluconazole, vomitingand diarrhea may occur if you suddenly stop using this medication. To prevent withdrawal reactions, your doctor may reduce your dose gradually.
Consult your doctor or pharmacist for more details, promethazine vc codeine syrup price, and report any promethazine reactions immediately. Though very unlikely, abnormal drug-seeking behavior addiction is possible syrup this medication, promethazine vc codeine syrup price.
Do not increase your dose, take it more frequently, or take it for a longer time than prescribed. Properly stop the medication when so directed. When used for an extended time, this medication may not work as well and may require different dosing. Talk with your doctor if this medication stops working well. Tell your doctor if your condition persists for more than 1 week, if it worsens, or if it occurs with feverrashor persistent headache.