Promethazine Hydrochloride 6.25mg/5mL, Codeine Phosphate 10mg/5mL, Oral solution
Cannabis
· Severity: Major
· Notes for Consumers: Discuss cannabis use with your care team. The effects of your medication may be altered if used with cannabis. Call emergency services right away if you experience slow or shallow breathing, shortness of breath, feeling faint, dizziness, confusion, or trouble staying awake.
· Notes for Professionals: Advise patients to avoid cannabis use while taking CNS depressants due to the risk for additive CNS depression and potential for other cognitive adverse reactions.
Promethazine Hydrochloride 6.25mg/5mL, Codeine Phosphate 10mg/5mL, Oral solution
Grapefruit juice
· Severity: Moderate
· Notes for Consumers: It is recommended that you limit and do not significantly alter your intake of grapefruit or grapefruit juice while taking codeine. Side effects from codeine may get worse if you increase your intake of grapefruit juice. Talk to your doctor first. Contact your doctor right away if you have symptoms of codeine side effects such as slurred speech, confusion, weakness, or trouble breathing. Do not drive or operate machinery until you know how codeine affects you.
· Notes for Professionals: Patients should not significantly alter their intake of grapefruit or grapefruit juice during therapy with codeine. Grapefruit juice, a CYP3A4 inhibitor, may increase plasma concentrations of codeine, a CYP3A4 substrate. This may increase or prolong codeine-related toxicities including respiratory depression. Advise patients accordingly; patient monitoring and dosage adjustments may be necessary if grapefruit is consumed regularly.
Promethazine Hydrochloride 6.25mg/5mL, Codeine Phosphate 10mg/5mL, Oral solution
Alcohol
· Severity: Major
· Notes for Consumers: Do not drink alcohol while taking this medication. Drinking alcohol while taking this medication can cause serious side effects, such as central nervous system (CNS) depression, and can increase the risk of an opioid overdose. Call emergency services right away if you experience symptoms of CNS depression: slow or shallow breathing, shortness of breath, feeling faint, dizziness, confusion, trouble staying awake. Talk to your care team about naloxone, a medication for the emergency treatment of opioid overdose.
· Notes for Professionals: Advise patients to avoid alcohol consumption while taking opioids. Alcohol consumption may result in additive CNS depression and may increase the risk for opioid overdose. Consider the patient's use of alcohol when prescribing opioid medications. If the patient is unlikely to be compliant with avoiding alcohol, consider prescribing naloxone especially if additional risk factors for opioid overdose are present.
Promethazine Hydrochloride 6.25mg/5mL, Codeine Phosphate 10mg/5mL, Oral solution
Tobacco
· Severity: Major
· Notes for Consumers: Do not smoke or use tobacco products while taking this medication. When used together, your medication may not work as well for you.
· Notes for Professionals: Advise patients to avoid smoking tobacco while taking phenothiazines. Tobacco smoking may increase the clearance of phenothiazines, which may reduce their efficacy.