Home Drug Guide Bromodiphenhydramine Hydrochloride and Codeine Phosphate

Drug Guide

Generic Name

Bromodiphenhydramine Hydrochloride and Codeine Phosphate

Brand Names Ambenyl, Bromanyl, Bromodiphenhydramine Hydrochloride And Codeine Phosphate

Classification

Therapeutic: Antitussive and Antihistamine

Pharmacological: Antihistamine and Opioid

FDA Approved Indications

  • Temporary relief of coughs and colds associated with allergies or respiratory infections

Mechanism of Action

Bromodiphenhydramine acts as an antihistamine, blocking H1 receptors to reduce allergy symptoms; codeine is an opioid that suppresses cough reflex in the brain's cough center.

Dosage and Administration

Adult: As prescribed, typically 15-30 mg bromodiphenhydramine and 10-20 mg codeine every 4-6 hours as needed, not exceeding 120 mg bromodiphenhydramine and 120 mg codeine per day.

Pediatric: Use is generally not recommended for children under 12 years due to safety concerns. Consult specific age-related dosing guidelines.

Geriatric: Caution due to increased sensitivity, start at lower doses and monitor closely.

Renal Impairment: Adjust dosage based on severity of impairment; consult specific guidelines.

Hepatic Impairment: Use with caution; dosage adjustments may be necessary.

Pharmacokinetics

Absorption: Well absorbed orally.

Distribution: Widely distributed, crossing the blood-brain barrier.

Metabolism: Liver metabolism via CYP2D6 and other pathways.

Excretion: Primarily renal.

Half Life: Approximately 3-4 hours for bromodiphenhydramine; codeine half-life around 3 hours.

Contraindications

  • History of hypersensitivity to antihistamines, codeine, or components of the formulation.
  • Respiratory depression, asthma, multi-system failure.
  • Children under 12 years.
  • Pregnancy Category C/D depending on trimester.

Precautions

  • Use with caution in elderly, those with respiratory compromise, or head injuries. Monitor for signs of sedation or respiratory depression. Risk of dependency and abuse with opioids.

Adverse Reactions - Common

  • Drowsiness (Common)
  • Dizziness (Common)
  • Nausea (Common)

Adverse Reactions - Serious

  • Respiratory depression (Rare)
  • Allergic reactions including rash, hives (Rare)
  • Dependence and abuse potential (Caution in opioid-tolerant individuals)

Drug-Drug Interactions

  • CNS depressants, alcohol, other sedatives, monoamine oxidase inhibitors (MAOIs)

Drug-Food Interactions

  • Alcohol may enhance sedative effects.

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor for signs of respiratory depression, sedation, and allergic reactions. Assess pain and cough severity.

Diagnoses:

  • Risk for respiratory depression
  • Ineffective airway clearance
  • Risk for dependency.

Implementation: Administer with caution, especially in vulnerable groups. Educate patient on risk of sedation and respiratory depression.

Evaluation: Effectiveness in cough suppression, relief of allergy symptoms, and monitoring adverse effects.

Patient/Family Teaching

  • Do not operate machinery or drive until effects are known.
  • Avoid alcohol and other CNS depressants.
  • Report signs of respiratory difficulty, allergic reactions, or excessive sedation.
  • Use exactly as prescribed; do not increase dose.

Special Considerations

Black Box Warnings:

  • Potential for opioid addiction, abuse, and misuse.
  • Risks of respiratory depression, especially in children and with overdose.

Genetic Factors: CYP2D6 polymorphisms may alter metabolism of codeine, affecting efficacy and safety.

Lab Test Interference: May cause false-positive urinary tests for opioids.

Overdose Management

Signs/Symptoms: Severe drowsiness, respiratory depression, hypotension, coma.

Treatment: Supportive care, respiratory support, naloxone for opioid overdose, gastrointestinal decontamination if early.

Storage and Handling

Storage: Store at room temperature, away from light and moisture.

Stability: Stable under recommended storage conditions.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.