Cough

Updated 16 January 2017

Diphenhydramine, ammonium chloride and codeine

The combination of diphenhydramine, ammonium chloride and codeine is an antitussive and expectorant cough mixture.

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Diphenhydramine, ammonium chloride and codeine is the active ingredient of Benylin with codeine (Nappi Code: 707600-006/014) and Expectalin + codeine (Nappi Code: 805351-019/027).

General information
The combination of diphenhydramine, ammonium chloride and codeine is an antitussive and expectorant cough mixture.

Antitussives are used to suppress or relieve/sooth coughing, while expectorants stimulate the respiratory tract to increase the production of bronchial secretions. This then thins mucus, facilitating the expulsion of phlegm or mucus from the respiratory tract.

Diphenhydramine is an antihistamine that relieves congestion and post-nasal drips, while ammonium chloride is the expectorant which thins mucus. Codeine suppresses the cough reflex by calming the part of the brain that regulates coughing.

This formulation has the potential to be habit-forming. It should only be used as directed by your doctor or pharmacist, and only for as long as required.

It should be noted that neither diphenhydramine, ammonium chloride nor codeine cures the underlying condition causing coughing, but simply keeps the symptoms under control.

This formulation is highly effective in treating dry and persistent coughs.

How does diphenhydramine, ammonium chloride and codeine work?
Diphenhydramine is an antihistamine that relieves congestion and post-nasal drips, while ammonium chloride is the expectorant which thins mucus. Codeine suppresses the cough reflex by calming the part of the brain that regulates coughing.

Fast facts

Drug schedule: schedule 2
Available as: diphenhydramine, ammonium chloride and codeine is available as syrup
What does it do? This combination relieves congestion, dries a runny nose and post-nasal drip, thins mucus to relief coughing and also suppresses the cough reflex centrally.
Overdose risk: high
Dependence risk: high
Is this combination available as a generic? yes
Is this combination available on prescription only? no

User information

Onset of effect: within 3 hours
Duration of action: up to 6 hours
Stopping this medicine: this medication can be safely discontinued when no longer needed.
Prolonged use: this formulation has the potential to be habit-forming. It should only be used as directed by your doctor or pharmacist, and only for as long as required.

Special precautions Consult your doctor before using this drug if:

  • you have asthma

  • you have liver or kidney disease

  • you have glaucoma

  • you have epilepsy

  • you have heart rhythm disturbance, i.e. a fast heart rate

  • you are younger than 16

  • you have an enlarged prostate

  • you have difficulty urinating

  • you have myasthenia gravis

  • you have a history of alcohol or drug abuse

  • you have a head injury

  • you have a thyroid disorder

  • you have obstructive bowel disease

Pregnancy: avoid. Potential risk to the foetus has been reported. Consult your doctor before use, or if you are planning to fall pregnant.
Breastfeeding: avoid. It is unknown how this medication may affect your baby. Consult your doctor before use.
Porphyria: avoid. It is unknown how this medication may affect your condition. Consult your doctor before use.
Infants and children: this medication is not intended for use in children under the age of 6 years.
The elderly: caution is advised in the elderly as adverse effects may be more likely.
Driving and hazardous work: this medication should be avoided as it may lead to extreme sedation
Alcohol: avoid concomitant use of alcohol with this medication.

Possible side effects

Side Effect
Frequency
Consult your doctor
 
Common
Rare
Only if severe
In all cases
dry mouth
X
X
drowsiness
X
X
dizziness
X
X
headaches
X
X
constipation
X
X
nausea/vomiting
X
X
anxiety
X
X
euphoria
X
X
change in mood
X
X
heart palpitations
X
X
blurred vision
X
X
sudden low blood pressure
X
X
slurred speech
X
X
difficulty breathing
X
X
seizures
X
X

Interactions

alcoholenhanced sedation
drugs for anxietyenhanced sedation
sleeping tabletsenhanced sedation
monoamine oxidase inhibitorsincreased occurrence of diphenhydramine related side-effects and a decrease in blood pressure
tricyclic antidepressantsincreased occurrence of diphenhydramine related side-effects
drugs that may cause hearing losssigns of hearing damage may be masked
atropine and related drugsincreased risk of constipation, urinary retention, etc.
drugs for diarrhoearisk of severe constipation
blood pressure medicationincrease risk of low blood pressure
carbamazepineincreased risk of carbamazepine toxicity

Overdose action
A small overdose is no cause for concern. In case of intentional large overdose, seek emergency medical attention.

Recommended dosage
Adults, oral: 5 - 10 ml every 4 hours

This material is not intended to substitute medical advice, but is for informational purposes only. Please consult a physician for specific treatment and recommendations.

 

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Cough Expert

Professor Keertan Dheda has received several prestigious awards including the 2014 Oppenheimer Award, and has published over 160 peer-reviewed papers and holds 3 patents related to new TB diagnostic or infection control technologies. He serves on the editorial board of the journals PLoS One, the International Journal of Tuberculosis and Lung Disease, American Journal of Respiratory and Critical Medicine, Lancet Respiratory Diseases and Nature Scientific Reports, amongst others. Read his full biography at the University of Cape Town Lung Institute.

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