Generic Name: dihydrocodeine and phenylephrine (dye HYE dro KOE deen and FEN il EFF rin)Brand Names: Alahist DHC
Dihydrocodeine is a narcotic cough suppressant.
Phenylephrine is a decongestant that shrinks blood vessels in the nasal passages. Dilated blood vessels can cause nasal congestion (stuffy nose).
The combination of dihydrocodeine and phenylephrine is used to treat cough and nasal congestion caused by the common cold.
Dihydrocodeine will not treat a cough that is caused by smoking, asthma, or emphysema.
Dihydrocodeine and phenylephrine may also be used for other purposes not listed in this medication guide.What is the most important information I should know about dihydrocodeine and phenylephrine?Do not use this medication if you have used an MAO inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate) within the past 14 days. Serious, life-threatening side effects can occur if you take a cough and cold medicine before the MAO inhibitor has cleared from your body.
You should not use dihydrocodeine and phenylephrine if you are allergic to it, or if you have severe or uncontrolled high blood pressure, severe coronary artery disease, narrow-angle glaucoma, peptic ulcer or a bowel obstruction called paralytic ileus, if you are unable to urinate, if you are pregnant, or if you are having an asthma attack.
Before taking this medication, tell your doctor if you have heart disease or high blood pressure, ischemic heart disease (reduced circulation of blood to the heart), asthma or other breathing disorder, diabetes, glaucoma, a thyroid disorder, Addison's disease or other adrenal gland disorder, head injury or brain tumor, kidney or liver disease, gallbladder disease, pancreatitis, a seizure disorder, an enlarged prostate, problems with urination, mental illness, or a history of drug or alcohol addiction.Always ask a doctor before giving cough or cold medicine to a child. Death can occur from the misuse of cough or cold medicine in very young children. Dihydrocodeine and phenylephrine should not be given to a child younger than 6 years old.What should I discuss with my healthcare provider before taking dihydrocodeine and phenylephrine?Do not use this medication if you have used an MAO inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate) within the past 14 days. Serious, life-threatening side effects can occur if you take a cough and cold medicine before the MAO inhibitor has cleared from your body. You should not use dihydrocodeine and phenylephrine if you have ever had an allergic reaction to it, or if you have:
severe or uncontrolled high blood pressure;
severe coronary artery disease;
peptic ulcer or a bowel obstruction called paralytic ileus;
if you are unable to urinate;
if you are pregnant; or
if you are having an asthma attack.
If you have certain conditions, you may need a dose adjustment or special tests to safely take dihydrocodeine and phenylephrine. Before taking this medication, tell your doctor if you have:
heart disease or high blood pressure;
ischemic heart disease (reduced circulation of blood to the heart);
asthma, COPD, or other breathing disorder;
a thyroid disorder;
Addison's disease or other adrenal gland disorders;
a history of head injury or brain tumor;
epilepsy or other seizure disorder;
gallbladder disease or pancreatitis;
enlarged prostate, urination problems;
mental illness; or
a history of drug or alcohol addiction.
Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Follow the directions on your prescription label. Cold medicine is usually taken for only a short time until your symptoms clear up.Always ask a doctor before giving cough or cold medicine to a child. Death can occur from the misuse of cough or cold medicine in very young children. Dihydrocodeine and phenylephrine should not be given to a child younger than 6 years old.
Measure liquid medicine with a special dose-measuring spoon or cup, not a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist for one.Talk with your doctor if your symptoms do not improve after 7 days of treatment, or if you have a fever with a headache or skin rash. Store dihydrocodeine and phenylephrine at room temperature away from moisture and heat.
Keep track of how much of this medicine has been used from the bottle. Dihydrocodeine is a drug of abuse and you should be aware if any person in the household is using this medicine improperly or without a prescription.
See also: Dihydrocodeine and phenylephrine dosage in more detail
Since cough and cold medicine is usually taken only as needed, you may not be on a dosing schedule. If you are taking the medication regularly, take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the medicine at your next regularly scheduled time. Do not take extra medicine to make up the missed dose.
Overdose symptoms may include extreme drowsiness, pinpoint pupils, cold and clammy skin, limp muscles, fainting, seizure (convulsions), shallow breathing or breathing that stops.
Tell your doctor if you regularly use other medicines that make you sleepy (such as pain medication, sleeping pills, muscle relaxers, and medicine for seizures, depression or anxiety). They can add to sleepiness caused by dihydrocodeine and phenylephrine.
Avoid taking diet pills, caffeine pills, or other stimulants (such as ADHD medications) without your doctor's advice. Taking a stimulant together with phenylephrine can increase your risk of unpleasant side effects.Do not use any other over-the-counter cold, allergy, or pain medication without first asking your doctor or pharmacist. Phenylephrine is contained in many medicines available over the counter. If you take certain products together you may accidentally take too much of this drug. Read the label of any other medicine you are using to see if it contains phenylephrine.
feeling like you might pass out;
weak or shallow breathing;
fast or pounding heartbeat;
painful or difficult urination; or
urinating less than usual or not at all.
Less serious side effects may include:
dizziness, drowsiness, headache, tired feeling;
feeling excited or restless;
nausea, vomiting, stomach pain, diarrhea, constipation;
increased sweating or urination;
warmth, redness, or tingly feeling under your skin;
mild skin rash or itching.
This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect. You may report side effects to FDA at 1-800-FDA-1088.
Usual Adult Dose for Cough and Nasal Congestion:
Dihydrocodeine-phenylephrine 3 mg-7.5 mg/5 mL oral liquid:5 mL orally every 4 to 6 hours not to exceed 30 mL daily.
Usual Pediatric Dose for Cough and Nasal Congestion:
Dihydrocodeine-phenylephrine 3 mg-7.5 mg/5 mL oral liquid:6 to 11 years: 2.5 mL orally every 4 to 6 hours not to exceed 15 mL daily.12 years or older: 5 mL orally every 4 to 6 hours not to exceed 30 mL daily.
Tell your doctor about all other medicines you use, especially:
medicines to treat high blood pressure;
an antidepressant such as amitriptyline (Elavil), clomipramine (Anafranil), imipramine (Janimine, Tofranil), and others;
a beta-blocker such as atenolol (Tenormin), carteolol (Cartrol), metoprolol (Lopressor, Toprol), nadolol (Corgard), propranolol (Inderal), sotalol (Betapace), timolol (Blocadren), and others; or
phenothiazines such as chlorpromazine (Thorazine), mesoridazine (Serentil), perphenazine (Trilafon), prochlorperazine (Compazine), promethazine (Phenergan, Adgan, Anergan 50, Pentazine), thioridazine (Mellaril), and others.
This list is not complete and there may be other drugs that can interact with dihydrocodeine and phenylephrine. Tell your doctor about all your prescription and over-the-counter medications, vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start a new medication without telling your doctor.