Generic Name: dihydrocodeine, guaifenesin, and pseudoephedrine (dye hye dro KOE deen, gwye FEN e sin, and soo doe e FED rin)Brand names: Welltuss EXP, Pancof EXP, Hydro-Tussin EXP, DiHydro-GP, Uni-Cof Expectorant
Dihydrocodeine is in a group of drugs called narcotics. It is a cough suppressant that affects the signals in the brain that trigger cough reflex.
Guaifenesin is an expectorant. It helps loosen congestion in your chest and throat, making it easier to cough out through your mouth.
Pseudoephedrine is a decongestant that shrinks blood vessels in the nasal passages. Dilated blood vessels can cause nasal congestion (stuffy nose).
The combination of dihydrocodeine, guaifenesin, and pseudoephedrine is used to treat cough, nasal, and sinus congestion, and to reduce chest congestion caused by the common cold, infections, or allergies.
Dihydrocodeine, guaifenesin, and pseudoephedrine may also be used for other purposes not listed in this medication guide.What is the most important information I should know about dihydrocodeine, guaifenesin, and pseudoephedrine?Always ask a doctor before giving a cough or cold medicine to a child. Death can occur from the misuse of cough and cold medicines in very young children. Do not use a cough or cold medicine 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 cough or cold medicine before the MAO inhibitor has cleared from your body. Do not take this medication with alcohol, other narcotic pain medications, sedatives, tranquilizers, muscle relaxers, or other medicines that can make you sleepy or slow your breathing. Dangerous side effects may result. Dihydrocodeine may be habit-forming and should be used only by the person it was prescribed for. Dihydrocodeine should never be shared with another person, especially someone who has a history of drug abuse or addiction. Keep the medication in a secure place where others cannot get to it. Do not use any other over-the-counter cough or cold medication without first asking your doctor or pharmacist. If you take certain products together you may accidentally take too much of one or more types of medicine. Read the label of any other medicine you are using to see if it contains guaifenesin or pseudoephedrine.What should I discuss with my healthcare provider before taking dihydrocodeine, guaifenesin, and pseudoephedrine?Do not use a cough or cold medicine 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 cough or cold medicine before the MAO inhibitor has cleared from your body.
If you have any of these other conditions, you may need a dose adjustment or special tests to safely take dihydrocodeine, guaifenesin, and pseudoephedrine:
heart disease or high blood pressure;
asthma, COPD, sleep apnea, or other breathing disorders;
a history of head injury or brain tumor;
epilepsy or other seizure disorder;
a thyroid disorder;
low blood pressure;
Addison's disease or other adrenal gland disorders;
enlarged prostate, urination problems;
mental illness; or
a history of drug or alcohol addiction.
Take this medication exactly as it has been prescribed by your doctor. Do not use the medication in larger amounts, or use it for longer than recommended. Cough or cold medicine is usually taken only for 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.
Measure the liquid form of this 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.Drink extra fluids to help loosen the congestion and lubricate your throat while you are taking this medication. Take dihydrocodeine, guaifenesin, and pseudoephedrine with food if it upsets your stomach. Talk with your doctor if your symptoms do not improve after 7 days of treatment, or if you have a fever with a headache, cough, or skin rash.
If you need to have any type of surgery, tell the surgeon ahead of time if you have taken a cold medicine within the past few days.
Store this medicine at room temperature, away from heat, light, and moisture.
Since cough or 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 nausea, vomiting, feeling restless or nervous, extreme dizziness or drowsiness, confusion, cold and clammy skin, shallow breathing, slow heart rate, pinpoint pupils, fainting, or coma.What should I avoid while taking dihydrocodeine, guaifenesin, and pseudoephedrine?Do not drink alcohol while you are taking this medication. Alcohol can increase some of the side effects of dihydrocodeine. Do not take this medication with narcotic pain medications, sedatives, tranquilizers, muscle relaxers, or other medicines that can make you sleepy or slow your breathing. Dangerous side effects may result.
Avoid taking diet pills, caffeine pills, or other stimulants (such as ADHD medications) without your doctor's advice. Taking a stimulant together with a decongestant can increase your risk of unpleasant side effects.Do not use any other over-the-counter cold, allergy, or cough medicine without first asking your doctor or pharmacist. Guaifenesin, and pseudoephedrine are contained in many medicines available over the counter. If you take certain products together you may accidentally take too much of a certain drug. Read the label of any other medicine you are using to see if it contains guaifenesin or pseudoephedrine.
fast, pounding, or uneven heartbeat;
shallow breathing, slow heartbeat;
cold, clammy skin;
severe dizziness, anxiety, restless feeling, or nervousness, tremors;
confusion, unusual thoughts or behavior;
easy bruising or bleeding, unusual weakness, fever, chills, body aches, flu symptoms; or
increased blood pressure (severe headache, blurred vision, trouble concentrating, chest pain, numbness, seizure).
Less serious side effects may include:
dizziness or headache;
nausea, vomiting, upset stomach, mild loss of appetite;
feeling excited or restless;
sleep problems (insomnia);
warmth, tingling, or redness under your skin; or
skin rash or itching.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
Before taking dihydrocodeine, guaifenesin, and pseudoephedrine, tell your doctor if you are using any of the following drugs:
medicines to treat high blood pressure;
rifampin (Rifadin, Rifater, Rifamate, Rimactane);
zidovudine (Retrovir, AZT);
a beta-blocker such as atenolol (Tenormin), carteolol (Cartrol), metoprolol (Lopressor, Toprol), nadolol (Corgard), propranolol (Inderal), sotalol (Betapace), timolol (Blocadren), and others;
antidepressants such as amitriptyline (Elavil), clomipramine (Anafranil), imipramine (Janimine, Tofranil), and others;
medicines to treat psychiatric disorders, such as chlorpromazine (Thorazine), haloperidol (Haldol), mesoridazine (Serentil), pimozide (Orap), or thioridazine (Mellaril); or
seizure medication such as phenytoin (Dilantin) or phenobarbital (Luminal, Solfoton).
This list is not complete and there may be other drugs that can affect dihydrocodeine, guaifenesin, and pseudoephedrine. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.