Chlorpheniramine Maleate & Codeine Phosphate
DRY COUGH LINCTUS  

Clinical Pharmacology

Cocorex Cough Syrup is formulated for the relief of irritating and troublesome cough. It has antitussive, antihistaminic and nasal decongestant actions.

Chlorpheniramine Maleate is an antihistamine which reduces allergic vasodilation and mucosal congestion. It provides relief in allergic conditions. Codeine Phosphate acts centrally and has a cough suppressant action. It reduces the intensity and frequency of bouts of coughing and is the reference compound with which other antitussives are compared. It also has a mild analgesic action.

Cocorex Cough Syrup is indicated for the relief of troublesome bouts of coughing, especially coughs that disturb sleep and cause pain. It is effective in dry unproductive coughs such as those which are associated with influenza, whooping cough, heavy smoking and allergies. Cocorex Cough Syrup is contraindicated in patients who are hypersensitive to any of its constituents.

Chlorpheniramine, commonly marketed as its salt chlorpheniramine maleate (CPM; Chlor-Trimeton, Piriton, Chlor-Tripolon), is a first-generation alkylamine antihistamine used in the prevention of the symptoms of allergic conditions such as rhinitis and urticaria. Its sedative effects are relatively weak compared to other first-generation antihistamines. Chlorpheniramine is one of the most commonly-used antihistamines in small-animal veterinary practice as well. Although not generally approved as an antidepressant or anti-anxiety medication, chlorpheniramine appears to have these properties as well.

Chlorpheniramine is part of a series of antihistamines including pheniramine (Naphcon) and its halogenated derivatives and others including fluorpheniramine, dexchlorpheniramine (Polaramine), brompheniramine (Dimetapp), dexbrompheniramine (Drixoral), deschlorpheniramine, dipheniramine (also known as triprolidine with the trade name Actifed), and iodopheniramine.
The halogenated alkylamine antihistamines all exhibit optical isomerism, and chlorpheniramine in the indicated products is racemic chlorpheniramine maleate, whereas dexchlorpheniramine (Polaramine) is the dextrorotary (right-handed) stereoisomer.
It is also known as Comakin in Taiwan and parts of Asia.

Chlorpheniramine is part of a series of antihistamines including pheniramine (Naphcon) and its halogenated derivatives and others including fluorpheniramine, dexchlorpheniramine (Polaramine), brompheniramine (Dimetapp), dexbrompheniramine (Drixoral), deschlorpheniramine, dipheniramine (also known as triprolidine with the trade name Actifed), and iodopheniramine.
The halogenated alkylamine antihistamines all exhibit optical isomerism, and chlorpheniramine in the indicated products is racemic chlorpheniramine maleate, whereas dexchlorpheniramine (Polaramine) is the dextrorotary (right-handed) stereoisomer.
It is also known as Comakin in Taiwan and parts of Asia.
Pharmacodynamics
Pharmacokinetics: chlorpheniramine is an H1-receptor antagonist which competetively blocks H1-receptor sites on tissues.

Adverse effects occur rarely with the suggested dosage. Chlorpheniramine Maleate may cause drowsiness, dry mouth, blurred vision, weakness, nausea and headache. Codeine is generally well tolerated. Vomiting, constipation, dizziness, drowsiness, pruritus, sweating and agitation have been reported.

Use in pregnancy and lactation: No data are available on the use of Cocorex Cough Syrup during human pregnancy and lactation.

There have been no reports of over dosage with Cocorex Cough Syrup. Necessary measures should be taken to maintain and support circulation and respiration, possibly using respiratory stimulants. Gastric lavage should be performed if indicated and convulsion controlled with diazepam. Catheterisation of the bladder may be necessary. Hypertension  may be controlled with alpha adrenoceptor blocking drugs.

Codeine and Chlorphaniramine may cause drowsiness. Caution should be exercised when driving and operating machinery or appliances. Dependence on codeine occur but it isuncommon with antitussive use, because of the short duration of therapy and the small doses required. The following should not be administered concomitantly with Cocorex, antihypertensives with central nervous system depressant effects, sedatives tranquilizers, alcohol, MAO inhibitors and other CNS depressants. Cocorex should be used with caution in patients with a history of hypertension, heart disease, diabetes mellitus, hyperthyroidism, increased intra-ocular pressure, bronchial asthma and hepatic impairment.

Cocorex Cough Syrup is usually given 4 times a day in the following doses:

Adults and children over 12 years:
1 teaspoonful (5ml) 3 to 4 times daily.

Children 6 to 12 years
1/2 teaspoonful (2.5ml) 3 to 4 times daily.

Children 2 to 6 years
1/4 teaspoonful (1.25ml) 3 to 4 times daily.

Children below 2 years

On advice of a physician

Codeine, a derivative of morphine and a powerful narcotic painkiller is usually added to all cough formulations. This suppresses pain centers in the brain and provides the relief. However it is potentially very addictive and so it is not a very good thing to give to the children. Therefore it is best to avoid cough syrups containing codeine.

Cocorex is not generally a fatal drug substitute unless taken in extremely high quantities.

Side effects of Cocorex are the following:
.It can cause short term memory loss, Sleeplessness, Tremors, Spasms, Muscular pains, Dehydration –common side effects
Serious kidney damage or constipation are the results for long term abuse of the drug. It may be unsuitable for acute diabetic patients and this said medicine has high sugar content.

Pharmacokinetics:
chlorpheniramine is an H1-receptor antagonist which competetively blocks H1-receptor sites on tissues.

Duration
4-6 hours

Absorption
Absorbed relatively slowly from the GI tract (oral); peak plasma concentrations after 2.5-6 hours.

Distribution
Widely distributed; CNS. Protein-binding: 70%.

Metabolism
Extensive; converted to desmethyl- and didesmethylchlorphenamine.

Excretion
Via urine (as unchanged drug and metabolites).
chlorpheniramine Indications / chlorpheniramine Uses
Information Not Available
chlorpheniramine Adverse Reactions / chlorpheniramine Side Effects
CNS depression, sedation, drowsiness, lassitude, dizziness. GI upsets, anorexia, or increased appetite, epigastric pain, blurring of vision, dysuria, dryness of mouth, tightness in chest, hypotension, muscular weakness, tinnitus, euphoria, headache, paradoxical CNS stimulation.

Potentially Fatal: CV collapse and respiratory failure.
Precautions
Information Not Available
Special Precautions
Elderly, pylori duodenal obstruction, angle-closure glaucoma, urinary retention, prostatic hyperplasia, epilepsy, renal and hepatic impairment. May affect performance of skilled tasks. BPH, bladder neck obstruction, hypertension. Pregnancy, lactation.
Other Drug Interactions
Potentiates sedative effect of psychotropic drugs e.g. barbiturates, hypnotics, opiod analgesics, anxiolytics and antipsychotics. Interaction with alcohol could be dangerous (sedation/excitation).
Other Interactions
Food Interactions: Reduced bioavailability
Dosage
Oral Allergic conditions
Adult: 4 mg every 4-6 hours. Max: 24 mg daily.
Child: 1-2 years: 1 mg bid, 2-5 years: 1 mg every 4-6 hours, 6-12 years: 2 mg every 4-6 hours. Max: 6 mg daily (1-5 years); 12 mg daily (6-12 years).

Parenteral Adjunct in the emergency treatment of anaphylactic shock
Adult: 10-20 mg IM, SC, or slow IV injection over 1 minute. Max dose: 40 mg daily.
Child: 87.5 mcg/kg SC 4 times daily

Incompatibility
Incompatible with calcium chloride, kanamycin sulfate, noradrenaline acid tartrate, pentobarbital sodium and meglumine adipiodone.
Food(before/after)
May be taken with or without food
List of Contraindications
chlorpheniramine and Pregnancy
Caution when used during pregnancy

Category B: Either animal-reproduction studies have not demonstrated a foetal risk but there are no controlled studies in pregnant women or animal-reproduction studies have shown an adverse effect (other than a decrease in fertility) that was not confirmed in controlled studies in women in the 1st trimester (and there is no evidence of a risk in later trimesters).
chlorpheniramine and Lactation
Caution when used during lactation
chlorpheniramine and Children
Information Not Available
chlorpheniramine and Geriatic
Information Not Available
chlorpheniramine and Other Contraindications
Hypersensitivity, neonates
Storage
Oral
Store below 25°C.

Parenteral
Store below 25°C.

 

Note : This product information is intended only for residents of the India. Taj Pharmaceuticals Limited,  medicines help to treat and prevent a range of conditions—from the most common to the most challenging—for people around the world. The Price of the drugs indicated above may not match the actual price at which they are sold. Prices can change depending on many factors, including local taxes. These are only approximate indicative prices of the drug. The products discussed herein may have different product labelling in different countries. The product information provided in this site is intended only for the residents of India.

Information for Health Care Professionals

*** Please consult local Prescribing Information for any product before use. This website is an international information resource for healthcare professionals with an interest in disease management. This website is not intended to replace the advice of a qualified healthcare professional. Above brand is a trademark of the Taj group of companies (Taj Pharmaceuticals Limited).

Cocorex description, Cocorex actions, Cocorex indications, codeine phosphate cough syrup warnings, codeine phosphate cough syrup description, codeine phosphate cough syrup actions, codeine phosphate cough syrup Indications, cocorex cough syrup add, cocorex cough syrup commercial, cocorex cough syrup during pregnancy, cocorex cough syrup price, cocorex cough syrup addiction, cocorex drug, codeine phosphate cough syrup warnings, alcohol syrups india, chlorpheniramine maleate actions, chlorpheniramine maleate indications, chlorpheniramine maleate description, chlorpheniramine maleate syrup, excess dose, codeine overdose, codeine syrup overdose, during pregnancy, Cocorex brand cough syrup addiction, pharmaceuticals, cocorex brand easily available manufacturer, price india | Taj Pharma India, addicted, cocorex cough syrup manufacturers & cocorex cough syrup suppliers directory, cocorex cough syrup add, cocorex cough syrup commercial, cocorex cough syrup price, cocorex cough syrup addiction, cocorex dru