A fixed-dose combination antitussive and antihistaminic medication. Codeine is a centrally-acting opioid cough suppressant, while Triprolidine is a first-generation H1-antihistamine that provides symptomatic relief from allergic symptoms like rhinorrhea and sneezing, often associated with cough. This combination is primarily used for the symptomatic relief of dry, non-productive cough associated with allergic conditions like allergic rhinitis or the common cold.
Adult: One tablet every 6-8 hours. Maximum: 4 tablets (40mg Codeine / 5mg Triprolidine) in 24 hours.
Note: Oral administration. Can be taken with or without food. Taking with food may reduce GI upset. Swallow whole with a glass of water. Do not crush or chew. Use for the shortest duration necessary to control symptoms, typically not exceeding 5-7 days for acute cough.
The combination works synergistically. Codeine suppresses the cough reflex by a direct action on the cough center in the medulla oblongata. Triprolidine competitively antagonizes histamine at H1-receptors, reducing capillary dilation, edema, and secretions from the respiratory tract, thereby alleviating allergic symptoms that can trigger or accompany cough.
Pregnancy: Category C (US FDA). Avoid, especially in third trimester. Codeine can cause neonatal respiratory depression and withdrawal syndrome. Triprolidine may have anticholinergic effects on fetus. Use only if potential benefit justifies potential risk.
Driving: STRONGLY DISCOURAGED. Causes significant drowsiness, dizziness, and impaired judgment and coordination. Patients should not drive or operate heavy machinery until effect is known.
| Other CNS Depressants (Alcohol, Benzodiazepines, Barbiturates, other Opioids) | Additive CNS depression, profound sedation, respiratory depression, risk of death. | Major |
| Monoamine Oxidase Inhibitors (MAOIs) - e.g., Phenelzine, Selegiline | Exaggerated anticholinergic effects, hyperpyrexia, hypertension, serotonin syndrome. | Contraindicated |
| Selective Serotonin Reuptake Inhibitors (SSRIs), SNRIs, TCAs | Increased risk of serotonin syndrome with codeine. | Major |
| Anticholinergic drugs (Atropine, TCAs, Antipsychotics) | Additive anticholinergic side effects (dry mouth, urinary retention, constipation, blurred vision). | Moderate |
| CYP2D6 Inhibitors (Fluoxetine, Paroxetine, Quinidine) | Reduced conversion of codeine to morphine, decreasing analgesic/antitussive efficacy. | Moderate |
| CYP3A4 Inducers (Rifampicin, Carbamazepine, Phenytoin) | Increased metabolism of codeine, potentially reducing effect. | Moderate |
| CYP3A4 Inhibitors (Ketoconazole, Clarithromycin, Ritonavir) | Decreased metabolism of codeine, increasing its levels and toxicity risk. | Moderate |
Same composition (Codeine (10mg) + Triprolidine (1.25mg)), different brands: