Tricode AR

Coughs due to colds as well as coughs and congestive symptoms associated with upper respiratory tract infections such as tracheobronchitis or laryngobronchitis, croup, pharyngitis, allergic bronchitis, and infectious bronchitis, when accompanied by disturbing and fatiguing cough

Chlorpheniramine (Tricode AR) is an antihistamine that reduces the effects of natural chemical histamine in the body. Histamine can produce symptoms of sneezing, itching, watery eyes, and runny nose.

Codeine (Tricode AR) is a narcotic cough suppressant that affects the signals in the brain that trigger cough reflex.

Pseudoephedrine (Tricode AR) is a decongestant that shrinks blood vessels in the nasal passages. Dilated blood vessels can cause nasal congestion (stuffy nose).

The combination of Chlorpheniramine (Tricode AR), Codeine (Tricode AR), and Pseudoephedrine (Tricode AR) is used to treat runny or stuffy nose, sneezing, itching, watery eyes, cough, and sinus congestion caused by allergies, the common cold, or the flu.

This medicine will not treat a cough that is caused by smoking, asthma, or emphysema.

Chlorpheniramine (Tricode AR), Codeine (Tricode AR), and Pseudoephedrine (Tricode AR) may also be used for purposes not listed in this medication guide.

Dosage Forms

Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] = Discontinued product

Liquid,

Oral:

Tricode AR: Chlorpheniramine (Tricode AR) maleate 2 mg, Pseudoephedrine (Tricode AR) hydrochloride 30 mg, and Codeine (Tricode AR) phosphate 8 mg per 5 mL (473 mL [DSC]) [dye free, ethanol free, gluten free, sugar free; contains propylene glycol; berry vanilla flavor]

Phenylhistine DH: Chlorpheniramine (Tricode AR) maleate 2 mg, Pseudoephedrine (Tricode AR) hydrochloride 30 mg, and Codeine (Tricode AR) phosphate 10 mg per 5 mL (120 mL [DSC], 480 mL [DSC]) [contains ethanol 5.3%, menthol, sodium benzoate]

Dosing: Adult

Cough and upper respiratory allergy symptoms:

Oral:

Chlorpheniramine (Tricode AR) 2 mg/Codeine (Tricode AR) 8 mg/Pseudoephedrine (Tricode AR) 30 mg per 5 mL: 10 mL every 4 to 6 hours (maximum: 40 mL/24 hours)

Chlorpheniramine (Tricode AR) 2 mg/Codeine (Tricode AR) 10 mg/Pseudoephedrine (Tricode AR) 30 mg per 5 mL: 10 mL every 4 hours (maximum: 40 mL/24 hours)

Dosing: Geriatric

Avoid use (Beers Criteria [AGS 2019]).

Dosing: Pediatric

Note: Due to risk of adverse effects (slowed or difficult breathing, misuse, abuse, addiction, overdose, and death), the FDA in January 2018 recommended against routine use of Codeine (Tricode AR)-/hydrocodone-containing cough/cold products for patients <18 years and that future manufacturer labeling for these products include a contraindication in this population (AAP 2018; FDA 2018a; FDA 2018b).

Cough and upper respiratory allergy symptoms:

Oral:

Children 6 to <12 years:

Chlorpheniramine (Tricode AR) 2 mg/Codeine (Tricode AR) 8 mg/Pseudoephedrine (Tricode AR) 30 mg per 5 mL: 5 mL every 4 to 6 hours (maximum: 20 mL/24 hours)

Chlorpheniramine (Tricode AR) 2 mg/Codeine (Tricode AR) 10 mg/Pseudoephedrine (Tricode AR) 30 mg per 5 mL: 5 mL every 4 hours (maximum: 20 mL/24 hours)

Children ≥12 years and Adolescents: Refer to adult dosing.

See also:
What is the most important information I should know about Tricode AR?

OTC labeling: When used for self-medication, do not use in children <2 years; use with or within 14 days of stopping a monoamine oxidase inhibitor (MAO) inhibitor therapy; sedation in children; chronic pulmonary disease or shortness of breath

Documentation of allergenic cross-reactivity for sympathomimetics, antihistamines, and morphine and related agents is limited. However, because of similarities in chemical structure and/or pharmacologic actions, the possibility of cross-sensitivity cannot be ruled out with certainty.

Use Tricode AR suspension as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• Take Tricode AR suspension by mouth with or without food. If stomach upset occurs, take with food to reduce stomach irritation.
• Shake well before use.
• Take Tricode AR suspension with a full glass of water (8 oz/240 mL).
• Drink plenty of water while taking Tricode AR suspension.
• Use a measuring device marked for medicine dosing. Ask your pharmacist for help if you are unsure of how to measure your dose.
• If you miss a dose of Tricode AR suspension and you are taking it regularly, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use Tricode AR suspension.

Use: Labeled Indications

Cough and upper respiratory allergy symptoms: Temporary relief of symptoms (runny nose, sneezing, itching of nose or throat, itchy/watery eyes, cough due to minor throat and bronchial irritation, nasal congestion, reduces swelling of nasal passages) associated with the common cold, allergic rhinitis, or other upper respiratory allergies.

See also:
What other drugs will affect Tricode AR?

Alcohol, barbiturates (eg, phenobarbital), tricyclic antidepressants (eg, amitriptyline), other CNS depressants

Effects may be enhanced by carbinoxamine.

MAOIs (eg, isocarboxazid)

May prolong and intensify the effects of Chlorpheniramine (Tricode AR) and increase the effects of Pseudoephedrine (Tricode AR).

Mecamylamine, methyldopa, reserpine, veratrum alkaloids

Antihypertensive effects may be reduced by Pseudoephedrine (Tricode AR).

See also:
What are the possible side effects of Tricode AR?

The only significant untoward effects that have occurred are mild anorexia and an occasional tendency to constipation. However, discontinuance of this medicine has seldom been required. Mild drowsiness occurs in some patients but, when cough is relieved, the quieting effect of this medicine is considered beneficial in many instances. Because of its iodide content, this medicine may cause elevation of the protein-bound iodine. Adverse reactions to Codeine (Tricode AR) include: Central Nervous System: Sedation, drowsiness, mental clouding, dizziness, lethargy, impairment of mental and physical performance, anxiety, convulsions, fear, miosis, dysphoria, psychic dependence, mood changes, and respiratory depression. Gastrointestinal System: Nausea, vomiting, increased pressure in the biliary tract, and constipation. Cardiovascular System: Orthostatic hypotension, fainting, and tachycardia. Genitourinary System: Ureteral spasm, spasm of vesical sphincters and urinary retention have been reported. Other: Flushing, sweating, pruritus, allergic reactions, and suppressed cough reflex. Adverse reactions to phenylephrine hydrochloride include headache, reflex bradycardia, excitability, restlessness, and, rarely, arrhythmias.

Adverse reactions to Chlorpheniramine (Tricode AR) maleate include slight to moderate drowsiness. Other possible side effects common to antihistamines in general include: General: Urticaria, drug rash, anaphylactic shock, photosensitivity, excessive perspiration, chills, dryness of mouth, nose, and throat. Cardiovascular System: Hypotension, headache, palpitations, tachycardia, and extrasystoles. Hematologic System: Hemolytic anemia, thrombocytopenia, and agranulocytosis. Nervous System: Sedation, dizziness, disturbed coordination, fatigue, confusion, restlessness, excitation, nervousness, tremor, irritability, insomnia, euphoria, paresthesias, blurred vision, diplopia, vertigo, tinnitus, acute labyrinthitis, hysteria, neuritis, and convulsions. Gastrointestinal System: Epigastric distress, anorexia, nausea, vomiting, diarrhea, and constipation. Genitourinary System: Urinary frequency, difficult urination, urinary retention, and early menses. Respiratory System: Thickening of bronchial secretions, tightness of chest and wheezing, and nasal stuffiness.