Cofno
Generic Name
Dextromethorphan Hydrobromide + Phenylephrine Hydrochloride + Chlorpheniramine Maleate
Manufacturer
Renata Limited
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| cofno 10 mg syrup | ৳ 70.21 | N/A |
Description
Overview of the medicine
Cofno syrup is a combination medicine used to relieve symptoms of cough, common cold, allergies, or other breathing illnesses. It contains an antitussive (dextromethorphan), a decongestant (phenylephrine), and an antihistamine (chlorpheniramine maleate).
Uses & Indications
Dosage
Adults
Adults and adolescents (12 years and above): 10 ml (2 teaspoonfuls) 3-4 times a day. Maximum daily dose should not exceed 40 ml.
Elderly
Elderly patients may require a reduced dosage due to increased sensitivity and potential for adverse effects. Consult a physician.
Renal_impairment
Use with caution in patients with renal impairment; dosage adjustment may be necessary. Consult a physician.
How to Take
Administer orally with or without food. Use a measuring spoon or cup for accurate dosing.
Mechanism of Action
Dextromethorphan acts centrally on the cough center in the medulla to elevate the cough threshold. Phenylephrine is an alpha-1 adrenergic agonist that causes vasoconstriction in the nasal mucosa, thereby reducing swelling and congestion. Chlorpheniramine maleate is a first-generation antihistamine that competitively blocks H1 receptors, reducing allergic symptoms like sneezing and runny nose.
Pharmacokinetics
Onset
Typically within 15-30 minutes.
Excretion
Mainly via urine.
Half life
Dextromethorphan 2-4 hours, Phenylephrine 2-3 hours, Chlorpheniramine Maleate 12-43 hours.
Absorption
Dextromethorphan is rapidly absorbed from the GI tract. Phenylephrine is variably absorbed orally and undergoes significant first-pass metabolism. Chlorpheniramine maleate is well absorbed after oral administration.
Metabolism
Primarily hepatic (CYP2D6 for dextromethorphan, MAO for phenylephrine, hepatic for chlorpheniramine).
Side Effects
Contraindications
- Hypersensitivity to any component of the formulation.
- Patients receiving monoamine oxidase inhibitors (MAOIs) or within 14 days of discontinuing MAOI therapy.
- Severe hypertension or coronary artery disease.
- Narrow-angle glaucoma, urinary retention.
Drug Interactions
Monoamine Oxidase Inhibitors (MAOIs)
Concomitant use with MAOIs can lead to hypertensive crisis due to phenylephrine and serotonin syndrome with dextromethorphan. Avoid concurrent use and for 14 days after MAOI discontinuation.
CNS Depressants (e.g., alcohol, sedatives, tranquilizers)
Increased sedative effect and central nervous system depression due to chlorpheniramine. Avoid concurrent use.
Storage
Store below 30°C in a cool, dry place, away from direct sunlight and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose may include severe drowsiness, dizziness, nausea, vomiting, rapid heartbeat, hypertension, hallucinations, and seizures. Management involves supportive care, gastric lavage if recent ingestion, and symptomatic treatment. Naloxone may be considered for severe dextromethorphan toxicity.
Pregnancy & Lactation
Pregnancy Category C. Use only if potential benefit outweighs potential risk to the fetus. Not recommended during breastfeeding as components may pass into breast milk and cause adverse effects in infants. Consult a doctor before use.
Side Effects
Contraindications
- Hypersensitivity to any component of the formulation.
- Patients receiving monoamine oxidase inhibitors (MAOIs) or within 14 days of discontinuing MAOI therapy.
- Severe hypertension or coronary artery disease.
- Narrow-angle glaucoma, urinary retention.
Drug Interactions
Monoamine Oxidase Inhibitors (MAOIs)
Concomitant use with MAOIs can lead to hypertensive crisis due to phenylephrine and serotonin syndrome with dextromethorphan. Avoid concurrent use and for 14 days after MAOI discontinuation.
CNS Depressants (e.g., alcohol, sedatives, tranquilizers)
Increased sedative effect and central nervous system depression due to chlorpheniramine. Avoid concurrent use.
Storage
Store below 30°C in a cool, dry place, away from direct sunlight and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose may include severe drowsiness, dizziness, nausea, vomiting, rapid heartbeat, hypertension, hallucinations, and seizures. Management involves supportive care, gastric lavage if recent ingestion, and symptomatic treatment. Naloxone may be considered for severe dextromethorphan toxicity.
Pregnancy & Lactation
Pregnancy Category C. Use only if potential benefit outweighs potential risk to the fetus. Not recommended during breastfeeding as components may pass into breast milk and cause adverse effects in infants. Consult a doctor before use.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Usually 24 to 36 months from the date of manufacture.
Availability
Available in pharmacies nationwide
Approval Status
Approved by DGDA
Patent Status
Off-patent
Clinical Trials
Extensive clinical data supports the efficacy and safety of its individual components in relieving cough and cold symptoms.
Lab Monitoring
- No routine lab monitoring is generally required for short-term use of this medicine.
Doctor Notes
- Counsel patients on potential drowsiness and advise against driving or operating machinery.
- Warn about interactions with MAOIs and other CNS depressants.
- Advise patients to report any persistent or worsening symptoms.
Patient Guidelines
- Do not exceed the recommended dose.
- Avoid operating heavy machinery or driving if experiencing drowsiness.
- Consult a doctor if symptoms persist for more than 7 days or worsen.
- Avoid alcohol consumption while taking this medicine.
Missed Dose Advice
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and resume your regular dosing schedule. Do not double the dose.
Driving Precautions
This medicine may cause drowsiness or dizziness. Patients should be warned not to drive or operate hazardous machinery until they are reasonably certain that the medicine does not adversely affect them.
Lifestyle Advice
- Ensure adequate hydration by drinking plenty of fluids.
- Get sufficient rest to aid recovery from cold symptoms.
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Global Brand Names
International brand names for this medicine. Click a brand to search for detailed information.
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