Multicod
Generic Name
Dextromethorphan Hydrobromide + Chlorpheniramine Maleate + Phenylephrine Hydrochloride
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| multicod syrup | ৳ 100.00 | N/A |
Description
Overview of the medicine
Multicod Syrup is a combination medication formulated to provide relief from symptoms associated with common cold, flu, allergies, and other respiratory conditions. It effectively alleviates cough, runny nose, sneezing, and nasal congestion.
Uses & Indications
Dosage
Adults
10 ml (2 teaspoonfuls) every 6-8 hours, not exceeding 4 doses in 24 hours. Dosage may vary, consult physician.
Elderly
Use with caution. Dosage adjustment may be required due to increased sensitivity to anticholinergic effects and risk of cardiovascular effects from phenylephrine. Consult physician.
Renal_impairment
Use with caution. Dosage reduction may be necessary. Consult a physician.
How to Take
Oral administration. Measure dose accurately using a dosing spoon or cup. May be taken with or without food.
Mechanism of Action
Dextromethorphan acts centrally on the cough center in the medulla to elevate the cough threshold. Chlorpheniramine Maleate, an antihistamine, blocks H1 histamine receptors, thereby reducing sneezing, watery eyes, and runny nose. Phenylephrine Hydrochloride is a sympathomimetic decongestant that constricts blood vessels in the nasal passages, reducing swelling and congestion.
Pharmacokinetics
Onset
15-30 minutes
Excretion
Primarily excreted renally (via urine) as metabolites or unchanged drug.
Half life
Dextromethorphan: 2-4 hours; Chlorpheniramine: 2-43 hours; Phenylephrine: 2-3 hours
Absorption
Well absorbed orally. Dextromethorphan undergoes rapid and extensive first-pass metabolism. Chlorpheniramine and Phenylephrine are also readily absorbed.
Metabolism
Dextromethorphan is extensively metabolized in the liver primarily by CYP2D6. Chlorpheniramine is metabolized in the liver. Phenylephrine undergoes first-pass metabolism in the gut and liver by monoamine oxidase.
Side Effects
Contraindications
- Hypersensitivity to any component of the syrup
- Patients receiving Monoamine Oxidase (MAO) inhibitors or within 14 days of stopping such treatment
- Severe hypertension, severe coronary artery disease
- Narrow-angle glaucoma, prostatic hypertrophy (due to anticholinergic effects of antihistamine)
Drug Interactions
MAO Inhibitors
Concurrent use may lead to hypertensive crisis or severe central nervous system depression.
Antihypertensives
Phenylephrine may reduce the effectiveness of antihypertensive drugs.
Other sympathomimetics
Increased risk of cardiovascular effects such as hypertension and tachycardia.
CNS Depressants (alcohol, sedatives, tranquilizers)
Increased central nervous system depressant effects, including drowsiness and dizziness.
Storage
Store below 30°C in a dry place, protected from light. Keep out of the reach and sight of children.
Overdose
Symptoms may include marked drowsiness, dizziness, nausea, vomiting, rapid heartbeat, hypertension, hallucinations, central nervous system depression, and convulsions. Seek immediate medical attention. Treatment is symptomatic and supportive, including gastric lavage or activated charcoal if indicated.
Pregnancy & Lactation
Consult a doctor before use during pregnancy or lactation. Use only if potential benefit justifies the potential risk to the fetus or infant. Dextromethorphan is generally considered low risk, but phenylephrine and chlorpheniramine should be used with caution.
Side Effects
Contraindications
- Hypersensitivity to any component of the syrup
- Patients receiving Monoamine Oxidase (MAO) inhibitors or within 14 days of stopping such treatment
- Severe hypertension, severe coronary artery disease
- Narrow-angle glaucoma, prostatic hypertrophy (due to anticholinergic effects of antihistamine)
Drug Interactions
MAO Inhibitors
Concurrent use may lead to hypertensive crisis or severe central nervous system depression.
Antihypertensives
Phenylephrine may reduce the effectiveness of antihypertensive drugs.
Other sympathomimetics
Increased risk of cardiovascular effects such as hypertension and tachycardia.
CNS Depressants (alcohol, sedatives, tranquilizers)
Increased central nervous system depressant effects, including drowsiness and dizziness.
Storage
Store below 30°C in a dry place, protected from light. Keep out of the reach and sight of children.
Overdose
Symptoms may include marked drowsiness, dizziness, nausea, vomiting, rapid heartbeat, hypertension, hallucinations, central nervous system depression, and convulsions. Seek immediate medical attention. Treatment is symptomatic and supportive, including gastric lavage or activated charcoal if indicated.
Pregnancy & Lactation
Consult a doctor before use during pregnancy or lactation. Use only if potential benefit justifies the potential risk to the fetus or infant. Dextromethorphan is generally considered low risk, but phenylephrine and chlorpheniramine should be used with caution.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
36 months from the date of manufacture
Availability
Pharmacies, drugstores
Approval Status
Approved by national regulatory authorities (e.g., DGDA)
Patent Status
Off-patent (for generic components)
Clinical Trials
Clinical trials for the individual components and similar combinations have established their efficacy and safety profiles for symptomatic relief of cough and cold. No specific recent clinical trials for 'Multicod Syrup' as a unique entity are typically conducted due to its generic nature.
Lab Monitoring
- No routine laboratory monitoring is required. Blood pressure monitoring may be advisable in susceptible individuals, especially those with pre-existing cardiovascular conditions, due to phenylephrine.
Doctor Notes
- Advise patients about potential drowsiness and the importance of avoiding driving or operating machinery.
- Caution should be exercised in patients with cardiovascular conditions, hypertension, thyroid disorders, or diabetes due to the phenylephrine component.
- Thoroughly evaluate patients for underlying causes of chronic cough before prescribing this symptomatic relief.
Patient Guidelines
- Do not exceed the recommended dose.
- Avoid driving or operating heavy machinery if you experience drowsiness or dizziness.
- Consult a doctor if symptoms do not improve within 7 days or if they worsen, or if cough is accompanied by fever, rash, or persistent headache.
- Avoid alcohol consumption while taking this medication.
Missed Dose Advice
If a dose is missed, take it as soon as remembered unless it is almost time for the next dose. Do not take a double dose to make up for a missed one.
Driving Precautions
This medicine may cause drowsiness, dizziness, or blurred vision. Patients should be cautioned against engaging in activities requiring mental alertness, such as driving or operating machinery, until they know how the medication affects them.
Lifestyle Advice
- Maintain good hydration by drinking plenty of fluids.
- Get adequate rest to aid recovery.
- Avoid exposure to allergens or irritants if possible.
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Global Brand Names
International brand names for this medicine. Click a brand to search for detailed information.