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Pholcodine
Systematic (IUPAC) name
7,8-didehydro- 4,5α-epoxy- 17-methyl- 3- [2- (morpholin- 4- yl) ethoxy] morphinan- 6α-ol
Identifiers
CAS number 509-67-1
ATC code R05DA08
PubChem ?
DrugBank ?
Chemical data
Formula C 23H30N2O4  
Mol. mass 398.55 g/mol
Pharmacokinetic data
Bioavailability Maximum plasma conc. attained 4-8 hours after oral dose.
Protein binding 23.5%
Metabolism Hepatic
Half life 32-43 hours; volume of distribution is 36-49L/kg.
Excretion Renal
Therapeutic considerations
Pregnancy cat. A(AU)
Legal status Class B (UK) Schedule I (US) OTC (UK)
Dependence Liability Low
Routes Oral

Pholcodine is a drug which is an opioid cough suppressant (antitussive). It helps suppress unproductive coughs and also acts as an antifungal agent. It also has a mild sedative effect, but has little or no analgesic effects. It is also known as morpholinylethylmorphine.

Pholcodine is found in certain cough lozenges. [1] However, in the UK, the preparation is almost exclusively an oral solution, typically 5 mg / 5 ml. Adult dosage is 5-10ml up to 3-4 times daily[1]. Pholcodine now largely replaces the previously more common codeine linctus, as it has a much lower potential for dependence.

Pholcodine is a Schedule I drug in the US.

Contents

Mechanism of action

Pholcodine is readily absorbed from the gastrointestinal tract and freely crosses the blood-brain barrier. It acts primarily on the central nervous system (CNS), causing depression of the cough reflex, partly by a direct effect on the cough centre in the medulla. It is metabolized in the liver and its action may be prolonged in individuals with hepatic insufficiency (i.e. liver problems). Its use is therefore contraindicated in patients with liver disease, while care is advised in patients with hepatic impairement.

Side effects

Side effects are rare and may include dizziness and gastrointestinal disturbances such as nausea or vomiting.

Adverse effects such as constipation, drowsiness, excitation, ataxia and respiratory depression have been reported occasionally or after large doses.

A Norwegian cough-syrup containing pholcodine "Tuxi" has been withdrawn from the market because it caused increased levels of IgE-antibodies, regardless of an actual allergy to the drug. This is believed to increase the risk of anaphylaxis to neuromuscular blocking agents used during anaesthesia.

See also

References

  1. ^ BNF (2007). British National Formulary 54. BMJ Publishing Group Ltd., RPS Publishing, London. Page 175.

External links








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