See also:
What is the most important information I should know about Codeine (Neo Pectol)?
Codeine (Neo Pectol) Sulfate is contraindicated for postoperative pain management in children who have undergone tonsillectomy and/or adenoidectomy.
Codeine (Neo Pectol) Sulfate is contraindicated in patients with known hypersensitivity to Codeine (Neo Pectol) or any components of the product. Persons known to be hypersensitive to certain other opioids may exhibit cross-sensitivity to Codeine (Neo Pectol).
Codeine (Neo Pectol) Sulfate is contraindicated in patients with respiratory depression in the absence of resuscitative equipment.
Codeine (Neo Pectol) Sulfate is contraindicated in patients with acute or severe bronchial asthma or hypercarbia.
Codeine (Neo Pectol) Sulfate is contraindicated in any patient who has or is suspected of having paralytic ileus.
See also:
What is the most important information I should know about Potassium Citrate (Neo Pectol)?
You should not use this medication if you have kidney failure, a urinary tract infection, uncontrolled diabetes, a peptic ulcer in your stomach, Addison's disease, severe burns or other tissue injury, if you are dehydrated, if you take certain diuretics (water pills), or if you have high levels of potassium in your blood (hyperkalemia).
You should not take Potassium Citrate (Neo Pectol) tablets if you have problems with your esophagus, stomach, or intestines that make it difficult for you to swallow or digest pills.
Do not crush, chew, break, or suck on an extended-release tablet. Swallow the pill whole. Breaking or crushing the pill may cause too much of the drug to be released at one time. Sucking on a potassium tablet can irritate your mouth or throat.
Avoid lying down for at least 30 minutes after you take this medication.
Take this medication with a meal or bedtime snack, or within 30 minutes after a meal.
To be sure this medication is helping your condition, your blood may need to be tested often. Your heart rate may also be checked using an electrocardiograph or ECG (sometimes called an EKG) to measure electrical activity of the heart. This test will help your doctor determine how long to treat you with potassium. Do not miss any scheduled appointments.
Serious side effects of Potassium Citrate (Neo Pectol) include uneven heartbeat, muscle weakness or limp feeling, severe stomach pain, and numbness or tingling in your hands, feet, or mouth.
Do not stop taking this medication without first talking to your doctor. If you stop taking potassium suddenly, your condition may become worse.
See also:
What are the possible side effects of Codeine (Neo Pectol)?
Applies to Codeine (Neo Pectol): oral solution, oral syrup, oral tablet, oral tablet extended release
In addition to its needed effects, some unwanted effects may be caused by Codeine (Neo Pectol). In the event that any of these side effects do occur, they may require medical attention.
Major Side EffectsYou should check with your doctor immediately if any of these side effects occur when taking Codeine (Neo Pectol):
Incidence not known:
If any of the following symptoms of overdose occur while taking Codeine (Neo Pectol), get emergency help immediately:
Symptoms of overdose:
Some of the side effects that can occur with Codeine (Neo Pectol) may not need medical attention. As your body adjusts to the medicine during treatment these side effects may go away. Your health care professional may also be able to tell you about ways to reduce or prevent some of these side effects. If any of the following side effects continue, are bothersome or if you have any questions about them, check with your health care professional:
More common:
See also:
What are the possible side effects of Ipecac (Neo Pectol)?
Applies to Ipecac (Neo Pectol): oral syrup
In addition to its needed effects, some unwanted effects may be caused by Ipecac (Neo Pectol). In the event that any of these side effects do occur, they may require medical attention.
Severity: ModerateIf any of the following side effects occur while taking Ipecac (Neo Pectol), check with your doctor or nurse as soon as possible:
Symptoms of overdose (may also occur if Ipecac (Neo Pectol) is taken regularly)
See also:
What are the possible side effects of Potassium Citrate (Neo Pectol)?
Applies to Potassium Citrate (Neo Pectol): oral patch extended release, oral solution, oral tablet, oral tablet extended release
As well as its needed effects, Potassium Citrate (Neo Pectol) (the active ingredient contained in Potassium Citrate (Neo Pectol)) may cause unwanted side effects that require medical attention.
Major Side EffectsIf any of the following side effects occur while taking Potassium Citrate (Neo Pectol), check with your doctor immediately:
Incidence not known:
If any of the following symptoms of overdose occur while taking Potassium Citrate (Neo Pectol), get emergency help immediately:
Symptoms of overdose:
Codeine (Neo Pectol) sulfate is an opioid analgesic indicated for the management of mild to moderately severe pain where the use of an opioid analgesic is appropriate.
An indication is a term used for the list of condition or symptom or illness for which the medicine is prescribed or used by the patient. For example, acetaminophen or paracetamol is used for fever by the patient, or the doctor prescribes it for a headache or body pains. Now fever, headache and body pains are the indications of paracetamol. A patient should be aware of the indications of medications used for common conditions because they can be taken over the counter in the pharmacy meaning without prescription by the Physician.Renal tubular acidosis (RTA) with calcium stonesPotassium Citrate (Neo Pectol) is indicated for the management of renal tubular acidosis.
Hypocitraturic calcium oxalate nephrolithiasis of any etiology
Potassium Citrate (Neo Pectol) is indicated for the management of Hypocitraturic calcium oxalate nephrolithiasis.
Uric acid lithiasis with or without calcium stones
Potassium Citrate (Neo Pectol) is indicated for the management of Uric acid lithiasis with or without calcium stones.
An indication is a term used for the list of condition or symptom or illness for which the medicine is prescribed or used by the patient. For example, acetaminophen or paracetamol is used for fever by the patient, or the doctor prescribes it for a headache or body pains. Now fever, headache and body pains are the indications of paracetamol. A patient should be aware of the indications of medications used for common conditions because they can be taken over the counter in the pharmacy meaning without prescription by the Physician.heart failure, kidney disorders
Codeine (Neo Pectol) is an opioid pain medication. An opioid is sometimes called a narcotic.
Codeine (Neo Pectol) is used to treat mild to moderately severe pain.
Codeine (Neo Pectol) may also be used for purposes not listed in this medication guide.
An indication is a term used for the list of condition or symptom or illness for which the medicine is prescribed or used by the patient. For example, acetaminophen or paracetamol is used for fever by the patient, or the doctor prescribes it for a headache or body pains. Now fever, headache and body pains are the indications of paracetamol. A patient should be aware of the indications of medications used for common conditions because they can be taken over the counter in the pharmacy meaning without prescription by the Physician.Causing vomiting in emergency situations (eg, poisoning, overdose).
Ipecac (Neo Pectol) is an emetic. It works by irritating the stomach lining and stimulating the vomiting center of the brain.
Potassium is a mineral that is found in many foods and is needed for several functions of your body, especially the beating of your heart.
Potassium Citrate (Neo Pectol) is used to treat a kidney stone condition called renal tubular acidosis.
Potassium Citrate (Neo Pectol) may also be used for other purposes other than those listed in this medication guide.
An opioid analgesic related to morphine but with less potent analgesic properties and mild sedative effects. It also acts centrally to suppress cough. [PubChem]
Potassium Citrate (Neo Pectol) (also known as tripotassium citrate) is a potassium salt of citric acid. It is a white, hygroscopic crystalline powder. It is odorless with a saline taste. It contains 38.3% potassium by mass. In the monohydrate form it is highly hygroscopic and deliquescent.
Use Ipecac (Neo Pectol) as directed by your doctor. Check the label on the medicine for exact dosing instructions.
Ask your health care provider any questions you may have about how to use Ipecac (Neo Pectol).
Use Potassium Citrate (Neo Pectol) as directed by your doctor. Check the label on the medicine for exact dosing instructions.
Ask your health care provider any questions you may have about how to use Potassium Citrate (Neo Pectol).
There are specific as well as general uses of a drug or medicine. A medicine can be used to prevent a disease, treat a disease over a period or cure a disease. It can also be used to treat the particular symptom of the disease. The drug use depends on the form the patient takes it. It may be more useful in injection form or sometimes in tablet form. The drug can be used for a single troubling symptom or a life-threatening condition. While some medications can be stopped after few days, some drugs need to be continued for prolonged period to get the benefit from it.Use: Labeled IndicationsPain management: Management of mild- to moderately-severe pain
Limitations of use: Reserve Codeine (Neo Pectol) for use in patients for whom alternative treatment options (eg, nonopioid analgesics, opioid combination products) are ineffective, not tolerated, or would be otherwise inadequate.
Off Label UsesCough in select patients
In a metaanalysis of trials evaluating the treatment of chronic cough, the use of Codeine (Neo Pectol) demonstrated efficacy in patients with this condition.
There are specific as well as general uses of a drug or medicine. A medicine can be used to prevent a disease, treat a disease over a period or cure a disease. It can also be used to treat the particular symptom of the disease. The drug use depends on the form the patient takes it. It may be more useful in injection form or sometimes in tablet form. The drug can be used for a single troubling symptom or a life-threatening condition. While some medications can be stopped after few days, some drugs need to be continued for prolonged period to get the benefit from it.Cystitis, gout, kidney stone.
Excipient information presented when available (limited, particularly for generics); consult specific product labeling.
Tablet,
Oral, as sulfate:Generic: 15 mg, 30 mg, 60 mg
Dosing: Adult
Pain management (analgesic):
Injection [Canadian product]:
Opioid-naive patients: IM, SubQ: 30 to 60 mg every 4 to 6 hours as needed (use the lowest effective dose for the shortest period of time necessary)
Conversion from oral Codeine (Neo Pectol) or another opioid: IM, SubQ: Refer to product labeling for dose conversions.
Oral: Note: These are guidelines and do not represent the maximum doses that may be required in all patients. Doses should be titrated to pain relief/prevention.
Immediate release (tablet, oral solution [Canadian product]): Initial: 15 to 60 mg every 4 hours as needed; maximum total daily dose: 360 mg/day; patients with prior opioid exposure may require higher initial doses. Note: The American Pain Society recommends an initial dose of 30 to 60 mg for adults with moderate pain (American Pain Society 2016).
Controlled release: Codeine (Neo Pectol) Contin [Canadian product]: Note: Titrate at intervals of ≥48 hours until adequate analgesia has been achieved. Daily doses >600 mg/day should not be used; patients requiring higher doses should be switched to an opioid approved for use in severe pain. In patients who receive both Codeine (Neo Pectol) Contin and an immediate release or combination Codeine (Neo Pectol) product for breakthrough pain, the rescue dose of immediate release Codeine (Neo Pectol) product should be ≤12.5% of the total daily Codeine (Neo Pectol) Contin dose.
Opioid-naive patients: Initial: 50 mg every 12 hours
Conversion from immediate release Codeine (Neo Pectol) preparations: Immediate release Codeine (Neo Pectol) preparations contain ~75% Codeine (Neo Pectol) base. Therefore, patients who are switching from immediate release Codeine (Neo Pectol) preparations may be transferred to a ~25% lower total daily dose of Codeine (Neo Pectol) Contin, equally divided into 2 daily doses every 12 hours.
Conversion from a combination Codeine (Neo Pectol) product (eg, Codeine (Neo Pectol) with acetaminophen or aspirin): See table:
Conversion from another opioid analgesic: Using the patient's current opioid dose, calculate an equivalent daily dose of immediate release Codeine (Neo Pectol). A ~25% lower dose of Codeine (Neo Pectol) Contin should then be initiated, equally divided into 2 daily doses.
Discontinuation of therapy: When discontinuing chronic opioid therapy, the dose should be gradually tapered down. An optimal universal tapering schedule for all patients has not been established (CDC [Dowell 2016]). Proposed schedules range from slow (eg, 10% reductions per week) to rapid (eg, 25% to 50% reduction every few days) (CDC 2015). Tapering schedules should be individualized to minimize opioid withdrawal while considering patient-specific goals and concerns as well as the pharmacokinetics of the opioid being tapered. An even slower taper may be appropriate in patients who have been receiving opioids for a long duration (eg, years), particularly in the final stage of tapering, whereas more rapid tapers may be appropriate in patients experiencing severe adverse events (CDC [Dowell 2016]). Monitor carefully for signs/symptoms of withdrawal. If the patient displays withdrawal symptoms, consider slowing the taper schedule; alterations may include increasing the interval between dose reductions, decreasing amount of daily dose reduction, pausing the taper and restarting when the patient is ready, and/or coadministration of an alpha-2 agonist (eg, clonidine) to blunt withdrawal symptoms (Berna 2015; CDC [Dowell 2016]). Continue to offer nonopioid analgesics as needed for pain management during the taper; consider nonopioid adjunctive treatments for withdrawal symptoms (eg, GI complaints, muscle spasm) as needed (Berna 2015; Sevarino 2018).
Cough in select patients (off-label use):
Oral: Reported doses vary with a range of 7.5 to 120 mg/day as a single dose or in divided doses; however, evidence is of low quality (ACCP [Bolser 2006]; Smith 2010). Some experts recommend 30 to 60 mg 4 times daily in specific patient populations (eg, lung cancer) (ACCP [Molassiotis 2017]). Additional data may be necessary to further define the role of Codeine (Neo Pectol) in this condition.
Diarrhea (persistent) (palliative care) (off-label use):
Oral: 15 to 30 mg every 4 hours as needed (von Gunten 2013). Additional data may be necessary to further define the role of Codeine (Neo Pectol) in this condition.
Restless leg syndrome (off-label use):
Oral: Initial: 30 mg once daily at bedtime or during the night; may increase to 60 mg if needed; maximum dose: 180 mg in 2 to 3 divided doses. May be used alone or in combination with other medications used to treat RLS (Earley 2003; Sandyk 1987; Silbers 2013; Walters 2001).
Dosing: Geriatric
Refer to adult dosing. Use with caution and consider initiation at the low end of the dosing range; reduced initial dosages may be necessary.
Dosing: Pediatric
Note: Codeine (Neo Pectol) 30 mg/5 mL oral solution has been discontinued in the US for more than 1 year. Doses should be titrated to appropriate analgesic effect; use the lowest effective dose for the shortest period of time:
Pain management; analgesia: Limited data available: Note: Use is contraindicated in pediatric patients <12 years of age and for postoperative management in pediatric patients 12 to 18 years of age who have undergone tonsillectomy and/or adenoidectomy. Avoid Codeine (Neo Pectol) use in all pediatric patient populations in which it is contraindicated and in pediatric patients 12 to 18 years of age who have other risk factors that increase risk for respiratory depression associated with Codeine (Neo Pectol) (eg, conditions associated with hypoventilation like postoperative status, obstructive sleep apnea, obesity, severe pulmonary disease, neuromuscular disease, use of other medications known to depress respiratory drive); in rare cases in which Codeine (Neo Pectol)-containing product is the only option, consider genotype testing prior to use; use extra precaution; monitor closely for adverse effects. Codeine (Neo Pectol) has been associated with reports of life-threatening or fatal respiratory depression in children and adolescents; multifactorial causes have been identified; of primary concern are unrecognized ultrarapid metabolizers of CYP2D6 who may have extensive conversion of Codeine (Neo Pectol) (prodrug) to morphine and thus increased opioid-mediated effects. Avoid Codeine (Neo Pectol) use in pediatric patient populations in which it is contraindicated; in rare cases in which Codeine (Neo Pectol)-containing product is the only option, consider genotype testing prior to use; use extra precaution; monitor closely for adverse effects (AAP [Tobias 2016]; Dancel 2017; Gammal 2016; Goldschneider 2017; Poonai 2015).
Children and Adolescents:
Oral: 0.5 to 1 mg/kg/dose every 4 to 6 hours as needed; maximum single dose: 60 mg/dose (APS 2016)
Applies to the following strengths: 7%
Usual Adult Dose for:
15 to 30 mL of syrup of Ipecac (Neo Pectol), once. Approximately 240 mL of water should be administered after the Ipecac (Neo Pectol).
If emesis does not occur within 30 minutes, and emesis is still deemed to be of value, a second 15 to 30 mL dose may be administered with another 240 mL of water. No more than 2 doses (60 mL) of Ipecac (Neo Pectol) should be given. Gastric lavage should be performed if emesis does not occur after the second dose.
Usual Pediatric Dose for Emesis Induction
<6 months: Use is not recommended.
6 to 12 months: 5 to 10 mL orally once. 120 to 240 mL of water should be given before or after the Ipecac (Neo Pectol). Infants should be positioned carefully to avoid aspiration of vomitus.
1 to 12 years: 15 mL orally once. 240 mL of water should be given before or after the Ipecac (Neo Pectol).
>12 years: 15 to 30 mL orally once. 240 mL of water should be given before or after the Ipecac (Neo Pectol).
If emesis does not occur within 30 minutes, and emesis is still deemed to be of value, a second dose may be administered with more water. No more than 2 doses Ipecac (Neo Pectol) should be given. Gastric lavage should be performed if emesis does not occur after the second dose.
The American Academy of Pediatrics does not recommend routine use of Ipecac (Neo Pectol) for home treatment of poisonous ingestions.
Renal Dose Adjustments
The recommended dosage has not been reduced for this patient with renal dysfunction. Emetine, a major component of Ipecac (Neo Pectol), may be slowly eliminated by the kidney, however, toxicity is unlikely when Ipecac (Neo Pectol) is given only once or twice.
Liver Dose Adjustments
The recommended dosage has not been reduced for this patient with hepatic dysfunction. Emetine, a major component of Ipecac (Neo Pectol), may be distributed to the liver, however, toxicity is unlikely when Ipecac (Neo Pectol) is given only once or twice.
Precautions
If outside a medical facility, the victim's caregiver should contact a poison control center, physician, or emergency department before administering Ipecac (Neo Pectol) and if emesis does not occur within 20 minutes after the second dose.
Ipecac (Neo Pectol) should be used under the guidance and advice of a certified poison information center or qualified health care professional because indications for emesis vary considerably from substance to substance. It is unlikely that more than 40% of an ingestant will be removed, even when a good volume of emesis is obtained.
Contraindicated in patients with rapidly declining consciousness or who are unconscious, severely intoxicated, in shock, having seizures, or who lack gag reflexes.
Do not use after ingestion of caustic agents, nontoxic substances, drugs such as CNS depressants that may alter the gag reflex, or drugs that may potentiate seizures. Ipecac (Neo Pectol) is relatively contraindicated when an interval between hydrocarbon ingestion and Ipecac (Neo Pectol) administration is greater than 60 minutes or when a medical condition such as uncontrolled hypertension, late stage pregnancy, or severe respiratory or cardiac disease is aggravated by emesis.
Charcoal may adsorb Ipecac (Neo Pectol) and prevent emesis. If the products are used together, emesis should be induced with Ipecac (Neo Pectol) and completed before administering activated charcoal. Do not use in unconscious/semiconscious patients.
Do not give milk or carbonated beverages with Ipecac (Neo Pectol).
Dialysis
Data not available
Further informationAlways consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
Medical Disclaimer
More about Ipecac (Neo Pectol)
Treatment with extended release Potassium Citrate (Neo Pectol) should be added to a regimen that limits salt intake (avoidance of foods with high salt content and of added salt at the table) and encourages high fluid intake (urine volume should be at least two liters per day). The objective of treatment with Urocit®-K (Potassium Citrate (Neo Pectol) extended-release tablets) is to provide Urocit®-K (Potassium Citrate (Neo Pectol) extended-release tablets) in sufficient dosage to restore normal urinary citrate (greater than 320 mg/day and as close to the normal mean of 640 mg/day as possible), and to increase urinary pH to a level of 6.0 or 7.0.
Monitor serum electrolytes (sodium, potassium, chloride and carbon dioxide), serum creatinine and complete blood counts every four months and more frequently in patients with cardiac disease, renal disease or acidosis. Perform electrocardiograms periodically. Treatment should be discontinued if there is hyperkalemia, a significant rise in serum creatinine or a significant fall in blood hemocrit or hemoglobin.
Severe HypocitraturiaIn patients with severe hypocitraturia (urinary citrate < 150 mg/day), therapy should be initiated at a dosage of 60 mEq /day (30 mEq two times/day or 20 mEq three times/day with meals or within 30 minutes after meals or bedtime snack). Twenty-four hour urinary citrate and/or urinary pH measurements should be used to determine the adequacy of the initial dosage and to evaluate the effectiveness of any dosage change. In addition, urinary citrate and/or pH should be measured every four months. Doses of Urocit®-K (Potassium Citrate (Neo Pectol) extended-release tablets) greater than 100 mEq/day have not been studied and should be avoided.
Mild to Moderate HypocitraturiaIn patients with mild to moderate hypocitraturia (urinary citrate > 150 mg/day) therapy should be initiated at 30 mEq/day (15 mEq two times/day or 10 mEq three times/day with meals or within 30 minutes after meals or bedtime snack). Twenty-four hour urinary citrate and/or urinary pH measurements should be used to determine the adequacy of the initial dosage and to evaluate the effectiveness of any dosage change. Doses of Urocit®-K (Potassium Citrate (Neo Pectol) extended-release tablets) greater than 100 mEq/day have not been studied and should be avoided.
How suppliedDosage Forms And StrengthsUrocit®-K (Potassium Citrate (Neo Pectol) extended-release tablets) 5 mEq tablets are uncoated, tan to yellowish in color, modified ball shaped, with MPC 600 debossed on one side and blank on the other, supplied in bottles as:
NDC 0178-0600-01 Bottle of 100
Urocit®-K (Potassium Citrate (Neo Pectol) extended-release tablets) 10 mEq tablets are uncoated, tan to yellowish in color, elliptical shaped, with MPC 610 debossed on one side and MISSION on the other, supplied in bottles as:
NDC 0178-0610-01 Bottle of 100
Urocit®-K (Potassium Citrate (Neo Pectol) extended-release tablets) 15 mEq tablets are uncoated, tan to yellowish in color, modified rectangle shaped, with M15 debossed on one side and blank on the other, supplied in bottles as:
NDC 0178-0615-01 Bottle of 100
Storage: Store in a tight container.
Mission Pharmacal Company, San Antonio, TX USA 78230
See also:
What other drugs will affect Codeine (Neo Pectol)?
When this drug applied simultaneously with:
- drugs have a depressing effect on the central nervous system (including those with opioid analgesics, barbiturates, benzodiazepines, clonidine) it is possible an increase the action of Codeine (Neo Pectol).
- derivatives of morphine it may increased the inhibitory action on the respiratory center; ibuprofen - analgesic effect is enhanced; carbamazepine - it may increased the analgesic effect is apparently due to increased formation of Codeine (Neo Pectol) metabolite normorphine, which has a stronger effect.
- quinidine the analgesic effect of Codeine (Neo Pectol) decreased or almost disappeared.
- Codeine (Neo Pectol) increases the effect of ethanol on psychomotor function.
See also:
What other drugs will affect Potassium Citrate (Neo Pectol)?
Concomitant administration of Urocit®-K (Potassium Citrate (Neo Pectol) extended-release tablets) and a potassium-sparing diuretic (such as triamterene, spironolactone or amiloride) should be avoided since the simultaneous administration of these agents can produce severe hyperkalemia.
Potential Effects of Other Drugs on Potassium Citrate (Neo Pectol)Drugs that slow gastrointestinal transit time
These agents (such as anticholinergics) can be expected to increase the gastrointestinal irritation produced by potassium salts.
