J-Max DHC

Generic Name: dihydrocodeine and guaifenesin (dye HYE droe KOE deen gwye FEN e sin)Brand Names: J-Max DHC

What is J-Max DHC (dihydrocodeine and guaifenesin)?

Dihydrocodeine is a narcotic cough suppressant. It affects signals in the brain that trigger the cough reflex.

Guaifenesin is an expectorant. It helps loosen congestion in your chest and throat, making it easier to cough out through your mouth.

The combination of dihydrocodeine and guaifenesin is used to treat cough and to reduce chest congestion caused by allergies, flu, or the common cold.

Dihydrocodeine and guaifenesin will not treat a cough that is caused by smoking, asthma, or emphysema.

Dihydrocodeine and guaifenesin may also be used for other purposes not listed in this medication guide.

What is the most important information I should know about J-Max DHC (dihydrocodeine and guaifenesin)?Always ask a doctor before giving a cough or cold medicine to a child. Death can occur from the misuse of cough and cold medicines in very young children. Do not take this medication if you have taken furazolidone (Furoxone), sodium oxybate (GHB, Xyrem), or an MAO inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate) within the past 14 days. Serious or life-threatening side effects can occur if you take dihydrocodeine and guaifenesin before these other medications have cleared from your body. You also should not take dihydrocodeine and guaifenesin if you have severe high blood pressure, ischemic heart disease, stomach ulcer, blocked intestines, urination problems, narrow angle glaucoma, or if you are having an asthma attack or are allergic to other narcotic medications (Lortab, Vicodin, OxyContin, Demerol, and others). Do not take dihydrocodeine and guaifenesin with alcohol, other narcotic pain medications, sedatives, tranquilizers, muscle relaxers, or other medicines that can make you sleepy or slow your breathing. Dangerous side effects may result. Dihydrocodeine may be habit-forming and should be used only by the person it was prescribed for. Dihydrocodeine should never be shared with another person, especially someone who has a history of drug abuse or addiction. Keep the medication in a secure place where others cannot get to it.What should I discuss with my healthcare provider before taking J-Max DHC (dihydrocodeine and guaifenesin)?Do not take this medication if you have taken furazolidone (Furoxone), sodium oxybate (GHB, Xyrem), or an MAO inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate) within the past 14 days. Serious or life-threatening side effects can occur if you take dihydrocodeine and guaifenesin before these other medications have cleared from your body. You should not use this medication if you are allergic to dihydrocodeine or guaifenesin, or if you have:

• severe or uncontrolled high blood pressure;

• ischemic heart disease (reduced circulation of blood to the heart);

• stomach ulcer;

• a blockage in your intestines;

• urination problems;

• narrow angle glaucoma;

• if you are having an asthma attack; or

• if you are allergic to other narcotic medications such as codeine (Tylenol 3), hydrocodone (Lortab, Vicodin), hydromorphone (Dilaudid, Palladone), meperidine (Demerol), morphine (Kadian, MS Contin, Oramorph), oxycodone (OxyContin), and others.

If you have any of these other conditions, you may need a dose adjustment or special tests to safely take dihydrocodeine and guaifenesin:

• heart disease, high or low blood pressure;

• circulation problems or a history of stroke;

• asthma, COPD, emphysema, or other breathing disorders;

• kidney or liver disease;

• a history of head injury or brain tumor;

• epilepsy or other seizure disorder;

• diabetes;

• a gallbladder or pancreas problem;

• a thyroid disorder;

• glaucoma;

• enlarged prostate, urination problems;

• Addison's disease or other adrenal gland disorders;

• a history of stomach problems such as ulcers, intestinal blockage, ulcerative colitis, or any surgeries; or

• a history of drug or alcohol addiction, or suicidal thoughts.

FDA pregnancy category C. It is not known whether dihydrocodeine and guaifenesin is harmful to an unborn baby. Before taking this medication, tell your doctor if you are pregnant or plan to become pregnant during treatment. It is not known whether dihydrocodeine and guaifenesin passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby. Dihydrocodeine may be habit-forming and should be used only by the person it was prescribed for. Dihydrocodeine should never be shared with another person, especially someone who has a history of drug abuse or addiction. Keep the medication in a secure place where others cannot get to it. Dihydrocodeine is a drug of abuse and you should be aware if any person in the household is using this medicine improperly or without a prescription. Older adults may be more likely to have side effects from this medication.

How should I take J-Max DHC (dihydrocodeine and guaifenesin)?

Take this medication exactly as it has been prescribed by your doctor. Do not use the medication in larger amounts, or use it for longer than recommended. Cough or cold medicine is usually taken only for a short time until your symptoms clear up.

Always ask a doctor before giving cough or cold medicine to a child. Death can occur from the misuse of cough or cold medicine in very young children.

You may take this medication with or without food.

Drink extra fluids to help loosen the congestion and lubricate your throat while you are taking this medication.

Measure the liquid form of this medicine with a special dose-measuring spoon or cup, not a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist for one.

Take dihydrocodeine and guaifenesin with food if it upsets your stomach. Talk with your doctor if your symptoms do not improve after 7 days of treatment, or if you have a fever with a headache, cough, or skin rash.

This medication can cause you to have unusual results with allergy skin tests. Tell any doctor who treats you that you are taking an antihistamine.

If you need to have any type of surgery, tell the surgeon ahead of time if you have taken a cold medicine within the past few days.

Store this medicine at room temperature, away from heat, light, and moisture.

What happens if I miss a dose?

Cough or cold medicine is usually taken only as needed, so you may not be on a dosing schedule. If you are taking the medication regularly, take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the medicine at your next regularly scheduled time. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention if you think you have used too much of this medicine. An overdose of dihydrocodeine can be fatal.

Overdose symptoms may include vomiting, extreme dizziness or drowsiness, confusion, hallucinations, blurred vision, cold and clammy skin, fast/slow or uneven heart rate, pinpoint pupils, fainting, and seizure (convulsions).

What should I avoid while taking J-Max DHC (dihydrocodeine and guaifenesin)?

Avoid drinking alcohol while you are taking this medication. Alcohol can increase some of the side effects of dihydrocodeine. Dihydrocodeine and guaifenesin can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.

Avoid getting up too fast from a sitting or lying position, or you may feel dizzy. Get up slowly and steady yourself to prevent a fall.

Do not use any other over-the-counter cold, allergy, or cough medicine without first asking your doctor or pharmacist. Guaifenesin is contained in many medicines available over the counter. If you take certain products together you may accidentally take too much of a certain drug. Read the label of any other medicine you are using to see if it contains guaifenesin.

Avoid becoming overheated or dehydrated during exercise and in hot weather.

J-Max DHC (dihydrocodeine and guaifenesin) side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Stop taking this medication and call your doctor at once if you have any of these serious side effects:

• fast or uneven heart rate;

• feeling like you might pass out;

• confusion, hallucinations, unusual thoughts or behavior;

• severe dizziness or drowsiness, feeling irritable;

• shallow breathing, slow heartbeat;

• painful or difficult urination; or

• seizure (convulsions).

Less serious side effects may include:

• dizziness, drowsiness, headache;

• constipation;

• increased sweating;

• nausea, vomiting, upset stomach, mild loss of appetite;

• feeling excited or restless;

• sleep problems (insomnia);

• warmth, tingling, or redness under your skin; or

• skin rash or itching.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect J-Max DHC (dihydrocodeine and guaifenesin)?

Do not take this medication with alcohol, other narcotic pain medications, sedatives, tranquilizers, muscle relaxers, or other medicines that can make you sleepy or slow your breathing. Dangerous side effects may result.

Tell your doctor about all other medicines you take, especially:

• cimetidine (Tagamet);

• methyldopa (Aldomet);

• mecamylamine (Inversine);

• a beta-blocker such as atenolol (Tenormin), carvedilol (Coreg), esmolol (Brevibloc), labetalol (Normodyne, Trandate), metoprolol (Lopressor, Toprol), nadolol (Corgard), propranolol (Inderal, InnoPran), sotalol (Betapace), and others;

• HIV or AIDS medicine such as atazanavir (Reyataz), darunavir (Prezista), delavirdine (Rescriptor), fosamprenavir (Lexiva), indinavir (Crixivan), nelfinavir (Viracept), ritonavir (Norvir), or saquinavir (Invirase, Fortovase); or

• phenothiazines such as chlorpromazine (Thorazine), fluphenazine (Prolixin), perphenazine (Trilafon), prochlorperazine (Compazine), promethazine (Phenergan, Adgan, Anergan 50, Pentazine), thioridazine (Mellaril), or trifluperazine (Stelazine).

This list is not complete and there may be other drugs that can interact with dihydrocodeine and guaifenesin. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Where can I get more information?

• Your pharmacist can provide more information about dihydrocodeine and guaifenesin.

• Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed
• Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2006 Cerner Multum, Inc. Version: 1.04. Revision Date: 11/17/2009 11:18:54 AM.