pholcodine monohydrate at a glance
Medicine class
Centrally acting opioid cough suppressant.
Former role
Relief of acute dry, non-productive cough associated with upper respiratory tract infection.
Current availability
Withdrawn from sale and should not be supplied in the UK.
Surgery warning
Tell the anaesthetist about previous use, particularly within the preceding 12 months.
What is pholcodine monohydrate used for?
These were historical UK licensed uses; products have since been withdrawn.
Relief of acute non-productive cough associated with upper respiratory tract infection in adults and older children.
A selected paediatric product was intended for children aged 6–12 years when simple measures had not provided adequate relief.
How does pholcodine monohydrate work?
Pholcodine acts in the brain to reduce nerve signals responsible for the cough reflex. Suppressing a cough can allow mucus to accumulate when a productive cough is present.
How to take pholcodine monohydrate
Pholcodine should not be started or continued in the UK. If an old bottle remains, check its ingredients and ask a pharmacist about an alternative and what to do with the remaining product.
Selected products were oral liquids.
Do not combine an old pholcodine product with other cough and cold preparations.
Formulations had different excipients, including parabens, colourings, ethanol or propylene glycol.
pholcodine monohydrate side effects
Common or expected effects
- Drowsiness or dizziness.
- Nausea, vomiting or constipation.
- Excitation or confusion.
- Rash or other skin reaction.
- Difficulty coughing up phlegm because of sputum retention.
Get urgent medical advice
- Anaphylaxis, with breathing difficulty, swelling, collapse or severe dizziness.
- Acute generalised exanthematous pustulosis or another severe widespread skin reaction.
- Respiratory depression, particularly with excessive exposure or other sedating substances.
pholcodine monohydrate in pregnancy
Historical product information reported insufficient pregnancy data and advised use only when considered necessary by a physician, with avoidance in the first trimester. Products are now withdrawn, so an old supply should not be used.
pholcodine monohydrate while breastfeeding
Historical information stated that pholcodine was detected in human milk in amounts considered unlikely to affect a breastfed infant. Products are now withdrawn, so an old supply should not be used.
pholcodine monohydrate interactions
Previous exposure remains relevant before general anaesthesia. Historical interactions may also be relevant to accidental or retained-stock use.
Neuromuscular blocking agents used during general anaesthesia
Previous exposure is associated with increased risk of very rare perianaesthetic anaphylaxis, particularly within the preceding 12 months.
Monoamine oxidase inhibitors
Selected products were contraindicated during treatment and for two weeks after it ended.
Common questions about pholcodine monohydrate
Answers are fully visible for fast scanning and source review.
Is pholcodine monohydrate still available in the United Kingdom?
No. All pholcodine-containing medicines were recalled and withdrawn from the UK market in March 2023 and should not be sold or supplied.
Why was pholcodine monohydrate withdrawn?
A safety review concluded that its benefits did not outweigh the increased risk of a very rare severe allergic reaction to neuromuscular blocking agents used during general anaesthesia.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.