Makatussin Uses

Rating: 5 - 3 review(s)
How do you administer this medicine?
sponsored

What is Makatussin?

Makatussin is an opioid pain medication. An opioid is sometimes called a narcotic.

Makatussin is used to treat mild to moderately severe pain.

Makatussin may also be used for purposes not listed in this medication guide.

Makatussin indications

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.
sponsored

Makatussin sulfate is an opioid analgesic indicated for the management of mild to moderately severe pain where the use of an opioid analgesic is appropriate.

Uses of Makatussin in details

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 Indications

Pain management: Management of mild- to moderately-severe pain

Limitations of use: Reserve Makatussin 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 Uses

Cough in select patients

In a metaanalysis of trials evaluating the treatment of chronic cough, the use of Makatussin demonstrated efficacy in patients with this condition.

Makatussin description

An opioid analgesic related to morphine but with less potent analgesic properties and mild sedative effects. It also acts centrally to suppress cough. [PubChem]

Makatussin dosage

Dosage Forms

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 Makatussin 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: Makatussin 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 Makatussin Contin and an immediate release or combination Makatussin product for breakthrough pain, the rescue dose of immediate release Makatussin product should be ≤12.5% of the total daily Makatussin Contin dose.

Opioid-naive patients: Initial: 50 mg every 12 hours

Conversion from immediate release Makatussin preparations: Immediate release Makatussin preparations contain ~75% Makatussin base. Therefore, patients who are switching from immediate release Makatussin preparations may be transferred to a ~25% lower total daily dose of Makatussin Contin, equally divided into 2 daily doses every 12 hours.

Conversion from a combination Makatussin product (eg, Makatussin with acetaminophen or aspirin): See table:

Number of 30 mg Makatussin Combination Tablets Daily

Initial Dose of Makatussin Contin

Maintenance Dose of Makatussin Contin

≤6

50 mg every 12 hours

100 mg every 12 hours

7 to 9

100 mg every 12 hours

150 mg every 12 hours

10 to 12

150 mg every 12 hours

200 mg every 12 hours

>12

200 mg every 12 hours

200 to 300 mg every 12 hours (maximum: 300 mg every 12 hours)

Conversion from another opioid analgesic: Using the patient's current opioid dose, calculate an equivalent daily dose of immediate release Makatussin. A ~25% lower dose of Makatussin 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 Makatussin 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 Makatussin 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: Makatussin 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 Makatussin 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 Makatussin (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 Makatussin-containing product is the only option, consider genotype testing prior to use; use extra precaution; monitor closely for adverse effects. Makatussin 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 Makatussin (prodrug) to morphine and thus increased opioid-mediated effects. Avoid Makatussin use in pediatric patient populations in which it is contraindicated; in rare cases in which Makatussin-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)

Makatussin interactions

See also:
What other drugs will affect Makatussin?

sponsored

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 Makatussin.

- 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 Makatussin metabolite normorphine, which has a stronger effect.

- quinidine the analgesic effect of Makatussin decreased or almost disappeared.

- Makatussin increases the effect of ethanol on psychomotor function.

Makatussin side effects

See also:
What are the possible side effects of Makatussin?

Applies to Makatussin: oral solution, oral syrup, oral tablet, oral tablet extended release

In addition to its needed effects, some unwanted effects may be caused by Makatussin. In the event that any of these side effects do occur, they may require medical attention.

Major Side Effects

You should check with your doctor immediately if any of these side effects occur when taking Makatussin:

Incidence not known:

If any of the following symptoms of overdose occur while taking Makatussin, get emergency help immediately:

Symptoms of overdose:

Minor Side Effects

Some of the side effects that can occur with Makatussin 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:

Incidence not known:

Makatussin contraindications

See also:
What is the most important information I should know about Makatussin?

sponsored

Makatussin Sulfate is contraindicated for postoperative pain management in children who have undergone tonsillectomy and/or adenoidectomy​​.

Makatussin Sulfate is contraindicated in patients with known hypersensitivity to Makatussin or any components of the product. Persons known to be hypersensitive to certain other opioids may exhibit cross-sensitivity to Makatussin.

Makatussin Sulfate is contraindicated in patients with respiratory depression in the absence of resuscitative equipment​​.

Makatussin Sulfate is contraindicated in patients with acute or severe bronchial asthma or hypercarbia.

Makatussin Sulfate is contraindicated in any patient who has or is suspected of having paralytic ileus.

Active ingredient matches for Makatussin:

Codeine in Switzerland.

Camphor/cypress oil/eucalyptus oil/menthol/pumilio pine oil in Switzerland, Austria.

Guaifenesin/sodium dibunate in Germany.


List of Makatussin substitutes (brand and generic names)

Sort by popularity
Unit description / dosage (Manufacturer)Price, USD
Linctus Codeine Blanc liquid .2 % (Laboratoire Atlas Inc (Canada))
Drops; Oral; Codeine Phosphate
Drops; Oral; Codeine Phosphate 13.6 mg / g
Drops; Oral; Codeine Phosphate 13.6 mg / g
Pastilles; Oral; Codeine Phosphate Hemihydrate 3 mg
MARKODIN SYRUP 1 bottle / 100 ML syrup each (Glenmark Pharmaceuticals Ltd)$ 0.58
Syrup; Oral; Thyme 15% (Aventis)
Mod-Codyn Codeine phosphate 10 mg, Chlorpheniramine maleate 4 mg. SYR / 100ml (ModHike)
100ml (ModHike)
MOD-CODYN syr 100ml (ModHike)
MONTOKUF Liquid / 15mg per 5ml / 60ml units (Shreya)$ 0.48
MONTOKUF Liquid / 15mg per 5ml / 100ml units (Shreya)$ 0.73
Montokuf 15mg x 5mL SYR / 100ml (Shreya)$ 0.73
Montokuf 15mg x 5mL SYR / 60ml (Shreya)$ 0.48
15 mg x 5 mL x 100ml (Shreya)$ 0.73
15 mg x 5 mL x 60ml (Shreya)$ 0.48
MONTOKUF 15 MG SYRUP 1 bottle / 100 ML syrup each (Shreya)$ 1.22
MONTOKUF PLUS 15 MG SYRUP 1 bottle / 100 ML syrup each (Shreya)$ 1.28
MONTOKUF syr 15 mg x 5 mL x 100ml (Shreya)$ 0.73
MONTOKUF syr 15 mg x 5 mL x 60ml (Shreya)$ 0.48
Montokuf 15mg x 5mL SYR / 100ml (Shreya)$ 0.73
Montokuf 15mg x 5mL SYR / 60ml (Shreya)$ 0.48
Montokuf 15mg Syrup (Shreya)$ 1.28
Tablet, Film-Coated; Oral; Codeine Camsilate 25 mg; Grindelia Soft Extract 20 mg; Sulfoguaiacol 100 mg (Bouchara-recordati)
Neo-Codion 20 Tablet (Bouchara-recordati)
Syrup; Oral; Codeine Camsilate 25.83 mg / 5 ml
Nocough-U 0.6 mg/1 mL x 1 mL
Nocough-U 0.6 mg/1 mL x 60 mL
Nocough-U 0.6 mg/1 mL x 3.8 L
Drops; Oral; Codeine
Drops; Oral; Codeine
Syrup; Oral; Codeine Phosphate Hemihydrate 5 mg / 5 ml
Tablet, Film-Coated; Oral; Codeine Phosphate Hemihydrate 19.5 mg
Paderyl 20 Tablet

References

  1. DailyMed. "GUAIFENESIN; HYDROCODONE BITARTRATE: DailyMed provides trustworthy information about marketed drugs in the United States. DailyMed is the official provider of FDA label information (package inserts).". https://dailymed.nlm.nih.gov/dailyme... (accessed September 17, 2018).
  2. DailyMed. "CODEINE SULFATE: DailyMed provides trustworthy information about marketed drugs in the United States. DailyMed is the official provider of FDA label information (package inserts).". https://dailymed.nlm.nih.gov/dailyme... (accessed September 17, 2018).
  3. PubChem. "EUCALYPTUS OIL". https://pubchem.ncbi.nlm.nih.gov/sub... (accessed September 17, 2018).

Reviews

The results of a survey conducted on ndrugs.com for Makatussin are given in detail below. The results of the survey conducted are based on the impressions and views of the website users and consumers taking Makatussin. We implore you to kindly base your medical condition or therapeutic choices on the result or test conducted by a physician or licensed medical practitioners.

User reports

1 consumer reported useful

Was the Makatussin drug useful in terms of decreasing the symptom or the disease?
According to the reports released by ndrugs.com website users, the below mentioned percentages of users say the drug is useful / not useful to them in decreasing their symptoms/disease. The usefulness of the drug depends on many factors, like severity of the disease, perception of symptom, or disease by the patient, brand name used [matters only to a certain extent], other associated conditions of the patient. If the drug is not effective or useful in your case, you need to meet the doctor to get re-evaluated about your symptoms/disease, and he will prescribe an alternative drug.
Users%
Useful1
100.0%


2 consumers reported price estimates

Was the price you paid to purchase the drug reasonable? Did you feel it was expensive?
The below mentioned numbers have been reported by ndrugs.com website users about whether the Makatussin drug is expensive or inexpensive. There is a mixed opinion among users. The rating about the cost of the drug depends on factors like which brand drug the patient purchased, how effective it was for the price paid, the country or place the drug is marketed, and the economic condition of the patient. The users who feel the drug is expensive can look for an alternative brand drug or a generic drug to save the cost.
Users%
Not expensive1
50.0%
Expensive1
50.0%


4 consumers reported time for results

To what extent do I have to use Makatussin before I begin to see changes in my health conditions?
As part of the reports released by ndrugs.com website users, it takes 1 day and a few days before you notice an improvement in your health conditions.
Please note, it doesn't mean you will start to notice such health improvement in the same time frame as other users. There are many factors to consider, and we implore you to visit your doctor to know how long before you can see improvements in your health while taking Makatussin. To get the time effectiveness of using Makatussin drug by other patients, please click here.
Users%
1 day2
50.0%
5 days1
25.0%
> 3 month1
25.0%


17 consumers reported age

Users%
16-2913
76.5%
30-452
11.8%
< 11
5.9%
1-51
5.9%


Consumer reviews


There are no reviews yet. Be the first to write one!


Your name: 
Email: 
Spam protection:  < Type 16 here

Information checked by Dr. Sachin Kumar, MD Pharmacology

| Privacy Policy
This site does not supply any medicines. It contains prices for information purposes only.
© 2003 - 2022 ndrugs.com All Rights Reserved