Tosein: Formula, Presentation, Indications, Mechanism of Action, Dosage, Side Effects, Warnings, Contraindications and Interactions

It is an opioid pain reliever, the active ingredient of which is codeine phosphate hematohydrate.

Codeine phosphate hemihydrate belongs to a group of medicines called pain relievers, which are used to block pain and the emotional response to pain.

Chemical formula

  • C18H24NO7P* 0,5H2O.


Oral solution and tablets.

Indications of tosein

Codeine phosphate hemihydrate is used for the treatment of mild to moderate pain, diarrhea and the symptomatic treatment of unproductive cough.

Mechanism of action

The antitussive effect, the moderate analgesic and sedative effect, as well as its antidiarrheal action suppresses them through a direct central action.


The administration of tosein is orally.

The usual dose is:

  • In adults, 10 to 20 mg of tosein (approximately 5 to 10 ml) is given every 4 to 6 hours. The dose to be administered per day cannot exceed 120 mg.
  • In children 6 to 12 years of age, 5 to 10 mg (approximately 2.5 to 5 ml) is given every 4 to 6 hours. The daily dose should not exceed 60 mg per day.
  • In children 2 to 6 years old, 1 mg per kg of body weight per day, divided into 4 equal doses.

The tablets should be swallowed whole with a glass of water, and tosein continued only for as long as the doctor indicates.

Side effects of tosein

The most common side effects are: dizziness, drowsiness, seizures, constipation, nausea, vomiting.

Itching with skin rashes has been reported in patients with allergies.

Even seizures, mental confusion, euphoria, and dysphoria have been observed infrequently.

Respiratory, thoracic and mediastinal disorders, as well as respiratory depression, can occur in overdose cases.

Warnings and Contraindications

Before starting treatment, it should be taken into account if you have other medical conditions and other health problems such as:

  • Heart disease.
  • Liver disease, hepatitis.
  • Kidney disease or difficulty urinating.
  • Depression .
  • The underactive thyroid gland.
  • When there is little production of hormones in the adrenal glands (Addison’s disease).
  • A disorder of the prostate.
  • I use drugs or alcohol in excess.
  • Presence of gallstones or some other gallbladder disease.
  • A recent head injury.
  • Recent biliary tract surgery.
  • You are about to undergo surgery under general anesthesia.
  • You are pregnant or intend to become pregnant.
  • Are breastfeeding or intend to breastfeed

Tosein should not be given if the patient is allergic to any other medicine, any food, dye or preservative, to codeine, morphine, oxycodone or any of the ingredients of the medicine.

Tosein should not be given if:

  • There is a respiratory disorder, lung disease, and breathing difficulties such as acute attacks of asthma, bronchitis or emphysema or respiratory depression are experienced.
  • You have had recent biliary tract surgery, inflammatory bowel disease or other gastrointestinal problems, if you have paralytic ileus or are at risk; diarrhea associated with pseudomembranous colitis caused by cephalosporins, lincomycin, or penicillins, or diarrhea caused by intoxication until toxic material has been eliminated from the gastrointestinal tract.
  • In children under 12 years of age, nor in patients under 18 years of age who are going to undergo tonsillectomy or adenoidectomy for obstructive sleep apnea syndrome, due to the increased risk of serious adverse reactions.

Tosein interactions

Some medications can interfere with tosein. These include:

  • Medicines to help you sleep or relieve anxiety.
  • Anticholinergics, medicines to treat muscle spasms.
  • Medication for epilepsy .
  • Medicines used to treat high blood pressure.
  • Diuretics
  • Other opioid pain relievers used to block pain.
  • Antihistamines (medicines used to treat allergies, such as hay fever, insect bites, and some medicines used for colds).
  • Monoamine oxidase inhibitors (medicines to treat depression) taken in the last 10 days.
  • Metoclopramide, a medicine used to relieve nausea and vomiting.
  • Antidepressant medicines to treat depression.
  • Naloxone or naltrexone, medicines used to counteract the effects of opioid pain relievers.
  • Medicines used to relax the muscles.
  • Quinidine (a medicine used to treat abnormal or irregular heartbeats).
  • Cimetidine (a medicine used to treat reflux or stomach ulcer)

The medications mentioned above can reduce the effectiveness of tosein, reduce its own effectiveness, and react with acute asthma attacks, leading to adverse, sometimes dangerous side effects.