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

It is an opioid pain reliever; the active ingredient is codeine phosphate hemihydrate.

Codeine phosphate hemihydrate belongs to a group of medicines called pain relievers, which 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 to treat 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 direct central action.


The administration of those is oral.

The usual dose is:


  • In adults, 10 to 20 mg of those (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 is divided into four equal doses.

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

Side effects of those

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

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

Seizures, mental confusion, euphoria, and dysphoria have been observed infrequently.

Respiratory, thoracic, and mediastinal disorders and 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 you breastfeeding or plan to breastfeed

Those 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 drug’s ingredients.

Those should not be given if:

  • There is a respiratory disorder, lung disease, and breathing difficulties such as acute asthma attacks, 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 who will undergo tonsillectomy or adenoidectomy for obstructive sleep apnea syndrome, due to the increased risk of severe adverse reactions.

Those interactions

Some medications can interfere with those. These include:

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

The medications mentioned above can reduce their effectiveness, reduce effectiveness, and react to acute asthma attacks, leading to adverse, sometimes dangerous side effects.