Makatussin Comp: Uses, Dosage, Side Effects, Interactions, Addiction

Makatussin Comp is a common remedy for relieving cough and associated symptoms. It is primarily used to relieve cough symptoms associated with various respiratory conditions.

Makatussin Comp cough syrup is manufactured by Gebro Pharma AG and contains the following components:

Active Substances:

•          Each 5 ml of the syrup contains 10 mg of dihydrocodeine hydrochloride.

•          Each 5 ml of the syrup contains 15 mg of diphenhydramine hydrochloride.


•          Sodium benzoate (E211)

•          Citric acid

•          Neohesperidin dihydrochalcone

•          Sucrose

•          Cherry flavor

•          Elderberry concentrate

•          70% sorbitol solution (non-crystallizable)

•          Purified water

Each 5 ml of the syrup contains approximately 4 g of carbohydrates, which is roughly equivalent to 0.33 PU (Phenylketonuria units).

The Swiss National Authorization and Supervisory Authority for Drugs and Medical Products (Swissmedic) classify Makatussin Comp as a prescription-only medication under category B due to its active ingredient.

When Should Makatussin Comp. Cough Syrup Not Be Used?

Makatussin Comp should not be used in the following cases:

1.        Hypersensitivity: If you have a proven hypersensitivity to any of the components in the syrup, it is crucial to avoid using it. Allergic reactions can range from mild to severe and may include symptoms like skin rashes, itching, and swelling.

2.        Age Restrictions: This cough syrup is not suitable for children and adolescents under the age of 18. It is important to follow age-specific recommendations and consult with a healthcare professional for alternative treatments for younger individuals.

3.        Ultra-Rapid Metabolizers: Patients of all ages known to be “ultra-rapid metabolizers,” who convert codeine into morphine very quickly, should not use codeine-containing medications for cough and cold. They are at a higher risk of experiencing serious side effects from codeine, including respiratory depression and overdose.

4.        Pregnancy: It is not advisable to use Makatussin Comp during pregnancy. Pregnant individuals should explore safer alternatives for managing cough and cold symptoms and consult their healthcare provider for guidance.

5.        Breastfeeding: Breastfeeding women should avoid taking codeine-containing medications, as codeine can pass into breast milk and potentially harm a nursing baby. Consult with a healthcare professional to determine suitable alternatives for managing cough while breastfeeding.

6.        Bronchial Asthma: If you have bronchial asthma, it is advisable to steer clear of Makatussin Comp. This medication can exacerbate respiratory issues, making it an unsuitable choice for individuals with asthma.

7.        Respiratory Center Depression: In cases where it is necessary to avoid depression of the respiratory center, this medication should not be used. It can affect breathing, and individuals with conditions requiring unimpaired respiratory function should seek alternative treatments.

8.        Chronic Constipation: Long-term use of this medication can lead to chronic constipation. If you already suffer from chronic constipation, it is essential to consult with a healthcare provider before using Makatussin Comp syrup.

9.        Narrow Angle Glaucoma: If you have been diagnosed with narrow-angle glaucoma, avoid using this cough syrup, as it can worsen the condition and lead to increased intraocular pressure.

10.      Prostatic Hypertrophy: Individuals with an enlarged prostate (prostatic hypertrophy) should avoid using Makatussin Comp. cough syrup, as it can exacerbate urinary symptoms and lead to discomfort.

11.      Mucus-Producing Cough: If you have a cough accompanied by significant mucus formation, this medication may not be the best choice, as it primarily targets dry coughs. Consult with a healthcare professional for an appropriate treatment option.

12.      Post-Surgical Procedures: After surgical procedures involving the intestines and stomach, it is advisable to avoid using Makatussin Comp. Surgical interventions can affect how your body processes medications, so consulting with a healthcare provider is crucial.

13.      Cardiac and Duodenal Stenosis: In the case of stenosis in the cardia, duodenum, or pylorus, using this medication should be avoided, as it may exacerbate these conditions.

14.      Pheochromocytoma: Individuals with pheochromocytoma, a rare neuroectodermal tumor, should not use Makatussin Comp, as it can interact with the condition and potentially lead to adverse effects.

15.      Mono-Amino Oxidase Inhibitors (MAO Inhibitors): If you are undergoing treatment with certain medications for emotional disturbances, particularly mono-amino oxidase inhibitors (MAO inhibitors) for depression, it is crucial to avoid using Makatussin Comp, as it may interact with these medications and lead to adverse reactions.

16.      Opiate Dependence: If you are dependent on opiates, such as codeine or similar substances, it is essential to avoid using Makatussin Comp, as it can exacerbate dependence and withdrawal symptoms.

How to Use Makatussin Comp. Cough Syrup

The recommended dosage for Makatussin Comp cough syrup is as follows:

•          Adults (18 years and older): Take 5 ml of the syrup 2 to 3 times a day. A measuring cup is included for precise dosing.

It is essential to follow the dosage instructions provided on the package insert or as prescribed by your doctor. If you believe that the medication’s effectiveness is too weak or too strong, do not hesitate to contact your doctor or pharmacist for guidance and potential adjustments.

Precautions When Using Makatussin Comp. Cough Syrup

While using Makatussin Comp, certain precautions should be observed:

1.        Respiratory Problems: Caution is required when using this medication in individuals with pre-existing respiratory problems. Codeine, one of the active ingredients, can suppress the respiratory system. It is not recommended in adolescents aged 12 to 18 years with respiratory disorders.

2.        Addiction Risk: Long-term use of this medication can lead to addiction and dependence. It is crucial to follow the prescribed dosage and duration, as misuse can result in dependency.

3.        Drug Interactions: The combination of Makatussin Comp with other drugs that produce central depression, such as sedatives, sleeping pills, or alcohol, may lead to an enhanced effect. It is important to inform your healthcare provider about any other medications you are taking to avoid potential interactions.

4.        Liver or Kidney Disease: If you have liver or kidney disease, or if your body eliminates codeine slower than most other people due to a genetic factor, you should use Makatussin Comp cough syrup with caution. In some cases, it may be necessary to use this medication only under the supervision of a healthcare professional and for a limited duration.

5.        Impaired Reactions: Makatussin Comp can affect your ability to drive, operate machinery, or engage in tasks that require full attention and quick reactions. This effect can be more pronounced when alcohol is consumed simultaneously. Avoid such activities while using this medication, especially in combination with alcohol.

6.        Other Medical Conditions: Inform your doctor or pharmacist if you have any other medical conditions, allergies, or are using other medications, even for self-medication. They can provide guidance on the safety and appropriateness of using Makatussin Comp. in your specific circumstances.

7.        Sugar Content: Makatussin Comp. cough syrup contains sorbitol, which is a source of fructose. If you have been diagnosed with an intolerance to certain sugars or suffer from hereditary fructose intolerance (HFI), consult your doctor before taking this medication. HFI is a rare congenital condition characterized by the inability to break down fructose, and sorbitol may exacerbate the condition.

8.        Sodium Content: This medication contains sodium benzoate. If you have an intolerance to any sugar, consult your doctor before using Makatussin Comp. syrup. The sodium content is minimal and considered “sodium-free.”

Makatussin Comp. Cough Syrup During Pregnancy and Breastfeeding

Makatussin Comp. cough syrup should not be used during pregnancy. It is important to seek alternative treatments for cough and cold symptoms while pregnant, as the safety of this medication during pregnancy has not been established.

For breastfeeding women, it is also advisable to avoid taking codeine-containing medications, including Makatussin Comp., as codeine can pass into breast milk and potentially harm a nursing baby. Consult with your healthcare provider to find a safe and suitable alternative for managing cough while breastfeeding.

Side Effects of Makatussin Comp. Cough Syrup

Makatussin Comp. cough syrup, like any medication, can have side effects. These side effects can vary in frequency and severity. Common side effects include:

•          Nausea: Nausea is a frequent side effect of this medication. It may occur after taking a dose and can range from mild discomfort to more pronounced queasiness.

          Constipation: Constipation is another common side effect of Makatussin Comp. Long-term use of the medication can exacerbate this symptom, and individuals prone to constipation should use the medication with caution.

•          Drowsiness: Drowsiness is common when using this medication. It can affect your alertness and ability to concentrate, so it is important to avoid activities that require full attention while under the influence of the medication.

•          Headache: Headaches can occasionally occur as a side effect of Makatussin Comp. If you experience a persistent or severe headache, consult with your healthcare provider.

•          Risk of Dependence: With abusive use, there is a risk of dependence on codeine, one of the active ingredients in the syrup. It is important to follow the prescribed dosage and duration to mitigate this risk.

Other less common side effects may include:

•          Dyspnea: Occasional shortness of breath, known as dyspnea, may occur.

•          Fatigue: Rarely, users may experience fatigue as a side effect.

•          Vomiting: Vomiting can occur on rare occasions as a side effect of the medication.

•          Depression: Rarely, users may experience symptoms of depression. It is essential to report any mood changes or emotional disturbances to your healthcare provider.

•          Dry Mouth: Dry mouth may occur in rare cases, causing discomfort and increased thirst.

•          Central Nervous Disorders: Central nervous disorders, including dizziness or unsteadiness, may occasionally occur.

•          Urination Disorders: Rarely, individuals may experience changes in urination patterns.

•          Visual Disturbances: Onset of visual disturbances, such as blurred vision, may occur in rare cases.

•          Glaucoma: Rarely, the use of this medication may lead to the onset of glaucoma, a condition characterized by increased intraocular pressure.

•          Hypersensitivity Reactions: In rare cases, hypersensitivity reactions, such as skin rashes, may occur as a side effect. If you experience any signs of an allergic reaction, seek medical attention promptly.

•          Blood Count Changes: Changes in blood count, which may affect your overall health, can occur rarely. Regular monitoring by a healthcare provider is essential.

•          Sleep Disturbances: Interruption of sleep patterns may occur in rare cases.

•          Euphoria: Euphoria, characterized by an exaggerated sense of well-being, can occur rarely as a side effect.

It’s important to note that individual responses to medication can vary, and not everyone will experience these side effects. If you notice any side effects not listed in the package insert, inform your doctor or pharmacist, as they can provide guidance and potential solutions.

Additional Considerations

•          Storage: Store Makatussin Comp cough syrup at room temperature (15 – 25°C) and out of reach of children. Ensure the medication is stored in its original container and follow any specific storage instructions provided.

•          Expiration Date: Do not use the medicine beyond the date indicated after the words “EXP” on the container. Expired medications may not be as effective and can potentially be harmful. Always check the expiration date before using any medication.

•          Consult a Healthcare Professional: If you have questions or concerns about using Makatussin Comp cough syrup or its potential interactions with your specific health conditions or other medications you are taking, consult your doctor or pharmacist. They can provide personalized guidance and ensure your safety.


Dr. Oche Otorkpa PG Cert, MPH, PhD

Dr. Oche is a seasoned Public Health specialist who holds a post graduate certificate in Pharmacology and Therapeutics, an MPH, and a PhD both from Texila American University. He is a member of the International Society of Substance Use Professionals and a Fellow of the Royal Society for Public Health in the UK. He authored two books: "The Unseen Terrorist," published by AuthorHouse UK, and "The Night Before I Killed Addiction."
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