Makatussin Cough Drops: Uses, Dosage, Side Effects, Addiction

Coughs can be annoying and disruptive, affecting our daily lives and keeping us up at night. Fortunately, there are various remedies available to relieve these discomforts, and Makatussin cough drops are one such option. These cough drops contain codeine as their active ingredient, which plays a crucial role in suppressing the urge to cough.

In this article, we shall be taking an extensive look at Makatussin cough drops, exploring what they are, when they are used, precautions to consider, and potential side effects and addiction warnings. Let’s embark on this journey of understanding Makatussin cough drops.

What Are Makatussin Cough Drops?

Makatussin cough drops are a type of cough medicine designed to alleviate coughs and cough irritation, particularly for dry and irritating coughs. The key active ingredient in these drops is codeine, which works by lowering the stimulus threshold of the cough center, thus reducing the frequency of coughing and the urge to cough. These cough drops are formulated to provide relief from the discomfort associated with persistent coughing.

Makatussin cough drops are manufactured by Gebro Pharma AG and contain the following active ingredients and excipients:

Active Ingredients:

•          Each 1 gram (equivalent to 20 drops) contains 13.6 mg of codeine phosphate, equivalent to 10.6 mg of codeine base.


•          Glycerol 100% (E422)

•          Propylene glycol (E1520)

•          Sorbitol solution 70% (non-crystallizing) (E420)

•          Sodium chloride

•          Licorice root extract

•          Saccharin sodium (E954)

Makatussin cough drops are available in 30g dropper bottles and dropper tubes. They can be obtained from pharmacies, but a prescription is typically required for their purchase. The Swiss National Authorization and Supervisory Authority for Drugs and Medical Products (Swissmedic) classify Makatussin drops as a prescription-only medication under category B due to its active ingredient.

When Are Makatussin Cough Drops Used?

Makatussin cough drops are primarily used to alleviate coughs and cough irritation. They are especially effective for dry, irritating coughs. These cough drops offer a duration of action for a dose that typically lasts between 4 to 6 hours. It’s essential to note that Makatussin cough drops should only be used as directed by a healthcare professional or following the instructions provided on the packaging.

Precautions to Take When Using Makatussin Cough Drops

Before using Makatussin cough drops, there are certain precautions to consider:

1.        Smoking: If you are a smoker, it’s important to be aware that smoking can contribute to the development of cough, often referred to as “smoker’s cough.” You can support the effectiveness of Makatussin cough drops by refraining from smoking.

2.        Hypersensitivity: These cough drops should not be used if you are hypersensitive to codeine or any other component of the medication.

3.        Age Restrictions: Medicines containing codeine are not recommended for children under 12 years of age due to the risk of serious side effects, including breathing problems. Additionally, adolescents between 12 and 18 years of age who have respiratory distress should avoid codeine-containing products, as they may be more susceptible to codeine-related respiratory issues.

4.        Pregnancy and Breastfeeding: Makatussin cough drops should not be taken during pregnancy. Breastfeeding women should also avoid codeine, as it can pass into breast milk and potentially harm the baby.

5.        Fructose Intolerance: Individuals with fructose intolerance, a rare congenital disorder of sugar metabolism, should steer clear of Makatussin cough drops, as they contain sorbitol, a source of fructose. It is essential to consult with a healthcare professional if you have any sugar intolerance or hereditary fructose intolerance (HFI).

6.        Respiratory Conditions: Avoid Makatussin cough drops in the acute phase of an asthma attack and other conditions that are accompanied by severe impairment of respiratory function. It is crucial to use them with caution or under the guidance of a healthcare provider.

7.        Opioid Addiction: If you are addicted to substances that are chemically related to codeine (opioids), you should not use Makatussin cough drops.

8.        Post-Operative: These cough drops should be used with caution after surgical interventions in the gastrointestinal tract, for narrowing of the stomach inlet, duodenum, and stomach outlet.

9.        Mono-Amino Oxidase Inhibitors (MAOIs): If you are undergoing treatment with certain medicines for mood disorders, such as mono-amino oxidase inhibitors (MAOIs) for depression, it is crucial to consult with your doctor before using Makatussin cough drops.

It’s important to discuss any specific medical conditions, allergies, or medications you are taking with your healthcare provider before using Makatussin cough drops.

When to Be Cautious with Makatussin Cough Drops

There are certain situations where caution should be exercised when using Makatussin cough drops:

1.        Excessive Bronchial Mucus: In cases of strong bronchial mucus secretion, using Makatussin cough drops should be approached with caution. These cough drops inhibit the cough reflex, which can lead to the accumulation of mucus in the airways and potentially cause bronchial spasms, leading to shortness of breath and the risk of pneumonia.

2.        Chronic Intestinal Constipation: If you suffer from chronic intestinal constipation, codeine in Makatussin cough drops may exacerbate this condition.

3.        Intracranial Pressure and Reduced Blood Volume: In conditions with increased intracranial pressure, reduced blood volume (e.g., due to severe blood loss), or impaired consciousness, Makatussin cough drops should only be taken with caution or given to a child under the guidance of a healthcare provider.

4.        Concomitant Use of Central Nervous System Medications: The simultaneous use of other medicines that act on the central nervous system, in combination with Makatussin cough drops, can increase the risk of tiredness and depression of breathing caused by codeine. This includes certain medicines for sleep disorders, agitation, or depression, as well as specific medications for allergies. It’s essential to consult with your doctor or pharmacist regarding potential interactions.

5.        Addiction and Dependence: Prolonged use of Makatussin cough drops can lead to addiction and dependence. It is advisable to use this medication as directed and consult with a healthcare professional if you have concerns about dependence.

6.        Liver or Kidney Disease: If you suffer from liver or kidney disease or have a hereditary predisposition that results in slower excretion of codeine, you should take Makatussin cough drops for only a few days without a doctor’s prescription. Your healthcare provider will guide you on the appropriate course of action.

Impaired Ability and Alcohol Interaction: Makatussin cough drops can impair the ability to react, drive, and operate machinery. This effect is amplified when combined with the consumption of alcoholic beverages.

Sodium and Sorbitol Content: Each dosage unit of Makatussin cough drops contains less than 1 mmol of sodium (23 mg), making it virtually “sodium-free.” The drops also contain 300 mg of propylene glycol and 286 mg of sorbitol solution 70% per 20 drops. Sorbitol is a source of fructose. If you have fructose intolerance or hereditary fructose intolerance (HFI), consult your doctor before using this medicine.

Use During Pregnancy and Breastfeeding

Makatussin cough drops are contraindicated during pregnancy and should not be taken by pregnant individuals. Additionally, breastfeeding women should avoid codeine, as it can potentially harm the baby by passing into breast milk.

How to Use Makatussin Cough Drops

The recommended usage of Makatussin cough drops for adults and adolescents over 12 years of age is 15 to 20 drops, taken 3 to 4 times daily. The maximum recommended dosage at once is 30 drops. It is essential to ensure a minimum time interval of 4 hours between two doses. The drops can be taken undiluted with a spoon, with a little water, or mixed with tea. They can be taken regardless of meals.

It is important to hold the drip tube vertically when counting the drops and to press the drip tube lightly. Approximately 1 gram of the drip solution corresponds to 20 drops.

In cases where patients have severely impaired kidney function, liver disease, or a hereditary change in the metabolism occurring in the liver, the time interval between two doses may need to be extended. Your healthcare provider will make this determination.

If your cough persists for 5 to 7 days after starting treatment or worsens significantly, it is crucial not to increase your intake of Makatussin cough drops independently. Instead, consult a doctor to identify the cause of the cough and explore specialized treatment options if necessary. Always adhere to the recommended dosage as indicated in the package leaflet or as prescribed by your healthcare provider. If you believe the medicine is either too weak or too strong, consult with your doctor or pharmacist.

Possible Side Effects of Makatussin Cough Drops

Like many medications, Makatussin cough drops can have potential side effects. These side effects can vary in frequency, and it is essential to be aware of them:

1.        Common Side Effects (Affecting 1 to 10 Users in 100): Common side effects may include constipation, gastrointestinal problems, fatigue, and headaches.

2.        Uncommon Side Effects (Affecting 1 to 10 Users in 1,000): Uncommon side effects can occur when higher doses are taken and may include visual disturbances (blurred vision, squinting), a drop in blood pressure (black eyes, dizziness), and breathing difficulties (slowing and shallowing of breathing).

3.        Rare Side Effects (Affecting 1 to 10 Users in 10,000): Rare side effects may involve listlessness, mood swings, sleep disorders, ringing in the ears, bronchial cramps, dry mouth, and, in very rare cases, hypersensitivity reactions (allergies), sleep disorders, or euphoria. Allergic reactions may manifest through itching, reddening of the skin, sweating, palpitations, malaise, and, in individual cases, fainting. If you experience sudden shortness of breath or hypersensitivity reactions, discontinue the use of the medicine immediately and seek medical attention.

It is worth noting that codeine can lead to dependence and mild withdrawal symptoms, which should be considered when using this medication.

Side Effects When Using Other Medicines Concurrently

The concomitant use of other medicines that act on the central nervous system, such as Makatussin cough drops, can intensify the tiredness and respiratory depression caused by codeine. This includes specific medications used for sleep disorders, agitation, depression, and certain allergy medications. It is essential to consult with your doctor or pharmacist to understand potential interactions and how to manage them.

Additional Considerations

It is imperative to keep Makatussin cough drops out of the reach of children, as taking the entire content of an undamaged dropper bottle or dropper tube at once can result in severe side effects, including respiratory paralysis, which can be life-threatening, especially in young children. Furthermore, Makatussin cough drops should only be used until the marked “EXP” date on the packaging.

Storage Instructions

To maintain the efficacy and safety of Makatussin cough drops, it is recommended to store them at room temperature, specifically between 15°C and 25°C, and protect them from exposure to light.


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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