Monoamine Oxidase Inhibitors: Dihydrocodeine, like all opioids, interact with monoamine oxidase
inhibitors causing central nervous system excitation and hypertension. MAO inhibitors and
beta-adrenergic blockers increase the effects of sympathomimetics. They may also prolong and
intensify the anticholinergic effects of antihistamines.

Information for Patient/Caregivers:
Patients receiving CENTUSSIN DHC Liquid should be given the following information:
1. Patients should be advised that CENTUSSIN DHC Liquid may impair the mental or physical
abilities required for the performance of potentialy hazardous tasks such as driving a car or
operating machinery.
2. Patients should be advised to report adverse experiences occurring during therapy.
3. Patients should be advised not to adjust the dose of CENTUSSIN DHC Liquid without
consulting the prescribing professional.
4. Patients should not combine CENTUSSIN DHC Liquid with alcohol or other central nervous
system stimulants.
5. Women of childbearing potential who become, or are planning to become pregnant should be
advised to consult their physician regarding the effects of opioids and other drug use during
pregnancy on themselves and their unborn child.
Patients should be advised that CENTUSSIN DHC Liquid is a potential drug of abuse. They should
protect it from theft, and it should never be given to anyone other than the individual for whom it
was prescribed.

Pregnancy: Teratogenic Effects - Pregnancy Category C:
Animal reproduction studies have not been conducted with CENTUSSIN DHC Liquid. It is also not
known whether this combination product can cause fetal harm when administered to pregnant
women or can affect reproduction capactiy in males and females. This combination product should
be given to pregnant women only if clearly needed, especially during the first trimester.

Nonteratogenic Effects: Babies born to mothers who have been taking opioids regularly prior to
delivery will be physically dependent. The withdrawal signs include irritability and excessive crying,
tremors, hyperactive reflexes, increased respiratory rate, increased stools, sneezing, yawning,
vomiting and fever. The intensity of the syndrome does not always correlate with the duration of
maternal opioid use or dose. There is no consensus on the best method of managing withdrawal.
Chlorpromazine 0.7-1.0 mg/kg q6h, phenobarbital 2 mg/kg q6h, and paregoric 24 drops/kg q4h,
have been used to treat withdrawal symptoms in infants. The duration of therapy is 4 to 28 days,
with the dosages decreased as tolerated.

Labor and Delivery:
CENTUSSIN DHC Liquid is not recommended for use by women during and immediately before
labor and delivery because oral opioids may cause respiratory depression in the newborn.

Pediatric Use:
This product is not recommended for use in children under 6 years of age. Children under two years
may be more susceptible to the respirator