Phlo po polsku7/7/2023 ![]() Pholcodine is slowly biotransformed in the body via oxidation and conjugation to a series of metabolites that are eliminated primarily in the urine. Its use is therefore contraindicated in patients with liver disease, while care is advised in patients with hepatic impairment. It is metabolized in the liver and its action may be prolonged in individuals with hepatic insufficiency (i.e. It acts primarily on the central nervous system (CNS), causing depression of the cough reflex, partly by a direct effect on the cough centre in the medulla. Pholcodine is readily absorbed from the gastrointestinal tract and freely crosses the blood–brain barrier. Pholcodine is not prescribed in the United States where it is classed as a Schedule I drug, the most highly controlled drug category. Pholcodine has been widely used as an antitussive agent but by 2023 concerns over its association with anaphylaxis in some circumstances meant that it has been withdrawn from sale in many territories. Pholcodine now largely replaces the previously more common codeine linctus, as it has a much lower potential for dependence. Adult dosage is 5-10 ml up to 3-4 times daily. Pholcodine is found in certain cough lozenges, and more commonly as an oral solution, typically 5 mg / 5 ml. It is also known as morpholinylethylmorphine and homocodeine. It helps suppress unproductive coughs and also has a mild sedative effect, but has little or no analgesic effects. Pholcodine is an opioid cough suppressant (antitussive).
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