Label: POLY-TUSSIN AC- brompheniramine maleate, codeine phosphate, phenylephrine hydrochloride liquid

  • NDC Code(s): 50991-723-15, 50991-723-16
  • Packager: Poly Pharmaceuticals, Inc.
  • Category: HUMAN OTC DRUG LABEL
  • DEA Schedule: CV
  • Marketing Status: unapproved drug other

DISCLAIMER: This drug has not been found by FDA to be safe and effective, and this labeling has not been approved by FDA. For further information about unapproved drugs, click here.

Drug Label Information

Updated January 27, 2024

If you are a consumer or patient please visit this version.

  • Active ingredients (in each 5 mL teaspoonful) 

    Brompheniramine Maleate 4 mg
    Codeine Phosphate 10 mg
    Phenylephrine Hydrochloride 10 mg

  • Purpose

    Antihistamine
    Antitussive
    Decongestant

  • Uses

    Temporarily relieves these symptoms due to the common cold, hay fever (allergic rhinitis) or other upper respiratory allergies:

    • runny nose
    • sneezing
    • itching of the nose or throat
    • itchy, water eyes
    • cough due to minor throat and bronchial irritation
    • nasal congestion
    • reduces swelling of the nasal passages
  • Warnings

    Do not exceed recommended dosage.

    Do not use this product

    • if you are now taking a prescription monoamine oxidase inhibitor (MAOI) (certain drugs for depression, psychiatric, or emotional conditions, or Parkinson's disease), or for 2 weeks after stopping

    Ask a doctor before use if you have

    • a breathing problem such as emphysema or chronic bronchitis

    • glaucoma

    • difficulty in urination due to the enlargement of the prostate gland

    • a cough that lasts or is chronic such as occurs with smoking, asthma or emphysema

    • a cough that occurs with too much phlegm

    • a chronic pulmonary disease or shortness of breath, or children who are taking other drugs

    • heart disease

    • high blood pressure

    • thyroid disease

    • diabetes

    Ask a doctor or pharmacist before use if you are

    taking sedatives or tranquilizers.

    When using this product

    • excitability may occur, especially in children
    • may cause marked drowsiness
    • avoid alcoholic drinks
    • may cause or aggravate constipation
    • alcohol, sedatives, and tranquilizers may increase drowsiness
    • be careful when driving a motor vehicle or operating machinery

    Stop use and ask a doctor if

    • nervousness, dizziness, or sleeplessness occur

    • cough or nasal congestion persists for more than 1 week, tends to recur, or is accompanied by a fever, rash or persistent headache.  These could be signs of a serious condition.

    • new symptoms occur

    If pregnant or breast-feeding,

    ask a health professional before use.

    Keep out of the reach of children.

    In case of overdose, get medical help or contact a Poison Control Center right away.

  • Directions

    Do not exceed recommended dosage.

    Adults and children over 12
    years of age:
    1 teaspoonful (5 mL) every 4 to 6 hours, not to exceed
    6 teaspoonfuls in a 24 hour period.
    Children 6 to under 12 years of age:

     1/2 teaspoonful (2.5 mL) every 4 to 6 hours, not to exceed
    3 teaspoonfuls in a 24 hour period.
    Children under 6 years of age:
     Not recommended for use.

  • Other information

    Store at 59° - 86°F(15° - 30°C)

  • Inactive ingredients

    Bubble gum flavor, citric acid, methylparaben, potassium citrate, potassium sorbate, propylparaben, propylene glycol, purified water, raspberry flavor, sorbitol, sucralose.

  • Questions? Comments?

    Serious side effects associated with use of this product may be reported to this number.  Call 1-800-882-1041
    Mon - Fri (8a.m. to 5 p.m. CST)

  • Product Packaging:

    Packaging below represents label currently used:

    Principal display panel and side panel for 473 mL label:

    NDC 50991-723-16

    POLY-TUSSIN AC LIQUID

    Antihistamine/Antitussive/Decongestant
    Alcohol Free/Dye Free

    NEW FORMULA
    Each 5 mL (1 teaspoonful) contains:
    Brompheniramine Maleate......................................4 mg
    Codeine Phosphate..............................................10 mg
    Phenylephrine HCl.............................................. 10 mg

    Raspberry-Bubble Gum Flavor

    CV

    Rx Only

    Distributed by:
    Poly Pharmaceuticals
    Huntsville, AL  35763


    16 fl oz. (473 mL)

    Tamper evident by foil seal under cap.  Do not use if foil seal is broken or missing.

    Dispense in a tight, light-resistant container with a child-resistant closure.

    This bottle is not to be dispensed to consumer.

    Principal display panel and side panel for 473 mL label: NDC 50991-723-16 POLY-TUSSIN AC LIQUID Antihistamine/Antitussive/Decongestant Alcohol Free/Dye Free NEW FORMULA Each 5 mL (1 teaspoonful) conta
  • INGREDIENTS AND APPEARANCE
    POLY-TUSSIN AC 
    brompheniramine maleate, codeine phosphate, phenylephrine hydrochloride liquid
    Product Information
    Product TypeHUMAN OTC DRUGItem Code (Source)NDC:50991-723
    Route of AdministrationORALDEA ScheduleCV    
    Active Ingredient/Active Moiety
    Ingredient NameBasis of StrengthStrength
    BROMPHENIRAMINE MALEATE (UNII: IXA7C9ZN03) (BROMPHENIRAMINE - UNII:H57G17P2FN) BROMPHENIRAMINE MALEATE4 mg  in 5 mL
    CODEINE PHOSPHATE (UNII: GSL05Y1MN6) (CODEINE ANHYDROUS - UNII:UX6OWY2V7J) CODEINE PHOSPHATE10 mg  in 5 mL
    PHENYLEPHRINE HYDROCHLORIDE (UNII: 04JA59TNSJ) (PHENYLEPHRINE - UNII:1WS297W6MV) PHENYLEPHRINE HYDROCHLORIDE10 mg  in 5 mL
    Inactive Ingredients
    Ingredient NameStrength
    CITRIC ACID MONOHYDRATE (UNII: 2968PHW8QP)  
    METHYLPARABEN (UNII: A2I8C7HI9T)  
    POTASSIUM CITRATE (UNII: EE90ONI6FF)  
    POTASSIUM SORBATE (UNII: 1VPU26JZZ4)  
    PROPYLPARABEN (UNII: Z8IX2SC1OH)  
    PROPYLENE GLYCOL (UNII: 6DC9Q167V3)  
    WATER (UNII: 059QF0KO0R)  
    SORBITOL (UNII: 506T60A25R)  
    SUCRALOSE (UNII: 96K6UQ3ZD4)  
    Product Characteristics
    Color    Score    
    ShapeSize
    FlavorRASPBERRY, BUBBLE GUMImprint Code
    Contains    
    Packaging
    #Item CodePackage DescriptionMarketing Start DateMarketing End Date
    1NDC:50991-723-1512 in 1 TRAY06/02/2014
    115 mL in 1 BOTTLE, PLASTIC; Type 0: Not a Combination Product
    2NDC:50991-723-16473 mL in 1 BOTTLE; Type 0: Not a Combination Product06/02/2014
    Marketing Information
    Marketing CategoryApplication Number or Monograph CitationMarketing Start DateMarketing End Date
    unapproved drug other06/02/2014
    Labeler - Poly Pharmaceuticals, Inc. (198449894)