Alcohol: Cosme P Duo Syrup should be used with caution in patients with kidney disease. Dose adjustment of Cosme P Duo Syrup may be needed. Please consult your doctor.Use of Cosme P Duo Syrup is not recommended in children with severe kidney disease. Pregnancy: Cosme P Duo Syrup is safe to use in patients with liver disease. No dose adjustment of Cosme P Duo Syrup is recommended.Regular monitoring of the liver by getting liver function tests (LFT) is recommended if your child is taking Cosme P Duo Syrup for a long time.