Top 300 Pharmacy Drug Cards

HYDROCODONE/CHLORPHENIRAMINE SYRUP: Tussionex, Various

Class: Antitussive, Opioid/Antihistamine Combination Product. C-III

Dosage Forms. Syrup: (Hydrocodone/Chlorpheniramine) 10 mg/5 mL-8 mg/5 mL

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Common FDA Label Indication, Dosing, and Titration.

1. Cough, due to minor throat and bronchial irritation: Adults and Children 12 y and older: 5 mL (hydrocodone 10-20 mg/guaifenesin 100-200 mg) po q12h prn; not to exceed 10 mL/24 h; Children 6-12 y old: 2.5 mL po q12h prn; not to exceed 5 mL/24 h

Off-Label Uses. None

MOA. Hydrocodone bitartrate is an opioid analgesic and antitussive with unknown mechanism of action, but it is thought to be related to the presence of opiate receptors in the central nervous system. Works as an antitussive through suppression of the cough reflex by directly affecting the cough center in the medulla. Chlorpheniramine specifically blocks the H1 receptor, which inhibits the action of histamine.

Drug Characteristics: Hydrocodone/Chlorpheniramine

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Medication Safety Issues: Hydrocodone/Chlorpheniramine

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Drug Interactions: Hydrocodone/Chlorpheniramine

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Adverse Reactions: Hydrocodone/Chlorpheniramine

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Efficacy Monitoring Parameters. Relief from cough.

Toxicity Monitoring Parameters. Seek medical attention if severe skin rash, excessive drowsiness, or decreased breathing.

Key Patient Counseling Points. If using chronically, use a stool softener and/or laxative for preventing constipation. May cause drowsiness; avoid driving or other tasks requiring motor coordination. Avoid alcohol.

Clinical Pearls. Use caution in elderly, appear more sensitive to the effects. Use of CNS depressants with caution, may have additive effects. Tolerance and physical dependence may occur with chronic use, avoid abrupt discontinuation.