chlorpheniramine and hydrocodone

Tussionex is a combination of an antihistamine that blocks allergic reactions and reduces the production of mucus (chlorpheniramine), and a narcotic that relieves pain and cough (hydrocodone). Tussionex is a liquid that slowly releases the chlorpheniramine and hydrocodone after it is ingested.

What brand names are available for chlorpheniramine and hydrocodone?

Tussionex, TussiCaps, Tussionex Pennkinetic, Vituz

Is chlorpheniramine and hydrocodone available as a generic drug?

Yes

Do I need a prescription for chlorpheniramine and hydrocodone?

Yes

The most frequent side effects of chlorpheniramine and hydrocodone include:

• lightheadedness,
• dizziness,
• sedation,
• nausea,
• vomiting,
• disturbed coordination, and
• drying and thickening of oral and other respiratory secretions.

Other important side effects include:

• dyspepsia (indigestion),
• constipation,
• spasm of the ureter (which can lead to difficulty urinating),
• palpitations,
• increased heart rate,
• confusion,
• drowsiness,
• anxiety,
• nervousness,
• irritability,
• blurred vision,
• double vision, and
• tremor.

Hydrocodone can depress breathing, and should be used with caution in elderly, debilitated patients, and in patients with serious lung disease. Hydrocodone can impair thinking and the physical abilities required for driving or operating machinery. Hydrocodone may be habit forming. Mental and physical dependence can occur but are unlikely when used for short-term relief of pain.

The usual dose is 2.5 ml (1/2 teaspoon) to 5 ml (1 teaspoonful) twice daily. The suspension should be shaken prior to each use.

Chlorpheniramine (although not generally sedating itself) and hydrocodone both add to the sedating effects of alcohol and other drugs that can cause sedation such as the benzodiazepine class of anti-anxiety drugs (for example, diazepam [Valium], lorazepam [Ativan], clonazepam [Klonopin], alprazolam [Xanax]); the narcotic class of pain medications and its derivatives (for example, oxycodone and acetaminophen [Percocet], hydrocodone/acetaminophen [Vicodin], Dilaudid, codeine, propoxyphene [Darvon]); the tricyclic class of antidepressants (for example, amitriptyline [Elavil, Endep], imipramine [Tofranil], desipramine [Norpramin]); the antipsychotic class of drugs (for example, thioridazine (Mellaril), triflupromazine (Stelazine)]; and certain antihypertensive medications (for example, clonidine [Catapres], propranolol [Inderal]).

Chlorpheniramine also can intensify the drying effects (due to decreased production of mucus) of other medications with anticholinergic properties (for example, dicyclomine [Bentyl], bethanechol [Urecholine], Probanthine).

Antihistamines are typically not recommended for use in pregnancy, especially during the third trimester, because of a risk of seizures in the fetus. The risk for depressed breathing in the newborn infant when the mother ingests hydrocodone is greatest in premature infants who are particularly sensitive to the effects of hydrocodone. Physicians may decide to prescribe chlorpheniramine and hydrocodone during pregnancy if the benefits to the mother are deemed to outweigh the risks to the fetus and newborn.

Chlorpheniramine and hydrocodone both are secreted in breast milk. Owing to the risk in infants of antihistamines causing hyperexcitability and even seizures, particularly in newborns and premature infants, the combination of chlorpheniramine and hydrocodone is not recommended for use in nursing mothers.

What preparations of chlorpheniramine and hydrocodone are available?

Liquid suspension. Each teaspoonful (5 ml) contains chlorpheniramine, 8 mg and hydrocodone, 10 mg.

How should I keep chlorpheniramine and hydrocodone stored?

The suspension should be stored at room temperature, between 15-30 C (59-86 F).