hydrocodone/chlorpheniramine/phenylephrine (Discontinued)Brand and Other Names:Histussin

 
 
 

Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

hydrocodone/chlorpheniramine/phenylephrine

oral liquid: Schedule III

  • (2.5mg/2mg/5mg)/5mL
  • (2.5mg/4mg/10mg)/5mL
  • (3.25mg/2.5mg/8mg)/5mL
  • (3.5mg/4mg/10mg)/5mL
  • (5mg/3mg/7.5mg)/5mL
  • (6mg/2mg/5mg)/5mL
  • (6mg/2mg/12mg)/5mL
  • (10mg/12mg/30mg)/5mL
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Cough with Congestion

Temporary relief of nasal congestion and cough associated with respiratory tract infections and related conditions

5-10 mL PO q4-6hr PRN, not to exceed maximum dosage limits

Recommended maximum dosage limits

  • Hydrocodone: 30 mg PO in 24 hr
  • Chlorpheniramine: 24 mg PO in 24 hr
  • Phenylephrine: 60 mg PO in 24 hr

Other Information

Administer with special measuring device for accurate dose

Administer with food if GI upset occurs

Use caution when dosing due to multiple strengths available

Dosage Forms & Strengths

hydrocodone/chlorpheniramine/phenylephrine

oral liquid: Schedule III

  • (2.5mg/2mg/5mg)/5mL
  • (2.5mg/4mg/10mg)/5mL
  • (3.25mg/2.5mg/8mg)/5mL
  • (3.5mg/4mg/10mg)/5mL
  • (5mg/3mg/7.5mg)/5mL
  • (6mg/2mg/5mg)/5mL
  • (6mg/2mg/12mg)/5mL
  • (10mg/12mg/30mg)/5mL
more...

Cough with Congestion

<6 years: safety and efficacy not established

6-12 years: 2.5-5 mL PO q4-6hr PRN, not to exceed maximum dosage limits

6-12 years: Recommended maximum dosage limits

  • Hydrocodone: 0.6 mg/kg PO, up to 20 mg in 24 hr 
  • Chlorpheniramine: 12 mg PO in 24 hr
  • Phenylephrine: 30mg PO in 24 hr
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Adverse Effects

Frequency Not Defined

Hydrocodone

  • Bradycardia, anticholinergic effects (dry mouth, palpitation, tachycardia)
  • Angina, arrhythmias, cardiac arrest, myocardial infarction, QT-interval prolongation, pectoris, syncope, severe cardiac ST segment elevation, ventricular tachycardia
  • Agitation, coma, dizziness, mental clouding/depression, dysphoria, euphoria, faintness, restlessness, nervousness, weakness, sedation, seizures, visual disturbances
  • Flushing, sweating, pruritus, urticaria, warmness of the face/neck/upper thorax
  • Constipation, nausea, vomiting
  • Urinary retention, oliguria
  • Respiratory/circulatory depression, respiratory arrest, shock, cardiac arrest

Chlorpheniramine

  • Anticholinergic side effects
  • Somnolence
  • Constipation, diarrhea, nausea, vomiting
  • Blurred vision

Phenylephrine

  • Hypertension, reflex bardycardia
  • Anxiety, headache
  • Extravasation
  • Burning, rebound congestion, sneezing
  • Pulmonary edema
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Warnings

Contraindications

Hydrocodone

  • Absolute: acute abdominal condition, diarrhea associated with toxins, paralytic ileus, pseudomembranous colitis, respiratory depression
  • Relative: asthma (acute), cardiac arrhythmia, cardiac disease, congestive heart failure, coronary artery DX, bladder outlet obstruction, GI tract obstruction, glaucoma (open & closed), hemorrhage, hiatal hernia, inflammatory bowel disease, intestinal atony, mitral valve stenosis, myasthenia gravis, obstructive uropathy, prostatic hypertrophy, reflux esophagitis, respiratory impairment, tachycardia, ulcerative colitis, urinary retention

Chlorpheniramine

  • Acute asthma, sleep apnea

Phenylephrine

  • Hypersensitivity to phenylephrine or sulfites; severe HTN, VTach, closed angle glaucoma
  • See Interactions below
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Pregnancy & Lactation

Pregnancy category: C

Lactation: hydrocodone, chlorpheniramine and phenylephrine excreted into breast milk; nursing not recommended

Pregnancy Categories

A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

NA:Information not available.

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Pharmacology

Hydrocodone

Half-life: 3.3-4.4 hr

Duration: 4-8 hr

Peak PlasmaTime: 1.3 hr

Metabolism: liver (O-demethylation, N-demethylation, 6-keto reduction); hepatic P450 enzyme CYP2D6

Excretion: urine (mainly)

Chlorpheniramine

Half-Life: 12-43 hr

Duration: 24 hr

Onset: 6 hr

Peak Plasma Time: 2-6 hr

Protein Bound: 69-72%

Vd: 2.5-3.2 L/kg

Metabolism: GI mucosa, liver

Metabolites: monodesmethylchlorpheniramine, didesmethylchlorpheniramine

Excretion: urine

Sedative effect: low

Antihistamine activity: moderate

Anticholinergic acitivity: moderate

Phenylephrine

Duration: 2-4 hr

Onset: 15-20 min

Metabolism: liver & intestine by MAO

Excretion: urine

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