hydrocodone/homatropine (Rx)

Brand and Other Names:Tussigon
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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

hydrocodone/homatropine

tablet: Schedule II

  • 5mg/1.5mg

oral solution: Schedule II

  • (5mg/1.5mg)/5mL
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Cough

5 mg/1.5 mg (1 tablet) PO q4-6hr

Not to exceed 30 mg/9 mg (6 tablets) in 24 hr

Dosage Forms & Strengths

hydrocodone/homatropine

tablet: Schedule II

  • 5mg/1.5mg

oral solution: Schedule II

  • (5mg/1.5mg)/5mL
more...

Cough

<6 years: Safety and efficacy not established

6-12 years: 2.5 mg/0.75 mg (1/2 tablet) PO q4-6hr, up to 15 mg/4.5 mg (3 tablets) in 24 hr

>12 years: 5 mg/1.5 mg (1 tablet) PO q4-6hr, up to 30 mg/9 mg (6 tablets) 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

Homatropine

  • Edema
  • Vascular congestion
  • Exudate
  • Eczematoid dermatitis
  • Increased IOP
  • Follicular conjunctivitis
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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

Homatropine

  • Sensitivity to homatropine, primary glaucoma or a predisposition to glaucoma

Cautions

Hydrocodone

  • Autonomic neuropathy, brain damage in children, cardiac arrhythmias, chronic lung disease, Down Syndrome, drug abuse/dependence, emotional liability, gallbladder disease, head injury, hepatic impairment, hypertension, hyperthyroidism, increased intracranial pressure, renal impairment, seizures with epilepsy, spastic paralysis in children, toxemia of pregnancy, urethral stricture, urinary tract surgery, xerostomia

Homatropine

  • Discontinue the drug if signs or symptoms of sensitivity occur during treatment or if irritation persists or increases
  • Use with extreme caution in infants and young children because of increased susceptibility to systemic effects
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Pregnancy & Lactation

Pregnancy category: C

Lactation: undetermined; 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

Mechanism of Action

Hydrocodone: Antitussive; narcotic agonist analgesic

Homatropine: Anticholinergic agent adjunct to hydrocodone bitartrate added in subtherapeutic amount to suppress deliberate overdosage

Pharmacokinetics

Hydrocodone

  • Half-life: 3.3-4.4 hr
  • Duration of action: 4-8 hr
  • Peak plasma time: 1.3 hr
  • Metabolism: liver (O-demethylation, N-demethylation, 6-keto reduction); hepatic P450 enzyme CYP2D6
  • Excretion: Urine (mainly)

Homatropine

  • Duration of action: 6 hr
  • Excretion: Urine
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Administration

Oral Administration

Administer liquid with special measuring device for accurate dose

Administer with food if GI upset occurs

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Formulary

FormularyPatient Discounts

Adding plans allows you to compare formulary status to other drugs in the same class.

To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

Adding plans allows you to:

  • View the formulary and any restrictions for each plan.
  • Manage and view all your plans together – even plans in different states.
  • Compare formulary status to other drugs in the same class.
  • Access your plan list on any device – mobile or desktop.

The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

Tier Description
1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
NC NOT COVERED – Drugs that are not covered by the plan.
Code Definition
PA Prior Authorization
Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
QL Quantity Limits
Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
ST Step Therapy
Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
OR Other Restrictions
Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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