chlorpheniramine/hydrocodone (Rx)

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Brand and Other Names:TussiCaps, Tussionex PennKinetic, more...Vituz

Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

chlorpheniramine/hydrocodone

capsule extended release: Schedule II

  • 4mg/5mg (TussiCaps Half Strength)
  • 8mg/10mg (TussiCaps Full Strength)

oral suspension extended release: Schedule II

  • (8mg/10mg)/5mL (Tussionex Pennkinetic)

oral solution: Schedule II

  • (4mg/5mg)/5mL (Vituz)
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Cough/Rhinorrhea

Capsule ER: 1 capsule PO q12hr; not to exceed 2 capsules/day

Solution: 5 mL PO q4-6hr PRN; not to exceed 20 mL/day

Suspension ER: 5 mL PO q12hr; not to exceed 10mL/day

Dosage Forms & Strengths

chlorpheniramine/hydrocodone

capsule extended release: Schedule II

  • 4mg/5mg (TussiCaps Half Strength)
  • 8mg/10mg (TuissiCaps Full Strength)

suspension: Schedule II

  • (8mg/10mg)/5mL (Tussionex Pennkinetic)
more...

Cough/Rhinorrhea

Capsules ER half strength

  • 6-12 years: 1 capsule PO q12hr; not to exceed 2 capsules/24hr

Capsules ER full strength

  • >12 years: 1 capsule PO q12hr; not to exceed 2 capsules/24hr

Oral suspension

  • 6-12 years: 2.5 mL PO q12hr; not to exceed 5 mL/day
  • >12 years: 5 mL PO q12hr; not to exceed 10 mL/day

Oral solution

  • <18 years: Safety and efficacy not established
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Interactions

Interaction Checker

and chlorpheniramine/hydrocodone

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     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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            Adverse Effects

            Frequency Not Defined

            Chest tightness

            Syncope

            Agitation

            Coma

            Depression

            Dizziness

            Dysphoria

            Euphoria

            Faintness

            Mental clouding

            Nervousness

            Restlessness

            Sedation

            Seizures

            Flushing

            Pruritus

            Sweating

            Urticaria

            Warmness of the face/neck/upper thorax

            Constipation

            Dry mouth

            Nausea

            Vomiting

            Respiratory/circulatory depression

            Shock

            Urinary retention

            Blurred vision

            Visual disturbances

            Diplopia

            Xerostomia

            Dysuria

            Ureteral spasm

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            Warnings

            Contraindications

            Hypersensitivity to opioids or chlorpheniramine

            Use of extended release in children < 6 years

            Cautions

            Ingredients and dosage could change; ALWAYS check label

            Use with caution in acute pancreatitis, Addison disease, cardiac arrhythmias, drug abuse/dependence, emotional lability, gallbladder disease, pseudomembranous colitis, GI surgery, head injury, myxedema, intracranial HTN, toxic psychosis, urethral stricture, seizures, acute alcoholism, emphysema, narrow angle glaucoma, asthma, prostatic hypertrophy, hypercapnia, renal/hepatic impairment, elderly debilitated patients

            Respiratory depressant effects of narcotics and capacity to elevate cerebrospinal fluid pressure may be markedly exaggerated in presence of head injury, other intracranial lesions, or a pre-existing increase in intracranial pressure; narcotics produce adverse reactions, which may obscure clinical course of patients with head injuries

            Administration of narcotics may obscure the diagnosis or clinical course of patients with acute abdominal conditions

            Use with caution extended-release suspension in elderly or debilitated patients and those with severe impairment of hepatic or renal function, hypothyroidism, Addison's disease, prostatic hypertrophy, or urethral stricture for possibility of respiratory depression

            MAO inhibitors or tricyclic antidepressants with hydrocodone preparations may increase the effect of either the antidepressant or hydrocodone

            May cause dose-related respiratory depression (risk increased in children)

            May impair ability to operate heavy machinery

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            Pregnancy & Lactation

            Pregnancy category: C; D if used for a prolonged period of time or in large doses near term; withdrawal symptoms or respiratory depression may be seen in babies born to mothers taking opioids

            Lactation: Excretion in milk unknown/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

            Chlorpheniramine: Histamine-1 receptor antagonist on effector cells in blood vessels, gastrointestinal tract, and respiratory tract

            Hydrocodone: Opioid agonist; elicits antitussive effect; suppresses cough in medullary center; alters perception and response to pain; produces generalized CNS depression

            Absorption

            Peak plasma time

            • Chlorpheniramine: 6.3 hr
            • Hydrocodone: 4-8 hr

            Peak plasma concentration

            • Chlorpheniramine: 58.4 ng/mL
            • Hydrocodone: 22.8 ng/mL

            Peak plasma time

            • Hydrocodone: 1-2 hr (solution); 3 hr (capsules)
            • Chlorpheniramine: 2-3 hr

            Distribution

            • Chlorpheniramine: 4-7 L/kg (children); 6-12 L/kg (adults)

            Protein binding

            • Chlorpheniramine: 33%

            Elimination

            Half-life

            • Chlorpheniramine: 10-13 hr (children); 14-24 hr (adults)
            • Hydrocodone: 4-5 hr

            Excretion

            • Hydrocodone: Urine
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            Images

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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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