hydrocodone/chlorpheniramine/pseudoephedrine (Rx)Brand and Other Names:Zutripro

 
 
 

Dosing & Uses

AdultPediatricGeriatric

Dosage Forms & Strengths

hydrocodone/chlorpheniramine/pseudoephedrine

oral solution: Schedule II

  • (5mg/4mg/60mg)/5mL
more...

Cough/Cold/Allergies

Indicated for relief of cough and nasal congestion associated with common cold or allergies in adults

5 mL PO q4-6hr PRN; not to exceed 4 doses (20 mL) in 24 hr

Renal & Hepatic Impairment

Severe renal or hepatic Impairment: Use with caution

Safety and efficacy not established

Caution advised because of greater potential for renal or hepatic impairment

Consider decreasing dose and/or frequency

Next

Interactions

Interaction Checker

hydrocodone/chlorpheniramine/pseudoephedrine and

No Results

     
     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

            Sort by :  
             activity indicator 
            Previous
            Next

            Adverse Effects

            Frequency Not Defined

            Hydrocodone, an opioid, may result in respiratory depression, drug dependence, increased ICP, decreased mental alertness, or paralytic ileus

            Pseudoephedrine, a sympathomimetic, may result in CNS effects (eg, insomnia, dizziness, weakness, tremor, convulsions or cardiovascular effects (eg, arrhythmias, increased blood pressure)

            Chlorpheniramine, an antihistamine, may result in decreased mental alertness or anticholinergic effects (urinary retention, ileus)

            Common adverse effects include sedation, somnolence, mental clouding, lethargy, impairment of mental and physical performance, anxiety, fear, dysphoria, dizziness, psychic dependence, mood changes, nervousness, or sleeplessness; blurred, double, or other visual disturbances; confusion, headache, euphoria, facial dyskinesia, feeling faint, lightheadedness, agitation, restlessness, insomnia, irritability, and tremor

            Previous
            Next

            Warnings

            Contraindications

            Hypersensitivity

            Coadministration with MAOIs or within 14 ays of discontinuing MAOIs; may increase risk of hypertensive crisis

            Narrow angle glaucoma

            Urinary retention

            Severe hypertension or severe coronary artery disease

            Cautions

            May cause dose-related respiratory depression; use with caution

            Hydrocodone can cause drug dependence; prescribe with caution that is appropriate to the use of other opioids

            Avoid use in patients with head injury or elevated ICP; opioids decrease respiratory depression and may increase ICP

            May cause drowsiness; avoid engaging in hazardous tasks requiring complete mental alertness such as driving or operating machinery

            Elicits CNS depressant effects; avoid concurrent use of alcohol or other central nervous system depressants

            Use with caution with acute abdominal conditions; opioids may obscure diagnosis and anticholinergics may increase risk of paralytic ileus

            Coexisting conditions: Use with caution with diabetes, thyroid disease, Addison’s disease, prostatic hypertrophy or urethral stricture, or asthma

            Use with TCAs may increase effects of hydrocodone or TCAs

            Pseudoephedrine component may increase risk for hypertension

            Previous
            Next

            Pregnancy & Lactation

            Pregnancy Category: C

            Lactation: Hydrocodone, chlorpheniramine, and pseudoephedrine are distributed in breast milk; caution advised, chlorpheniramine may suppress lactation is used prior to nursing

            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.

            more...
            Previous
            Next

            Pharmacology

            Mechanism of Action

            Hydrocodone: Antitussive; narcotic agonist analgesic

            Chlorpheniramine: Antihistamine; histamine H1-receptor antagonist; also elicits anticholinergic effects

            Pseudoephedrine: Decongestant; alpha adrenergic agonist

            Absorption

            Peak Plasma Time

            • Hydrocodone: 1.4 hr
            • Chlorpheniramine: 2-3 hr
            • Pseudoephedrine: 1.97 hr

            Peak Plasma Concentration

            • Hydrocodone: 10.6 ng/mL
            • Chlorpheniramine: 7.2 ng/mL
            • Pseudoephedrine: 212 ng/mL

            Distribution (Vd)

            • Chlorpheniramine: 4-7 L/kg (children); 6-12 L/kg (adults)
            • Pseudoephedrine: 2.5 L/kg (children); 2.64-3.51 L/kg

            Metabolism

            Hydrocodone: Metabolized to hydromorphone via CYP2D6

            Chlorpheniramine: GI mucosa, liver

            Pseudoephedrine: Liver, by N-demethylation

            Elimination

            Excretion

            • Hydrocodone: Urine (26%)
            • Chlorpheniramine: Urine
            • Pseudoephedrine: Urine (43-96%)

            Half-life

            • Hydrocodone: 3.3-4.4 hr
            • Chlorpheniramine: 10-13 hr (children); 14-24 hr (adults)
            • Pseudoephedrine: 3 hr (children); 9-16 hr (adults)

            Pharmacogenomics

            Hydrocodone is metabolized to hydromorphone via CYP2D6; CYP2D6 poor metabolizers may not achieve adequate analgesia

            Ultra-rapid metabolizers (up to 7% of Caucasians and up to 30% of Asian and African populations) may have increased toxicity due to rapid conversion

            Previous
            Next

            Images

            Previous
            Next

            Formulary

            FormularyPatient Discounts

            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.
            Add or Remove Plans
            Plans for
            Select State:
            Non-Medicare PlansMedicare Plans

            Select a box to add or remove a plan.

            Select a class to view formulary status for similar drugs

            Additional Offers
            Email to Patient

            From:

            To:

            The recipient will receive more details and instructions to access this offer.

            By clicking send, you acknowledge that you have permission to email the recipient with this information.

            Email Forms to Patient

            From:

            To:

            The recipient will receive more details and instructions to access this offer.

            By clicking send, you acknowledge that you have permission to email the recipient with this information.

            Previous
             
             
             
            All material on this website is protected by copyright, Copyright © 1994-2016 by WebMD LLC. This website also contains material copyrighted by 3rd parties.