Dosing & Uses
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)
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)
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
Interactions
Interaction Checker
No Results
Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor
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
Warnings
Black Box Warnings
Concomitant use of opioids with benzodiazepine or other central nervous system (CNS) depressants, including alcohol, may result in profound sedation, respiratory depression, coma, and death; avoid use of opioid cough medications in patients taking benzodiazepines, other CNS depressants, or alcohol
Advise both patients and caregivers about risks of respiratory depression and sedation if therapy is administered with benzodiazepines, alcohol, or other CNS depressants
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
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.
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
Images
Patient Handout
Formulary
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.
