Hydrocodone, Chlorpheniramine, Phenylephrine and Pyrilamine

Drug Class: Hydrocodone, Chlorpheniramine, Phenylephrine And Pyrilamine > Hydrocodone, Chlorpheniramine, Phenylephrine > Hydrocodone > Semi Synthetic Opioid > Opioids > Opioid Agonist > Analgesic.

Uses

Doctors prescribe hydrocodone, chlorpheniramine, phenylephrine, and pyrilamine combination products to relieve symptoms associated with allergies, upper respiratory infections, and the common cold. This product treats cough, sneezing, a stuffy or runny nose, and itchy, watery eyes.

General Drug Information

Hydrocodone, chlorpheniramine, phenylephrine, and pyrilamine work in different ways to provide complete relief from cold and allergy symptoms.

Hydrocodone is a semi-synthetic pain reliever, sometimes called a narcotic analgesic. Drug makers create hydrocodone from extracts of the opium poppy plant. Scientists classify hydrocodone as an opioid drug; it works like other opioids to relieve pain and soothe a cough.

Hydrocodone is the most widely prescribed drug in the United States, with pharmacists filling more than 139 million prescriptions for products containing hydrocodone in 2010. While most people use hydrocodone products as directed, nearly 10 percent of Americans use hydrocodone for non-medical reasons either to get high or to treat a condition other than the one the doctor had intended to treat.

Administration/Dosage

Drug makers usually offer hydrocodone, chlorpheniramine, phenylephrine, and pyrilamine products in syrup form for oral administration. To avoid stomach upset, consumers can take this product after a meal or snack.

Patients should take this product as described and dispose of any unused doses then they no longer need this drug to control symptoms. Consumers should stop using this drug as soon as possible to avoid becoming physically dependent on hydrocodone.

This product may not be suitable for children or for elderly patients. Physicians should monitor these patients closely for signs of breathing problems, especially at the beginning of treatment and after dosage increases.

Pediatricians recommend using an approved medical measuring devices when giving liquid medications to children. Never exceed recommended doses for children.

Action

Chlorpheniramine and phenylephrine are decongestants. They make it easier to breathe by shrinking the blood vessels inside the linings of nasal passages to allow more room for air to flow through the nose.

Pyrilamine is an antihistamine that works by reducing the level of histamines that cause small blood vessels to dilate and allow fluids to seep from blood vessels into surrounding tissues. Histamine release and the resulting fluid leakage cause symptoms such as watery eyes and runny nose. Histamines also indirectly stimulate the production of thick, sticky mucus.

Hydrocodone works like other opioids to suppress a cough by depressing the hypothalamus, which is the breathing center in the brain. Hydrocodone makes the brain apathetic about the need to cough. Large doses of hydrocodone can make the brain unaware of the need to clear fluid and dangerous debris from the lungs and windpipe.

Hydrocodone and other opioids affect the central nervous system, or CNS, in other ways. Strong doses of hydrocodone relieve pain by interacting with the CNS to change the way the brain interprets pain signals. Hydrocodone causes other neurological reactions, including relaxation, sedation, and euphoria that makes hydrocodone a prime target for recreational drug abusers.

With continuous use, as with drug abuse, some of the neurological changes become more permanent and begin to alter how the individual thinks, feels, and behaves. In time, these alterations have a profoundly negative effect on the individual’s life, interfering with his ability to work, take care of children or other responsibilities, and interact with others.

Warnings

Hydrocodone can be habit-forming. It is possible to develop physical dependence on hydrocodone resulting in uncomfortable withdrawal symptoms upon sudden cessation. Patients should not stop using hydrocodone, chlorpheniramine, phenylephrine, and pyrilamine products abruptly; anyone who uses hydrocodone regularly for more than a few weeks should wean himself from this drug by taking smaller doses each day.

This product may cause respiratory depression, a dangerous and sometimes fatal breathing problem, especially in children and the elderly. Patients with a history of respiratory depression or other serious breathing problems should use hydrocodone, chlorpheniramine, phenylephrine, and pyrilamine products with care.

Precautions

Products containing hydrocodone, chlorpheniramine, phenylephrine, and pyrilamine may cause dizziness, drowsiness, or impaired decision-making; consuming alcohol or other drugs along with this product can enhance these effects.

Contraindications

Someone allergic to hydrocodone, chlorpheniramine, phenylephrine, or pyrilamine should not use products containing these ingredients. Symptoms of a mild allergic reaction include hives, especially over the face and neck, nasal congestion, itching, rashes and watery, red eyes.

Anaphylaxis is a very grave, potentially fatal form of an allergic reaction that usually occurs within minutes of exposure to the drug. Without medical help, a person can die from anaphylaxis within 15 minutes of contact. Symptoms of anaphylaxis can include tightness or discomfort in the chest, difficulty breathing, wheezing, trouble swallowing, irregular heartbeat, feeling dizzy, lightheaded or an overwhelming feeling of impending doom.

Products containing hydrocodone, chlorpheniramine, phenylephrine, and pyrilamine may not be appropriate for all patients. This combination product may worsen some pre-existing illnesses; some conditions may change the way this product works. Patients with the following medical conditions should exercise caution when using hydrocodone, chlorpheniramine, phenylephrine, and pyrilamine products:

  • Allergies
  • Asthma
  • Depression
  • Diabetes
  • Emphysema
  • Glaucoma
  • Heart disease
  • High blood pressure
  • History of drug dependency
  • Kidney problems
  • Lung disease
  • Overactive thyroid
  • Prostate trouble

Pregnancy, Labor and Delivery, Breastfeeding

Scientists have not yet determined how hydrocodone, chlorpheniramine, phenylephrine, and pyrilamine might affect the reproductive capabilities of men or women. Researchers have not yet established how hydrocodone, chlorpheniramine, phenylephrine, and pyrilamine preparations may affect a pregnant woman or fetus. Pregnant women should not take hydrocodone, chlorpheniramine, phenylephrine, and pyrilamine products unless the benefits to the mother clearly outweigh the potential risk to the unborn baby.

A baby born to a woman who takes hydrocodone during pregnancy may suffer withdrawal symptoms and other dangerous complications during the first weeks or months of life; death may occur.

Hydrocodone, chlorpheniramine, phenylephrine, and pyrilamine may pass into breast milk and onto a nursing baby. Mothers should not use this product while breastfeeding.

Drug Interactions

Hydrocodone, chlorpheniramine, phenylephrine, and pyrilamine products can interact with other medications in unsafe or unwanted ways. Patients should supply a list of all prescription and non-prescription drugs to their doctors to avoid dangerous drug interactions.

Hydrocodone, chlorpheniramine, phenylephrine, and pyrilamine combination products are not appropriate for patients who have taken an MAO inhibitor within 14 days. Taking this medication while MAO inhibitors are still present in the body may result in a dangerous drug interaction or even death. Furazolidone, sodium oxybate and some antidepressants may increase side effects associated hydrocodone, chlorpheniramine and phenylephrine polydrugs. Hydrocodone, brompheniramine and guaifenesin increase the side effects associated with the class of drugs known as hydratoins, especially phenytoin.

This product may interact with the following drugs in unsafe or undesirable ways:

  • Antidepressants
  • Aspirin or salicylates
  • Beta-blockers
  • Bladder or urinary medications
  • Blood pressure medication
  • Cimetidine, known as the brand name drug Tagamet
  • Diuretics, sometimes known as “water pills”
  • Irritable bowel syndrome medications
  • Medicines to treat psychiatric disorder
  • Rifampin
  • Seizure drugs
  • Zidovudine

Side effects

All drugs can cause unwanted effects. Most side effects are not serious and disappear with regular product use. Patients should consult with the prescribing physician about minor side effects that do not go away or grow worse.

Common side effects include:

  • A feeling of warmth or tingling, or redness under the skin
  • Blurry vision
  • Constipation
  • Dizziness or drowsiness
  • Dry mouth
  • Insomnia
  • Itching
  • Nausea or upset stomach
  • Problems with memory or concentration
  • Ringing in the ears
  • Skin rash
  • Vomiting

Some side effects are serious and can even cause fatal adverse reactions. Anyone experiencing serious side effects should discontinue hydrocodone, chlorpheniramine, phenylephrine, and pyrilamine combination products and contact a doctor immediately.

Serious side effects include:

  • Anxiety, restlessness, nervousness
  • Clay-colored stools
  • Confusion, hallucinations
  • Dangerously high blood pressure
  • Dark urine
  • Easy bruising or bleeding
  • Fast, slow, pounding, or uneven heartbeats
  • Fever, chills, body aches, flu symptoms
  • Lightheadedness
  • Loss of appetite
  • Severe dizziness
  • Severe itching
  • Shallow breathing
  • Unusual thoughts or behavior
  • Unusual weakness
  • Upper abdominal pain
  • Urinating less than usual or not at all
  • Yellowing of the skin or eyes

Overdose

Overdose from prescription drugs like hydrocodone, chlorpheniramine, phenylephrine, and pyrilamine claim the lives of 15,000 people in the United States each year. The number of these overdose deaths have been rising steadily over the past decade, with 2008 seeing more than triple the number of overdose deaths than 1999.

Anyone suffering from a possible overdose must receive immediate professional treatment. Bystanders should transport the victim to the nearest emergency department or contact poison control center at 1-800-222-1222. Possible victims should not wait for symptoms to appear before seeking help.

Overdose symptoms include:

  • Abdominal pain
  • Cold, clammy skin
  • Confusion
  • Extreme drowsiness
  • Fainting
  • Feelings of warmth or tingling
  • Pinpoint pupils
  • Restlessness or nervousness
  • Seizure
  • Shallow or stopped breathing
  • Vomiting
  • Weak pulse

Abuse

Hydrocodone is the most frequently prescribed opioid in the United States. The U.S. Drug Enforcement Agency associates hydrocodone with more drug abuse than any other legal or illegal opioids, in part because it is so readily available.

Abuse increases the risk someone will become physically dependent on hydrocodone and suffer withdrawal symptoms when he stops using this product.

Withdrawal

When an opioid-dependent person stops using hydrocodone abruptly, he suffers uncomfortable, flu-like withdrawal symptoms. These symptoms usually appear in two phases, with the first set of symptoms beginning a few hours after the last dose of hydrocodone.

Initially, the patient might feel:

  • Agitation
  • Anxiety
  • Muscle aches
  • Increased tearing
  • Insomnia
  • Runny nose
  • Sweating
  • Yawning

Later, the individual might experience:

  • Abdominal cramping
  • Diarrhea
  • Dilated pupils
  • Goose bumps
  • Nausea
  • Vomiting

Left uninterrupted, withdrawal symptoms fade as the body completes the detoxification process. Withdrawal symptoms do not return unless the individual relapses to an opioid-dependent state.

Someone can take non-opioid drugs to reduce withdrawal symptoms, such as Imodium for diarrhea and ibuprofen for body aches. These drugs will not disrupt the detoxification process.

A person can stop withdrawal symptoms completely by taking more hydrocodone, but this halts the detoxification process and returns the individual to a drug-dependent state.

Chlorpheniramine, phenylephrine, and pyrilamine do not cause dependence resulting in withdrawal symptoms but these substances may complicate detoxification in a way that worsens discomfort.

Detoxification

The Institute of Addiction Medicine estimates there are about 2 million Americans dependent on hydrocodone and other opioids. Each of these individuals must participate in some form of detoxification to reach an opioid-free state.

The detoxification process involves lowering hydrocodone levels and reducing the resulting withdrawal symptoms. Detoxification can occur at home, with the help of an outpatient clinic, in a hospital, or in a special detoxification facility. Medical detoxification usually includes medical grade drugs to quickly drop opioid levels and effectively reduce withdrawal symptoms.

Rapid detox is the most humane and efficient approach to hydrocodone detoxification. During rapid detox, anesthesiologists sedate and anesthetize the patient before giving him the usual detoxification and anti-withdrawal drugs. The rapid detox patient rests in a comfortable “twilight sleep” through the detoxification process, unaware of the uncomfortable and demoralizing withdrawal symptoms. The patient awakens a few hours later, renewed and refreshed.

Chlorpheniramine, phenylephrine, and pyrilamine do not cause dependence requiring detoxification but these drugs may cause complications during detoxification. Physicians should screen patients who may have accumulated high levels of these compounds during drug abuse episodes to determine if they caused any long-lasting effects that may complicate recovery.

Storage

Keep hydrocodone, chlorpheniramine, phenylephrine, and pyrilamine at room temperature between 59 and 86 degrees Fahrenheit. Store this medication away from excessive heat and humidity.

Put this medicine and all drugs out of the reach of children and pets. Do not allow adults to take this product by accident or on purpose. Keep track of the amount of medicine in the bottle so you know if someone has been taking your medicine. Hydrocodone is a favorite among drug abusers who frequently divert drugs like this from its intended use as a prescription medicine to use as a recreational drug.