Hydrocodone, Diphenhydramine, Phenylephrine

Drug Class: Hydrocodone, Diphenhydramine, Phenylephrine > Hydrocodone > Semi Synthetic Opioid > Opioids > Opioid Agonist > Analgesic.

Uses

You can use drugs containing hydrocodone, diphenhydramine and phenylephrine to relieve symptoms associated with the common cold, allergies and upper respiratory infections. Doctors prescribe combination hydrocodone, diphenhydramine and phenylephrine drugs, known as polydrugs, to reduce coughing, sneezing, runny or congested nose and itchy, watery eyes. This medication will not cure your condition or shorten its duration but it will make you feel better. Use this medication so you can sleep, go to work or attend school without annoying symptoms.

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Administration/Dosage

Hydrocodone, diphenhydramine and phenylephrine polydrugs are available in liquid and syrup formulas.

Brand name preparations include Endal HD, Tussinate, Hydro-DP, Rindal HPD, Gestuss-HC, Dytan-HC and D-Tann HC.

Preparations contain various strengths of each medication, ranging from 2 mg to 3.5 mg of hydrocodone, 12 mg to 25 mg of diphenhydramine and 5 mg to 7.5 mg of phenylephrine per 5 ml dose. The typical prescription for adults calls for 10 ml orally every 4 to 6 hours, not to exceed 40 ml daily, except for preparations containing 3.5 mg hydrocodone, 25 mg diphenhydramine and 7.5 mg phenylephrine in every 5ml, which physicians normally prescribed at 5 ml to 10 ml every 12 hours.

Children over the age of 12 years may take adult doses under the guidance of a pediatrician. Dosages for children between the ages of 6 and 12 vary. Consult with your pediatrician to learn how much hydrocodone, diphenhydramine and phenylephrine to give to your child.

People over the age of 60 are more likely to experience side effects associated with hydrocodone, diphenhydramine and phenylephrine. Physicians should observe older patients closely, especially during initial doses until tolerance is established.

Your doctor may suggest you take hydrocodone, diphenhydramine and phenylephrine on a regular schedule to provide uninterrupted symptom relief. If you miss a dose, take the missed dose as soon as you can. If it is nearly time for your next dose, skip the missed dose and resume your normal schedule. Never double up in an attempt to catch up on missed doses. Talk with the prescribing physician if you have trouble taking your medicine on time.

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Action

Hydrocodone is an antitussive, or cough suppressant. Hydrocodone acts directly on your medulla, the part of your brain responsible for the cough reflex. Diphenhydramine is an antihistamine that relieves watery eyes and runny nose. It works by reducing histamines, naturally occurring substances that cause fluid to leak from blood vessels and result in the symptoms commonly associated with hay fever and allergies. Phenylephrine is a decongestant. It works by constricting blood vessels inside the lining of the nasal passages, allowing more room in your nose for air to flow.

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Precautions

Do not take hydrocodone, diphenhydramine and phenylephrine polydrugs if you are allergic to any active or inactive ingredient in the preparation or if you are allergic to another opioid, such as codeine or morphine. An allergic reaction is a serious medical event that can deteriorate rapidly into a life-or-death emergency. Discontinue use and seek medical help immediately at first onset of any symptom of an allergic reaction, including hives, difficulty breathing, swelling of the face, lips and tongue or closing of the throat.

Anaphylaxis is a serious form of allergic reaction. Without medical intervention, you could die within 15 minutes of contact with the allergen. Discontinue hydrocodone, diphenhydramine and phenylephrine and go to the hospital immediately at the first symptom of an anaphylactic response to a medication; call for an ambulance if it is faster than driving to the hospital. Approximately 82,000 cases of anaphylaxis occur each year in the United States. People with asthma are at greater risk for anaphylaxis than are persons without this chronic breathing problem.

Symptoms of a moderate or severe reaction include:

  • Abdominal Pain
  • Chest Discomfort or Tightness.
  • Difficulty Breathing or Wheezing.
  • Difficulty Swallowing.
  • Dizziness or Light-Headedness.
  • Fear or Feeling of Apprehension or Anxiety.
  • Flushing or Redness of the Face.
  • Nausea, Vomiting or Diarrhea.
  • Palpitations.
  • Stomach Cramps.
  • Swelling of the Face, Eyes or Tongue.
  • Unconsciousness.
  • Weakness.

The prescribing physician may alter your dose of hydrocodone, diphenhydramine and phenylephrine or select a different medication if you have a history of certain medical conditions. This medication may worsen your condition or hamper treatment for that disease. Alternately, your condition may change the way your body deals with hydrocodone, diphenhydramine and phenylephrine polydrugs.

Tell your physician about any significant illnesses or conditions, including:

  • A Head Injury.
  • Addison's Disease.
  • Asthma.
  • Bladder Problems or Difficulty Urinating.
  • Diabetes.
  • Enlarged Prostate.
  • Epilepsy or Another Seizure Disorder.
  • Gallbladder Disease.
  • Glaucoma.
  • Heart Disease.
  • High Blood Pressure.
  • Irregular Heartbeats.
  • Kidney Problems.
  • Liver Problems.
  • Sleep Apnea.
  • Thyroid Problems.
  • Ulcer or an Obstruction in the Stomach.

Hydrocodone, diphenhydramine and phenylephrine polydrugs can make you dizzy or drowsy or impair decision-making. Consuming alcohol or taking some medications, including antidepressants, sedatives and pain relievers, may enhance this effect. Do not stand up quickly, especially if you are an older person. Sit at the edge of the bed with your feet on the floor for a moment before rising to reduce dizziness in the morning. Sit or lie down immediately if you feel dizzy or lightheaded.

The hydrocodone in this preparation may be habit forming, especially when taken in high doses or for a long time. Lower your risk for developing a drug habit by taking this medication exactly as prescribed and discontinuing use when recommended by a physician.

This medication may cause dry eyes and blurred vision. Contact wearers may experience some eye discomfort. Use lubricating drops to reduce dry eyes. Consult with your eye doctor if your discomfort is severe or does not go away on its own.

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Warnings

Hydrocodone, diphenhydramine and phenylephrine preparations are a pregnancy category C, which means medical research has not yet determined if taking this medication during pregnancy will harm the fetus. Tell the prescribing doctor if you are pregnant or plan to become pregnant while taking this drug. Notify your healthcare provider immediately if you become pregnant while using hydrocodone, diphenhydramine and phenylephrine to discuss the benefits of using this product versus the possible risks to your unborn child. Children born to women taking hydrocodone during pregnancy may experience withdrawal symptoms after delivery. It is not known if hydrocodone, diphenhydramine and phenylephrine passes into breast milk and onto a nursing baby; do not breastfeed your child while taking this medication.

Sudden cessation may cause withdrawal symptoms, especially if you have been taking high doses or using this product for several weeks. To avoid withdrawal symptoms, slowly reduce the amount of hydrocodone, diphenhydramine and phenylephrine you take and use the polydrug less frequently.

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Drug Interactions

Hydrocodone, diphenhydramine and phenylephrine may interact with other medications in dangerous or adverse ways. Give the prescribing physician and pharmacist filling your prescription a list of all your medications. Include your prescriptions, over-the-counter drugs, herbal remedies and vitamin supplements. Do not start, stop or change the way you take any medication while using hydrocodone, diphenhydramine and phenylephrine.

  • Barbiturates such as Phenobarbital
  • Digoxin
  • Furazolidone
  • Heart Medicines such as Atenolol, Propranolol
  • Linezolid
  • Mecamylamine
  • Medicines for Depression, Anxiety, or Psychotic Disturbances
  • Medicines for Sleep During Surgery
  • Medicines for Urinary Problems
  • Methyldopa
  • Opioid Pain Medicines
  • Other Medicines for Cold, Cough or Allergy
  • Procarbazine
  • Reserpine
  • Ritonavir
  • St. John's Wort

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Side effects

Patients have reported side effects while using hydrocodone, diphenhydramine and phenylephrine. Rarely, these side effects can be serious. Immediately discontinue use and contact a doctor if you experience serious side effects such as confusion, hallucinations or unusual behavior.

Most common side effects are not serious and disappear on their own. Continue using hydrocodone, diphenhydramine and phenylephrine products but notify your physician if these common side effects become intolerable or do not go away on their own.

Common side effects include:

  • Blurred Vision.
  • Constipation.
  • Decreased Appetite.
  • Decreased Urination.
  • Dizziness, Drowsiness, or Sleepiness.
  • Dry Mouth.
  • Increased Sensitivity to Sunlight.
  • Itching.
  • Muscle Twitches.
  • Nausea, Vomiting.
  • Restlessness or Irritability.
  • Sweating.

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Overdose

The Centers for Disease Control and Prevention, or CDC, reports three times as many people died from prescription drug overdose in 2008 than did in 1990. Now more people die from prescription drug overdose than from cocaine and heroin combined. This skyrocketing rate of prescription drug overdoses parallels the record-setting rate at which doctors are prescribing opioids to control a patient's pain or other symptoms.

If you think that you or someone you know has taken an overdose, contact poison control center at 1-800-222-1222 or go to the emergency room. Overdose symptoms include:

  • Cold, Clammy Skin.
  • Difficulty or Decreased Breathing.
  • Dry Mouth.
  • Flushing.
  • Headache.
  • Nausea or Vomiting.
  • Seizures.
  • Severe Drowsiness or Dizziness.
  • Unconsciousness.

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Abuse

To abuse a drug means to use it for non-medical purposes, either by using a prescription drug without a prescription to reduce symptoms or to use these drugs to get high. Prescription drug abuse is a growing problem in the United States. Drug abusers no longer prefer illegal drugs like cocaine and heroin but now favor using prescription drugs to get high. According to the Centers for Disease Control and Prevention, or CDC, more than 12 million Americans admit to using narcotics for non-medical purposes in 2010. Two million of these people reported using the drugs non-medically for the first time that year. Almost all drug overdose deaths in the United States were from drugs originally legally obtained with a prescription. About 55 percent of people who abuse prescription drugs such as hydrocodone got the drugs free from a friend or relative, as compared to just over 4 percent of people who purchased opioids from a drug dealer. More than three out of four people who misuse prescription drugs abuse a medicine originally prescribed to another person. A minority of physicians prescribe the majority of opioids: approximately 20 percent of authorized prescribers write 80 percent of the prescriptions for painkillers.

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Withdrawal

Withdrawal symptoms are a normal, predictable outcome of using opioids and some other substances. When you discontinue medication on which your body has grown physically dependent to, your system struggles to stabilize its chemical balance and, as a result, you experience unpleasant withdrawal symptoms. Withdrawal symptoms are a physiological response to a medication and not necessarily an indication of criminal drug abuse. You might experience withdrawal symptoms upon discharge from a lengthy hospital stay in which doctors gave you strong medicine to control pain. Withdrawal symptoms can be overpowering, preventing you from discontinuing hydrocodone, diphenhydramine and phenylephrine without the help of qualified professionals. Consult with your doctor or a rehabilitation specialist if your withdrawal symptoms stop you from quitting this medication. Withdrawal symptoms include:

  • Dilated Pupils.
  • Fast Heartbeat.
  • Goose Bumps.
  • Irritability.
  • Loss of Appetite.
  • Muscle or Bone Pain
  • Restlessness.
  • Runny Nose.
  • Shakiness.
  • Sweating.

Detox

Dependence on opioids is a complex condition requiring an equally multifaceted treatment plan that addresses each aspect of drug dependence and detoxification. Standard drug rehabilitation includes administration of drugs to ease symptoms of withdrawal and medicines to detoxify the body from the effects of the narcotic. Methadone and buprenorphine are effective tools in rehabilitation from dependence on diacetylmorphine hydrochloride. One dose of methadone blocks the effects of diacetylmorphine hydrochloride for about 24 hours. After successful cessation of withdrawal symptoms and detoxification, you may choose to partake in counseling or other social services to enhance your chances of rehabilitation success. Rapid detox is a new, humane approach to detoxification. Along with the standard medications to reduce withdrawal and stabilize the body, compassionate and highly trained physicians administer sedatives and anesthetics. During this initial phase of treatment, you sleep lightly throughout withdrawal and detox. When you awaken, you will have no recollection of the unpleasant withdrawal symptoms. Rapid detox reduces recovery time two to four days, helping to your regular life quickly. Learn More About Hydrocodone, Diphenhydramine, Phenylephrine Detoxification Programs

Storage

Keep hydrocodone, diphenhydramine and phenylephrine preparations at room temperature, between 59 and 86 degrees Fahrenheit. Put this and all medications out of the reach of children and pets. Do not share this medication with others, even if their symptoms are similar to your own.

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