Hydrocodone, Guaifenesin, Phenylephrine

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


Physicians prescribe hydrocodone, guaifenesin and phenylephrine to relieve symptoms associated with the common cold, allergies or upper respiratory infections caused by bacteria or viruses. This product eases coughing and congestion. Use hydrocodone, guaifenesin and phenylephrine combination drugs, known as polydrugs, so you can sleep, go to work or school without suffering from annoying symptoms. Hydrocodone, guaifenesin and phenylephrine do not cure or shorten the duration of your illness; this product just makes you feel better. Learn More About Hydrocodone, Guaifenesin, Phenylephrine Uses


Hydrocodone, guaifenesin and phenylephrine is available as a liquid, syrup or elixir. Pharmacologists combine medicine with sugar and water to produce syrups. An elixir contains medicine and alcohol. This medication is available under the brand names, Ambi 5/15/100 and Levall 5.0.

Hydrocodone, guaifenesin and phenylephrine are available in a variety of strengths. Strengths range from 2.5 mg to 4 mg of hydrocodone, 100 mg to 225 mg of guaifenesin and 5 mg to 10 mg of phenylephrine in every 5 ml dose. The typical prescription for adults and children age 12 and older is 10 ml by mouth every four to six hours, not to exceed four to six doses in a 24-hour period. The only exception is the prescription for the preparation containing 4 mg of hydrocodone, 100 mg of guaifenesin and 10 mg phenylephrine in every 5 ml of oral liquid, in which the prescription usually calls for 5 ml by mouth every 4 to 6 hours, not to exceed six doses daily.

Follow your pediatrician's recommendations closely when administering hydrocodone, guaifenesin and phenylephrine preparations to your child. Misuse of cough and cold remedies has resulted in the deaths of small children.

For best results, take hydrocodone, guaifenesin and phenylephrine on a regular schedule rather than only when you need it to control symptoms. Take any missed doses as soon as possible. Do not take extra doses in an effort to make up for missed doses.

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Hydrocodone works on your medulla, the part of your brain responsible for issuing the cough reflex. This opioid makes your brain not care about coughing. In animal studies, the cough-suppressing action of codeine takes effect about 15 minutes after oral administration, reaching peak effectiveness 45 minutes to an hour after ingestion. Cough-suppression wears off after about three hours.

Guaifenesin is an expectorant, which means it thins and loosens mucus, making secretions easier to cough out of your lungs. Guaifenesin facilitates breathing. Phenylephrine is a decongestant. It works by reducing blood vessels deep inside the lining in your nasal passages to reduce nasal congestion.

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An allergic reaction to a drug is a serious, potentially lethal, medical emergency. If you have a reaction to hydrocodone, guaifenesin and phenylephrine, stop taking it immediately and contact your doctor. Symptoms of an allergic reaction include hives, difficulty breathing and swelling of the face, lips or tongue.

Anaphylaxis is a serious form of allergic reaction. A person can die within 15 minutes of contact with the allergen. Stop taking hydrocodone, guaifenesin and phenylephrine and go to the hospital immediately if you suspect you are having 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 respiratory 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.

Do not use hydrocodone, guaifenesin and phenylephrine polydrugs if you have very high blood pressure, rapid heartbeat or other heart problems, such as heart blood vessel disease.

You may not be able to take hydrocodone, guaifenesin and phenylephrine preparations if you have history of certain illnesses. Give your doctor a complete medical history, including all serious current and past ailments. The prescribing physician may alter your dosage or suggest a different medication to ease your symptoms.

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

  • A Recent Abdominal Surgery.
  • Abnormal Heartbeat.
  • Adrenal Gland Problems.
  • Alcohol or Substance Abuse.
  • Asthma.
  • Bowel Problems.
  • Brain Tumor.
  • Diabetes.
  • Enlarged Prostate.
  • Gallbladder Problems.
  • Glaucoma.
  • Head Injury.
  • Heart Blood Vessel Problems.
  • Heart Problems.
  • High Blood Pressure.
  • Increased Intracranial Pressure.
  • Infection in the Brain or Nervous System.
  • Lung or Breathing Problems.
  • Overactive Thyroid.
  • Prostate Problems.
  • Seizures.
  • Stomach Problems.
  • Stroke.
  • Thoughts of Suicide or Suicidal Behavior.

Hydrocodone, guaifenesin and phenylephrine polydrugs can make you feel dizzy or drowsy. Do not operate a motor vehicle or large machinery until you know how this medication affects you. Alcohol and some medications may enhance this effect.

Hydrocodone may be habit forming. Do not take higher doses than prescribed or use this medication more frequently than recommended to reduce your risk for developing a drug habit. Contact the prescribing physician if this medication stops working for you; this could be a sign that you are developing a tolerance to hydrocodone. Do not take extra medicine in an effort to relieve your symptoms.

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The FDA classifies hydrocodone, guaifenesin and phenylephrine as a pregnancy Category C, which means scientists have not yet established if taking this medication during pregnancy will cause harm to the unborn child. Tell the prescribing physician if you are pregnant or plan to become pregnant while taking hydrocodone, guaifenesin and phenylephrine polydrugs. Call your doctor immediately if you become pregnant while taking this medication. Some components of hydrocodone, guaifenesin and phenylephrine polydrugs pass into breast milk; do not breast-feed a baby while taking this drug.

You may experience flu-like symptoms if you stop taking this drug abruptly, especially if you have been taking high doses of hydrocodone, guaifenesin and phenylephrine or using this drug for a long time. To avoid unpleasant withdrawal symptoms, take successively smaller doses increasingly further apart. Talk with your doctor if withdrawal symptoms prevent you from quitting this drug.

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Drug Interactions

Do not take hydrocodone, guaifenesin and phenylephrine preparations if you have taken an MAO inhibitor within the previous 14 days. Taking this medication while an MAO inhibitor is still in your system may cause an unsafe, potentially fatal, drug interaction. Do not take hydrocodone, guaifenesin and phenylephrine polydrugs if you are taking sodium oxybate, otherwise known as GHB.

Some drugs may interact in unsafe or dangerous ways with hydrocodone, guaifenesin and phenylephrine polydrugs. Naltrexone may reduce the effectiveness of hydrocodone, guaifenesin and phenylephrine polydrugs. Beta-blockers such as propranolol may increase the risk for side effects associated with hydrocodone, guaifenesin and phenylephrine polydrugs, as can COMT inhibitors, furazolidone, indomethacin, MAO inhibitors or tricyclic antidepressants. Cimetidine and GHB increase the risk for severe drowsiness, breathing problems and seizures. Digoxin and droxidopa increase the risk for irregular heartbeat or heart attack. Hydrocodone, guaifenesin and phenylephrine polydrugs raise the chances you will experience side effects associated with bromocriptine. This medication may reduce the effectiveness of guanadrel, guanethidine, mecamylamine, methyldopa or reserpine.

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Side effects

Patients have reported side effects associated with hydrocodone, guaifenesin and phenylephrine use. Most of commonly reported side effects are not serious and go away on their own. Notify the prescribing doctor if your common side effects become severe or do not go away.

Common side effects include:

  • Dizziness.
  • Drowsiness.
  • Excitability, Especially in Children.
  • Feeling Nervous or Anxious.
  • Headache.
  • Insomnia.
  • Nausea.
  • Weakness.

Some side effects can be serious or even fatal. Discontinue use and contact your doctor or hospital if you experience serious side effects.

Serious side effects:

  • Fast or Irregular Heartbeat.
  • Hallucinations.
  • Seizure.
  • Severe Dizziness, Lightheadedness or Headache.
  • Severe Drowsiness.
  • Tremor.
  • Trouble Urinating.

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The Centers for Disease Control and Prevention, or CDC, reports rates for prescription drug overdose have reached epidemic proportions. Three times as many people died from prescription drug overdose in 2008 than did in 1990. More now 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 suspect that you or someone you know has taken an overdose of hydrocodone, guaifenesin and phenylephrine or any other drug, contact poison control center at 1-800-222-1222 or go to the emergency room. Overdose symptoms include:

  • Blurred Vision.
  • Confusion.
  • Hallucinations.
  • Seizure.
  • Severe Dizziness, Lightheadedness or Headache.
  • Severe Drowsiness.
  • Unusually Fast, Slow or Irregular Heartbeat.
  • Vomiting.

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To abuse a drug means to use it for non-medical purposes, either by using a prescription drug without a prescription to relieve a symptom or to use these drugs for recreational purposes. Drug abuse is a growing problem in the United States and the face of drug abuse is changing. Drug abusers no longer focus on illegal drugs like cocaine and heroin but, rather, prefer 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 used the drugs non-medically for the first time that year. Almost all prescription drug overdose deaths were 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 prescribed to someone else. Approximately 20 percent of authorized prescribers write 80 percent of the prescriptions for painkillers.

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Withdrawal symptoms are a normal, predictable physiological result of quitting a drug once you have become physically dependent on it. Your withdrawal symptoms may prevent you from quitting hydrocodone, guaifenesin and phenylephrine drugs. Withdrawal symptoms include:

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


Dependence on a drug is a complex condition requiring an equally complex treatment plan addressing each aspect of drug dependence and detoxification. Standard rehabilitation includes administration of drugs to ease symptoms of withdrawal and medicines to detoxify the body from the effects of the opioid. You may wish to participate in counseling or other social services to enhance your chances of rehabilitation success. Rapid detox is a new approach to detoxification. Along with the standard medications to reduce withdrawal and stabilize the body, physicians administer sedatives and anesthetics. You sleep lightly throughout withdrawal and detox. When you awaken, you will have no recollection of the unpleasant symptoms of withdrawal. Rapid detox reduces recovery time two to four days, speeding you back to your regular life. Learn More About Hydrocodone, Guaifenesin, Phenylephrine Detoxification Programs


Keep this medication at room temperature between 59 and 86 degrees Fahrenheit, away from excessive heat, moisture and light. Put out of the reach of children and pets. Do not allow adults to take this medication, either on purpose or by accident. Hydrocodone is a favorite among drug users for its euphoric effect; do not share this drug with people known to have abused alcohol or drugs in the past.

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