Hydrocodone, Phenylephrine

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

Uses

Doctors prescribe hydrocodone and phenylephrine preparations to treat symptoms associated with the common cold, sinus infections, the flu and bronchitis. This combination medication, known as a polydrug, relieves unpleasant symptoms such as cough and nasal congestion. Your doctor may prescribe this medication for uses other than those listed here. Learn More About Hydrocodone, Phenylephrine Uses

Administration/Dosage

Hydrocodone and phenlyephrinie polydrugs are available as capsules, tablets or in liquid form, all to be taken by mouth. Brand names of this preparation include Lortuss HC, Nalex-DH, Tusdec-HC Phenylephrine HD.

The usual adult prescription calls for one 5 ml dose of preparations containing 3.75 mg of hydrocodone and 7.5 mg of phenylephrine every four hours, not to exceed 30 ml in a 24-hour period, or one to two doses of preparations containing 2.5 mg of hydrocodone and 5 mg of phenylephrine in each 5 ml dose, not to exceed 60 ml in one day. Children aged 12 and older may take the adult dosage. Children aged six to twelve years may take 2.5 ml of polydrugs containing 3.75 mg of hydrocodone and 7.5 mg of phenylephrine every four hours, not to exceed 15 ml in a day, or one 5 ml doses of preparations containing 2.5 mg of hydrocodone and 5 mg of phenylephrine in each 5 ml dose, not to exceed 30 ml daily.

Take the tablet and capsule forms of this medication with a full glass of water. Use a special dose-measuring spoon or cup to administer the liquid form of hydrocodone and phenylephrine preparations, not a household tablespoon. Your pharmacist can help you get an approved measuring devices to ensure adequate and safe dosing.

Ask the prescribing physician if you are supposed to take this medication on a schedule or only when needed to relieve symptoms. If your doctor suggests you adhere to a strict schedule and you miss a dose, take the skipped dose as soon as possible. If it is nearly time to take your medicine again, skip the missed dose and resume the established schedule. Never take more than the prescribed dose in an effort to catch up.

Contact the prescribing physician if the prescribed dose does not provide adequate coverage for your symptoms or if it stops working for you. Decreasing efficacy could indicate a growing tolerance to opioids. Your healthcare provider may adjust the dosages or switch medications.

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Action

Hydrocodone is a narcotic cough suppressant. It works by working directly on the part of the brain responsible for the cough reflex; it depresses your desire to cough out mucus and foreign bodies from your lungs. In animal studies, researchers noted the cough-suppressing action of codeine takes effect about 15 minutes after oral administration, with peak effectiveness observed 45 minutes to an hour after ingestion. The cough-suppression action wears off after about three hours. Phenylephrine is a decongestant that acts by constricting the blood vessels in the tissue lining your nasal passages, opening up the airways in your nose.

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Precautions

Do not take this polydrug if you are allergic to hydrocodone, phenylephrine or any inactive ingredient contained in the preparation. Do not take this medication if you are allergic to other opioids, such as morphine or oxycodone. You can experience an allergic reaction to a medication even if you have had it before. Seek emergency medical help when you first notice symptoms of an allergic reaction; a person's condition can deteriorate rapidly and without warning. An allergic reaction is a serious, potentially lethal, medical crisis. Symptoms of an allergic reaction include hives, difficulty breathing or swelling of the face, lips, tongue or throat.

Some medical conditions may prevent you from taking this medication. Conversely, this drug may worsen these conditions or interfere with treatment for those illnesses. Additionally, your medical condition may change the way this medication works for you.

Tell the prescribing physician and pharmacist if you have a history of or are currently diagnosed with any significant illnesses or conditions, including:

  • A Head Injury.
  • Addison's Disease.
  • An Enlarged Prostate.
  • Asthma.
  • Bladder Problems or Difficulty Urinating.
  • Diabetes.
  • Epilepsy or Another Seizure Disorder.
  • Glaucoma.
  • High Blood Pressure, Irregular Heartbeats or Any Type of Heart Disease.
  • Kidney Problems.
  • Liver Problems.
  • Sleep Apnea.
  • Thyroid Problems.

This polydrug frequently causes drowsiness, dizziness or impaired thinking. Do not operate automobiles, use dangerous machinery or participate in risky behavior until you know how well your body tolerates this medication. Other substances may increase this effect, including other cold and allergy medications, pain medications, anti-depressants, sedatives and muscle relaxants. Your healthcare provider and druggist can assist you in choosing medications that interact safely together.

Hydrocodone is habit-forming. Tell your doctor or consult with a rehabilitation specialist if you find yourself habitually using this or any other medication.

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Warnings

Do not use hydrocodone and phenylephrine polydrugs if you have asthma or other lung diseases. Opioids such as hydrocodone may cause respiratory depression, which means airflow is too inadequate to allow for the proper exchange of oxygen and carbon dioxide. Symptoms of respiratory depression include slow and shallow breathing, or breathing that stops.

Researchers are still working to determine if taking this drug during pregnancy will harm an unborn child. Hydrocodone passes into breast milk and onto your nursing child. Do not take this medication while breastfeeding your baby. Notify the practitioner if you are pregnant or plan to become pregnant while using this drug. Call your doctor immediately if you become pregnant while using this medication.

Do not suddenly stop taking this medication unless a doctor instructs you to do so. Abrupt cessation may cause uncomfortable, flu-like withdrawal symptoms, especially if you have been using high doses or taking this medication for a long time. If you feel ill when you do not take this medication, you may have developed a physical dependence to this medication. Try weaning yourself from hydrocodone by taking successively smaller doses increasingly further apart. Talk with a healthcare professional or seek out a rehabilitation specialist if withdrawal symptoms prevent you from quitting this medication as directed.

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Drug Interactions

The prescribing physician may alter the dosage of hydrocodone and phenylephrine or switch you to a different medication if you are already taking certain drugs to treat other conditions. This polydrug could interact with other substances in dangerous or unhealthy ways. Give the prescribing physician and druggist a complete list of all your medications, including prescriptions, over-the-counter preparations and herbal remedies. Do not start or stop any medication, including over-the-counter and herbal remedies, without consulting your physician.

Hydrocodone and phenylephrine may increase drowsiness associated with other substances such as alcohol, antidepressants, muscle relaxants, seizure medications, pain relievers and anti-anxiety drugs.

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Side effects

Some patients have reported non-serious side effects while taking hydrocodone and phenylephrine preparations. Rarely, serious or life-threatening side effects do occur. Contact the prescribing physician if the common side effects become unbearable or if they do not disappear by themselves

Common side effects include:

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

Rarely, side effects are serious, even life threatening. Contact your doctor or local emergency room if you experience serious side effects. Serious side effects include allergic reaction, confusion, hallucinations and unusual behavior.

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Overdose

The Centers for Disease Control and Prevention, or CDC, reports deaths from drug overdose has tripled since 1990 with an increasing number of people dying from prescription drug overdose rather than from overdose of illicit drugs. In 2008, more people died from overdoses of prescription opioids than from cocaine and heroin combined. Whether from prescription medication or from illegal drugs, drug overdose is a serious medical emergency that may deteriorate rapidly into a life-or-death crisis. If you suspect you or someone you know has taken an overdose of this or any other substance, contact the poison control center at 1-800-222-1222 or go to the emergency room immediately. Overdose symptoms include:

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

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Abuse

A person abuses drugs by taking larger doses than prescribed or by taking a drug without a prescription to get high. According to the Drug Enforcement Administration, or DEA, hydrocodone is the most frequently prescribed opioid in the United States, with more than 139 million prescriptions written for polydrugs containing hydrocodone in 2010. Illicit users redirect hydrocodone from its intended use to recreational use in a process called diversion. Abusers acquire drugs through bogus prescriptions, doctor shopping, buying drugs on the street or by stealing them from friends, family members and strangers and divert the drug to illegal use. The DEA further notes that hydrocodone is the second most-widely diverted prescription drug. Opioids including hydrocodone are a favorite among abusers because of the way it gets users high.

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Withdrawal

You may develop physically or mentally dependence on hydrocodone, especially if you take large doses or for a long time. Physical dependence means your body needs that drug to feel normal; you suffer unpleasant, flu-like symptoms if you stop taking the substance. Withdrawal symptoms do not necessarily indicate criminal drug abuse - patients who take large doses of prescription opioids to treat severe pain may develop drug dependence while in the hospital, only to experience withdrawal symptoms after discharge from care. Unless a patient make the cognitive connection between his symptoms and taking opioids, he may think he has caught the flu and suffer through withdrawal alone. Withdrawal symptoms vary between people. One individual may be able to quit taking this drug on his own, while intense withdrawal symptoms may prevent another from quitting without the help of rehabilitation specialists. Tell your doctor if your withdrawal symptoms prevent you from quitting this drug. Medical professionals agree that dependence and withdrawal symptoms as predictable, normal physiological responses to opioid use.

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Detox

Drug detoxification and rehabilitation is a collective of therapies, each focusing on a different facet of drug dependence. Drug detoxification, commonly known as detox, cleanses hydrocodone or other opioids from your body, decreases unpleasant withdrawal symptoms, restores chemical balance and addresses the physiological effects of drug dependence. Rehabilitation programs frequently add counseling and other social services to help you work through other factors that may have added to, worsened or been the result of your dependence on drugs. Withdrawal symptoms can be overwhelming and the most terrible withdrawal symptoms can incapacitate even the strongest and most disciplined person for several days. Rapid detox programs are emerging that promise a safe, effective and humane alternative to standard detoxification. During rapid detox, doctors administer sedatives and anesthesia along with the standard detoxification and stabilization drugs so the patient sleeps through the procedure. When the patient awakens, they have no recollection of the unpleasant withdrawal symptoms.

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Storage

Store hydrocodone and phenylephrine preparations at room temperature, away from excessive heat, moisture and light. Put this polydrug out of the reach of children and pets. Do not allow adults to use this medication on purpose or by accident. Do not share hydrocodone and phenylephrine prescription medications with other people, even if they complain of symptoms similar to your own. Monitor the quantity of this medication, accounting for all doses. Hydrocodone is a favorite among recreational drug users. To enhance your personal safety and to reduce theft, do not tell anyone but trusted caretakers that you have this opioid in your home. Ask your pharmacist how to dispose of this medication once you are finished with it.

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