Hydrocodone, Pseudoephedrine

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


Doctors prescribe hydrocodone and pseudoephedrine preparations to relieve symptoms associated with the common cold, flu or hay fever. Patients use this combination drug, known as a polydrug, to soothe cough and alleviate nasal congestion. This medication does not cure nor shorten the duration of your cold, flu or allergy but it will ease symptoms so you can sleep and continue with your normal activities.

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Hydrocodone and pseudoephedrine is available as an oral solution, syrup, tablet and suspension. Consult with the prescribing physician to determine which form is right for you.

Common brand names include ColdCough HCM, Detussin, HC Tussive D, Histussin D, Hytussin Iotussin D, P V Tussin, Pancof HC, Rezira, SymTan and Tuss-S.

One brand name, Rezira, contains 5 mg of hydrocodone and 60 mg of pseudoephedrine in every ml dose.

The typical dose for hydrocodone and pseudoephedrine preparations is one 5 ml tablespoon every four to six hours, not to exceed 20 ml in a 24-hour period. Ask your doctor or pharmacist to review your prescription instructions with you if you do not understand how to take this medicine.

Researchers have not yet established the safety and efficacy of hydrocodone and pseudoephedrine polydrugs in children. Misuse of cough and cold medications have resulted in death in very young children. Do not give this or any other cough suppressant without first consulting your child's pediatrician.

Patients over the age of 65 may experience a stronger reaction to hydrocodone and pseudoephedrine polydrugs. Physicians should start with lower initial doses and monitor older patients closely in the earliest stages of treatment.

Take hydrocodone and pseudoephedrine preparations with or without food. Take with food if this medication upsets your stomach.

Take hydrocodone and pseudoephedrine at regular intervals to provide complete symptom relief. If you miss a dose, take the missed dose as soon as possible. If it is nearly time to take another dose, skip the missed dose and resume your normal schedule. Never take more than one dose in an effort to make up for missed doses. Contact the prescribing physician if you have trouble maintaining your dosing schedule.

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Hydrocodone is a narcotic cough suppressant that acts directly on your medulla, the part of your brain responsible for the cough reflex. It makes your brain not care about the need to cough. Only use hydrocodone to suppress a dry cough; do not use hydrocodone if your cough produces mucus. Pseudoephedrine is a decongestant that works by constricting the blood vessels inside the lining of your nasal passages. This action allows more room for air to flow through your nose, making it easier to breathe.

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Do not take hydrocodone and pseudoephedrine if you are allergic to either chemical or are allergic to other opioids or derivatives, such as morphine or oxycodone. Hydrocodone and pseudoephedrine may contain inactive ingredients; check the label or consult with the pharmacist if you are allergic to common substances such as food coloring.

An allergic reaction is a serious medical emergency that could result in death. Discontinue use and contact your doctor immediately if you suffer an allergic reaction to hydrocodone and pseudoephedrine or any other medication. Symptoms of an allergic reaction include rash or hives, itching, difficulty breathing or tightness in the chest or swelling of the mouth, face, lips or tongue.

Anaphylaxis is a very serious form of an allergic reaction that usually occurs within minutes of contact with the allergen. Without medical help, death from anaphylaxis can occur within 15 minutes of exposure. In general, the faster the onset of symptoms, the worse the anaphylactic reaction will be. People with asthma are more likely to experience an anaphylaxis than are those without this breathing disorder. Symptoms of a severe reaction include stomach cramps or abdominal pain, chest discomfort or tightness, trouble breathing or wheezing or difficulty swallowing. Other symptoms include feeling dizzy or light-headed, fearful or feeling of apprehension or anxiety. Seek immediate help if you have flushing or redness of the face, nausea, vomiting or diarrhea. More symptoms include heart palpitations, swelling of the face, eyes or tongue, weakness or unconsciousness

Your healthcare provider may change your dosage or switch to a different medication if you are currently experiencing or have a history of certain medical conditions. Taking hydrocodone and pseudoephedrine may worsen your ailment or interfere with treatment. Alternately, your medical condition may change the way hydrocodone and pseudoephedrine works in your body.

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

  • Diabetes.
  • Diarrhea.
  • Drug Abuse.
  • Glaucoma.
  • Head Trauma.
  • Heart Disease.
  • High Blood Pressure.
  • Lung or Breathing Disease, such as Asthma.
  • Stomach or Intestinal Problems.
  • Trouble Passing Urine.

Hydrocodone and pseudoephedrine may make you dizzy or drowsy. It may also interfere with the way you make decisions. Avoid operating heavy machinery or motorized vehicles or engaging in hazardous activities until you know how hydrocodone and pseudoephedrine affects your system. Alcohol and some medications may enhance this effect.

Do not use alcohol while taking hydrocodone and pseudoephedrine. Alcohol could worsen side effects associated with hydrocodone and pseudoephedrine. Tell your doctor if you have a history of alcohol or other substance abuse.

Hydrocodone and pseudoephedrine may be habit forming. Stop taking hydrocodone and pseudoephedrine when advised to do so by a doctor. Tell the prescribing physician if the prescribed dose stops working for you - this could be a sign of developing tolerance that may lead to dependence. Do not take higher doses or use this drug more frequently than recommended.

Contact your doctor if your symptoms do not go away after five to seven days or if your symptoms get worse.

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Do not use hydrocodone and pseudoephedrine preparations if you have asthma or other lung diseases. This drug may cause respiratory depression, meaning airflow is too inadequate to allow for the proper exchange of oxygen and carbon dioxide. Symptoms of respiratory depression include slow and shallow breathing.

The FDA classifies hydrocodone and pseudoephedrine preparations as pregnancy Category C drugs, which means research has not yet determined how taking this polydrug during pregnancy affects the unborn baby. Hydrocodone does pass through into breast milk and onto a nursing baby. Do not breast-feed an infant while taking this drug.

Do not stop taking hydrocodone and pseudoephedrine suddenly unless directed to do so by a physician. Quitting this medication abruptly may cause unpleasant withdrawal symptoms. Wean yourself from this opioid by taking successively smaller doses increasingly further apart; this gently reduces the level of hydrocodone in your system.

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Drug Interactions

Hydrocodone and pseudoephedrine may interact with other drugs in unfavorable or dangerous ways. Give the prescribing physician and pharmacist filling the order a complete list of all your medications, including prescriptions, over-the-counter drugs, vitamins and herbal remedies. Do not stop, start or change the way you take any medication while you are taking hydrocodone and pseudoephedrine without first consulting with a doctor or druggist.

Naltrexone may reduce the effectiveness of hydrocodone and pseudoephedrine. Beta-blockers, COMT inhibitors, furazolidone, indomethacin and some types of antidepressants increase the risk for side effects associated with hydrocodone and pseudoephedrine. Cimetidine and sodium oxybate, commonly known as GHB, increase the risk for severe drowsiness, breathing problems and seizures. Digoxin and droxidopa may increase the risk for irregular heartbeat or heart attack when combined with hydrocodone and pseudoephedrine. Taking hydrocodone and pseudoephedrine may increase your risk for side effects associated with bromocriptine. Hydrocodone and pseudoephedrine polydrugs may reduce the effectiveness of drugs containing guanadrel, guanethidine, mecamylamine, methyldopa or reserpine.

Do not take hydrocodone and pseudoephedrine polydrugs if you have taken an MAO inhibitor such as Carbex, Eldepryl, Marplan, Nardil or Parnate in the previous 14 days. Hydrocodone and pseudoephedrine may cause dangerous side effects if an MAO inhibitor is still in your system.

Do not take appetite suppressants while taking hydrocodone and pseudoephedrine. Diet pills often contain pseudoephedrine; taking these medications together may result in unintentional overdose. Pseudoephedrine is a common ingredient in many over-the-counter medications; read the package of all medicines to find out if they contain pseudoephedrine. Consult with the pharmacist if you are uncertain.

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Side effects

Some consumers have reported side effects associated with hydrocodone and pseudoephedrine. Most common side effects are not serious and go away on their own. Contact the prescribing doctor if these common side effects become severe or if they do not disappear by themselves.

Common side effects include:

  • Constipation.
  • Dizziness.
  • Fatigue.
  • Headache.
  • Insomnia.
  • Nausea or Vomiting.
  • Upset Stomach.

Some side effects are serious, potentially life threatening. Immediately discontinue use and seek medical help if you experience serious side effects, such as:

  • Confusion, Excitability or Nervousness.
  • Falling Down.
  • Fast or Irregular Heartbeat.
  • Feeling Faint or Lightheaded.
  • Feeling Unusually Weak or Tired.
  • High or Low Blood Pressure.
  • Seizure.
  • Tremors.
  • Trouble Breathing.
  • Trouble Passing Urine or Change in the Amount of Urine.
  • Vision Changes.

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A drug overdose is a serious, potentially fatal, medical emergency. According to the CDC, there were almost 48,000 prescription painkiller overdose deaths in the United States in 2008. If you or someone you know has taken an overdose of hydrocodone and pseudoephedrine or any other drug, immediately contact poison control center at 1-800-222-1222 or go to the emergency room. Overdose symptoms include:

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

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Hydrocodone is a favorite among drug abusers because of the way it gets people high. Prescription drug abuse is now an epidemic in the United States, 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 these drugs non-medically for the first time that year, which means they used opioids such as hydrocodone without a prescription or to get high. Drugs that had been legally obtained with a prescription caused almost all deaths from prescription drug overdose. 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 illegally purchased opioids from a drug dealer. More than three out of four people who misuse prescription drugs abuse a medicine prescribed to someone else. The minority of doctors prescribe the majority of these medicines; roughly 80 percent of prescription pain killers are written by 20 percent of authorized prescribers.

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Medical professionals and rehabilitation specialists view withdrawal symptoms as a normal, predictable outcome from taking high doses of opioids or taking them for a long time. Experiencing withdrawal does not serve as a moral barometer nor does it mean a person lacks self-discipline. Each person comes to dependence on drugs in a different way, and withdrawal symptoms can vary between individuals. Some may be able to withstand withdrawal and quit drug use on their own; others may need the help of qualified rehabilitation professionals.

Withdrawal symptoms include:

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


Rehabilitation typically involves detoxification before engaging in counseling or other social services. With conventional detoxification programs, specially trained personnel administer some drugs to ease withdrawal symptoms while giving other medications to cleanse the body.

Rapid detox is a new, humane procedure in which physicians also administer sedatives and anesthesia so the patient sleeps through withdrawal. Learn More About Hydrocodone, Pseudoephedrine Detoxification Programs


Keep hydrocodone and pseudoephedrine polydrugs at room temperature, away from excessive heat, light and moisture.

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