Hydrocodone, Chlorpheniramine, and Pseudoephedrine (Oral)

Overview

These three medications act powerfully together to suppress coughing and to manage the symptoms of allergies and severe cases of the common cold. The medicine can only be administered to adult patients over the age of 18, since it contains a narcotic component for cough suppression. Hydrocodone works directly on the portion of the brain that is responsible for the coughing action and suppresses the urge to cough.

Allergy symptoms are managed by Chlorpheniramine, an antihistamine that works to prevent the onset of those symptoms and reduce their severity when already in progress. The role played by pseudoephedrine in this combination medicine is that of a decongestant. It works to narrow blood vessels and decrease the flow of blood to nasal passages, thereby reducing nasal congestion and imparting some measure of relief to a patient.

This medication should always be prescribed and used with caution, since it contains a narcotic component that can cause it to become habit-forming for the patient. That does not mean, however, that it should be avoided as a potential treatment solution for a patient who legitimately does have the kind of medical condition that requires this kind of treatment.

Patients do not typically form any kind of mental dependence on this drug, because it is being used in a medicinal context rather than a recreational one. There may, however, be some signs of physical dependence if it is used for a long time and then suddenly withdrawn. This, too, can be circumvented, simply by gradually lowering the dosage level over a fairly long period, all under the direct supervision of your family doctor.

This combination medicine is available in a variety of forms, all to be taken orally. It can be purchased as a capsule, syrup, solution, suspension, tablet or liquid, all of them requiring a doctor's prescription. Some of the most popular commercial names associated with this medication are Hydron PSC, Zutripro, and Hyphed.

Condition Treated

  • Congestion
  • Coughing
  • Allergy relief

Type Of Medicine

  • Narcotic anti-tussive (Hydrocodone)
  • Antihistamine (Chlorpheniramine)
  • Decongestant (Pseudoephedrine)

Side Effects

In addition to its many beneficial effects, this combination medication may impart some unwanted side effects to some patients. While some patients may experience no side effects at all or some that are very minor in nature, other patients will experience some more moderate and possibly severe side effects when taking this drug. If your own side effects should reach the point where they become uncomfortable, you should seek consultation with your doctor about some form of treatment.

One of the first things to be on the lookout for in terms of side effects is an allergic reaction. There is a potential for an allergic reaction to become severe and possibly even life-threatening, so the symptoms listed below should be treated with genuine concern. If you should experience more than one of the side effects in this grouping, you should seek medical treatment at the earliest opportunity before the symptoms have a chance to worsen.

  • Extreme puffiness or swelling in the facial area, especially around the eyelids and in the tongue, lips, and throat
  • Itchiness at various locations around the body
  • Rashes and/or hives which appear on skin surfaces
  • Extreme tightness of the chest, usually accompanied by difficulty with breathing
  • Dizziness or lightheadedness, sometimes with the sensation that you are about to faint

There are a wide range of other side effects that are less serious in nature than an allergic reaction, but which may call for medical attention all the same. The side effects listed below are grouped according to the frequency with which they are experienced by patients taking this medication. While this may not be a reflection of your own experience, it is offered as a guideline for the relative frequency with which patients experience the side effects.

In the category of most commonly experienced side effects, the following seem to occur more frequently than others:

  • Extremely bright appearance of lights
  • Restlessness or agitation
  • Unusual drowsiness or sleepiness
  • Difficulty with sleeping
  • Disrupted perception of colors
  • Double vision or blurred vision
  • Dry mouth
  • Unusual sense of well-being or euphoria
  • Fear or paranoia
  • Halos which appear around lights
  • Hyperventilation
  • Nausea and/or vomiting
  • Uncharacteristic drowsiness, weakness, sluggishness or dullness
  • Tunnel vision
  • Difficulty with sleeping
  • Night blindness
  • Lightheadedness and/or fainting
  • Trembling or shaking of the feet, arms, or hands
  • General shakiness through the limbs and extremities of the body

The side effects listed in the grouping below are less common than those in the category above, but since less information is available on the frequency of occurrence for these specific side effects, the only thing that can be confidently said about them is that they occur less frequently than other side effects.

  • Abdominal or stomach pain and cramping
  • Bloating
  • Sore throat or throat spasms
  • Profuse sweating
  • Tightness of the chest
  • Pounding in the ears
  • Paleness of the face
  • Blue colored skin, fingernails or lips
  • Painful urination
  • Loss of appetite
  • Headaches
  • Irregular breathing
  • Fast, slow or irregular heartbeat
  • Lightheadedness, faintness or dizziness when quickly rising from a sitting or lying position
  • Difficulty with urinating e.g. dribbling
  • Dizziness
  • Diarrhea
  • Decrease in the frequency and/or volume of urination
  • Convulsions
  • Confusion
  • Change in the ability to see specific colors, primarily yellow or blue
  • Constipation
  • Acid or sour stomach
  • Stomach pressure
  • Pains in the side, abdomen or stomach, often accompanied by the sensation of radiating to the back
  • Continued buzzing or ringing noise in the ears
  • Dark-colored urine
  • Feelings of depression
  • Inappropriate belching
  • Dilated or large pupils
  • Chills or cold sweats
  • Coma
  • Difficulty with night vision
  • Sensation of constant movement either with yourself or your surroundings
  • Flushing or redness of the skin
  • Bloated feeling
  • Loss of hearing
  • Heartburn
  • Hives and or welts appearing on the skin surfaces
  • Increased appetite or hunger
  • Nightmares
  • Itchiness of the skin
  • Indigestion
  • Profuse sweating
  • Greater sensitivity to sunlight
  • Heightened desire for sexual intercourse
  • Significant increase in sexual performance and drive
  • Seizures
  • Sugar in the urine
  • Upset stomach or discomfort
  • Slurred speech
  • Skin rashes
  • Sensation of spinning
  • Unusual warmth on the skin
  • Watering of the eyes
  • Yellowish tinge to the skin
  • Swelling of the breasts or soreness of the breasts in both males and females
  • Swelling of the stomach or abdomen

Dosage

Patients taking this medication should be careful to use it only as directed by the family doctor, which means it should not be taken any more frequently than recommended and should not be used for a longer time than recommended. This is particularly important because of the narcotic component in the medicine, which can have a tendency to cause dependence on the medication.

Dosage should be carefully administered with a measuring spoon, a medicine cup or an oral syringe to ensure accuracy. If you miss a dose of your medicine, take it as soon as you remember to, unless you don't remember it until near the time of your next regularly scheduled dose. In this situation, it's better to skip the missed dosage entirely and just wait for the next dosage. It's never a good idea to double up on dosages simply to get back on track, and it is likewise inadvisable to take more medication because you happen to be experiencing worse symptoms than usual.

Although the dosage of this medication will be different from patient to patient, there is a standardized dosage described below as a guideline. Your specific dosage will be determined by your doctor, based on a number of factors, including the specific medical condition you have, the frequency of dosing, the duration of time you have been using this medication and your body's tolerance to the medicine.

For most adult patients using an oral solution form of this medicine, the symptoms of sneezing, coughing and runny nose can be relieved by taking 5 ml every four to six hours. It is generally not recommended to exceed four such dosages, or a total of 20 ml, within a 24 hour period.

Interactions

Most medications, including this one, have the potential for interacting with other drugs. These interactions can take the form of passing on adverse side effects to the patient or they can involve a decrease in the effectiveness of one or the other of the two drugs interacting. Neither of these is a desirable condition, so it is advisable to avoid such interactions if at all possible.

To facilitate this, it's worth your while to prepare a list of all medications are currently taking, including vitamins, over the counter drugs, other prescription medications and even herbal supplements, as well as all the dosages of each of these. Your doctor can review this list and make a determination on whether or not there is a potential for interaction between these medicines. You can also use this list if you have to go to the emergency room, because your doctor will not be in residence there, and an emergency room doctor can review your medication list to avoid drug interactions, as well.

Some of the drugs most frequently checked by doctors for interaction with this medication include the following: benztropine, belladonna, antihistamines, tricyclic antidepressants, some kinds of inhaled anesthetics, beta blockers, cimetidine, guanethidine, methyldopa, scopolamine, naltrexone, desipramine, amitriptyline, linezolid, isocarboxazid, methylene blue, moclobemide, rasagiline, safinamide, selegiline, tranylcypromine, phenelzine, procarbzine, codeine, hydrocodone, alcohol, marijuana, lorazepam, zolpidem, alprazolam, carasopridol, cyclobenzaprine, cetirizine, diphenhydramine, ketoconazole, view propionic, fluoxetine, rifabutin, rifampin, paroxetine, carbamazepine, phenytoin.

This medication has a tendency to disrupt or interfere with some kinds of laboratory tests, particularly brain scans for Parkinson's disease and tests for amylase levels. This disruption can take the form of causing inaccurate test results, so if you're scheduled for any such tests, be sure that laboratory personnel are aware that you are currently taking this combination medication and test results may be skewed.

The most serious side effects that are possible from taking this medication can all be made worse if you are also taking other kinds of medication, which could trigger drowsiness or breathing problems. This makes it very important that you check the labels on any other medications you are taking to be sure that they don't induce drowsiness or fatigue, since that can be become a danger to yourself and to others.

Warnings

There are certain precautions and warnings which should be adhered to for any patient involved in a program of treatment using this combination medication, and these precautions carry added significance because of the narcotic nature of the medication. It's very important that your doctor monitors your medical condition regularly to determine whether the medicine is working as intended, and to decide whether or not you should continue being treated with it.

You should not take this medication if you have used any kind of an MAO inhibitor in the past 14 days, for instance Parnate, Nardil, Eldepryl or Marplan, as well as some others.

You should be aware of the possibility of an overdose on this medication, the symptoms of which will include a slowed heartbeat or breathing, seizures or convulsions, skin which feels cold and clammy to the touch, shortness of breath and extreme weakness or dizziness. If you should experience any of these symptoms in the immediate aftermath of taking this medicine, seek medical attention immediately.

You should be aware that this medication may be habit-forming, and if you sense that this is occurring in your own situation, you should consult with your doctor regarding the risks versus benefits of using this medicine.

It's possible for this medication make you drowsy or dizzy, so that makes it inadvisable for you to drive a motor vehicle or operate any kind of machinery after taking this medicine. This medicine will compound the side effects imparted by alcohol and any other kinds of depressants that could make you less alert and induce drowsiness. This means you should avoid taking this medication in tandem with any antihistamines or depressants, such as tranquilizers, sedatives, sleeping medicine, pain medications, medicine for seizures, barbiturates, muscle relaxants and even anesthetics.

For this reason, if you're having any kind of surgery in the near future, even including oral surgery, be sure to mention that you are taking this medication to your doctor or dentist, especially if you know that some form of anesthetic will be used.

It is possible for extended term use of narcotics to cause extreme constipation, so you should take steps to prevent this from occurring by occasionally taking laxatives, flushing your body out with lots of fluids and water and including a high content of fiber in your regular diet. When doing this, however, make sure to follow any directions on the labels of such products so that you don't unwittingly induce a more severe medical condition.

There are certain medical conditions that can be negatively impacted by taking this medication, so it's important that you review your medical history with your doctor before agreeing to take this medicine.

Some of the specific medical conditions which are specifically impacted by this medicine are the following:

This medicine can contain aspartame, sugar and/or alcohol, so caution is recommended for patients who have diabetes, liver disease or alcohol dependence, since all these situations can be exacerbated by taking the medicine.

Geriatric patients may be more susceptible to the side effects of this drug, especially those such as constipation, irregular heartbeat, slow or shallow breathing, confusion or disorientation, dizziness and drowsiness, and trouble with urination.

Women who are at an age where childbearing is still possible should thoroughly discuss the benefits and risks associated with taking this medication with the family doctor. There is a slight potential for this medicine to cause birth defects within the first trimester of a pregnancy, and if it is used for a prolonged period of time or in very high doses, it can have other adverse effects on an unborn baby.

A woman who is pregnant and still taking this medicine may experience complications at delivery time, so it is not recommended that you should take this medication during the full-term of a pregnancy or a delivery. If you continue to take this medicine throughout the pregnancy, you should carefully monitor your baby's health after delivery, specifically looking for symptoms, such as unusual vomiting, diarrhea, persistent crying, breathing which is slow or shallow and constant irritability.

It is not known definitively whether or not this medication can be passed on to a nursing infant through breast milk, but it is known that other narcotic medications do have a tendency to induce unwanted side effects in infants. These can include difficulty breathing, excessive sleepiness and unusual difficulty with feeding. This makes it inadvisable for any woman to breast-feed, either while concurrently taking this medication, or when having taken the medication in the weeks leading up to delivery.

Storage

If you have any unused portions of this medication, you should not simply throw it away or flush it down the sink or toilet. Proper disposal methods should be used for any medication that has expired, or which is no longer needed. You can find out proper methods of disposal from your doctor or pharmacist, and if this information is lacking, you can also look it up on the FDA website for the safe disposal of medicines.

This medication should be stored in a location that is free from any extremes of heat, cold or humidity, which means the medicine cabinet in the bathroom is not a good storage place. It should also be kept well out of the reach of pets or small children around the household.

It is strongly advised for you to avoid storing this medication in a weekly pill reminder, since these containers are seldom are equipped with locking mechanisms that can prevent unwanted access. This medication should never be allowed to freeze and should not be exposed to direct lighting of any kind, as this may decrease its effectiveness.

Summary

Hydrochlorine, Chlorpheniramine, and Pseudoephedrine is a combination medication that can be very effective when used to combat the symptoms of colds or allergies. It does contain a narcotic agent, however, and for this reason should only be prescribed and used by people aged at least 18 years. Each of these medicines on their own act to relieve certain conditions in the body and altogether they can reduce or prevent many of the symptoms commonly associated with allergies and colds.

There are a great many potential side effects possible from using this medication, and while they are rarely severe in nature, there can be some that are uncomfortable enough to require other medical treatment. You should thoroughly discuss the benefits and risks of taking this medicine with your doctor beforehand, since there is a risk of it becoming habit-forming if taken for an extended period of time.