Hydrocodone, Pseudoephedrine, and Guaifenesin (Oral)


Hydrocodone, pseudoephedrine, and guaifenesin is a drug combination used in the treatment of coughs and nasal congestion that is caused by the cold. It works by relieving the symptoms.

Hydrocodone is known as a narcotic cough suppressant. It works directly on the cough center located in the brain to help relieve the severity of a cough. Pseudoephedrine is a decongestant, which works by decreasing nasal congestion by reducing the blood flow and narrowing the blood vessels to the nasal passage. Guaifenesin is used to help treat phlegm or mucus that builds up in the chest when you have congestion from the flu or cold. It works by thinning the phlegm or mucus in the lungs.

When the hydrocodone part of the drug is used for a long period of time, it could become habit-forming which could cause physical or mental dependence. This physical dependence could lead to unwanted withdrawal symptoms if the treatment is stopped quickly. You should discuss with your doctor if you have any queries.

You cannot obtain this medication on your own, it is only available via a prescription from your doctor. It is available in the following dosage forms:

  • Liquid

Conditions treated

  • A runny nose

Type of medication

  • Combination narcotic cough suppressant, decongestant and expectorant

Side effects

Along with relieving nasal congestion and coughs caused by the common cold, the consumption of this drug could cause some unwanted side effects. Not all of these effects may be present, but if they do occur, you may require medical attention.

Consult with your doctor or healthcare professional right away if you suffer from any of the following side effects whilst taking guaifenesin/hydrocodone/pseudoephedrine:

Incidence not known

  • Abdominal or stomach pain or cramps

Some side effects that occur with the use of guaifenesin/hydrocodone/pseudoephedrine usually don't require any medical attention as they aren't severe. Typically you will find that these side effects begin to reduce in severity as your body begins adjusting to the medication itself. However, if you are finding these side effects bothersome, you can contact your local healthcare professional or doctor for advice on ways to reduce these side effects or prevent them altogether. Consult with your doctor or health care professional if any of the following side effects become persistent or bothersome:

More common

  • Redness of the neck, face, arms, and occasionally, upper chest

Incidence not known

  • Trouble sleeping

It is possible that you may suffer from other side effects that are not listed above. Contact your doctor if you notice anything unusual and report side effects to the FDA.


Proper use

Only take this medication as it has been directed by your doctor. Do not take it more often, a higher quantity or for a longer period of time than your doctor has indicated. If you take too much of this medication for a long period of time it could lead to dependence or an overdose. Taking too little of the medication can reduce the effectiveness of treatment.

You can correctly measure the oral liquid by using a medicine cup, the marked measuring spoon or oral syringe. The average household teaspoon will not hold the correct amount of liquid required. You should seek advice from your local pharmacist for specific instructions for measuring the dose correctly for this medication.

Final dose

The final dose of any medication will depend upon individual factors. This includes your weight, age and height, other medications you are taking to treat other medical conditions, the strength of the medication, and the medical condition for which you are being treated for.

For oral dosage form (solution) for the relief of sneezing, cough, or runny or stuffy nose:

Adults: ten milliliters (mL) every four to six hours as required. Don't take more than four doses (40 mL) in a 24-hour period.

Children: This drug is not recommended for use in children.

Missed dose

Don't panic if you miss a dose of this medication. You can take it as soon as you next remember. The exception to this is if it's close to your next required dose. If this is the case, skip your missed dose and go back to the regular dosing schedule you have been assigned. Under no circumstances should you double a dose.


Although some medications should not be used together, in some situations it may be necessary despite the risk of an interaction occurring. Drug interactions can cause severe side effects and reduce the effective nature of each drug you are taking. In these cases, your doctor may alter one or both of the medications you are taking either in frequency, dose or both. In some cases, they may avoid treating you with the medication altogether. To help limit the risk of these interactions occurring, it's important to give your doctor a complete list of all the current medications you are taking, alongside any you may have taken in the past. It's also a good idea to inform them of any other medical conditions you are taking as these too could increase the risk of interactions occurring.

The use of this medication alongside any of the following medications is not recommended. Your doctor may avoid treating you with this medication completely or change some of the other drugs you are taking.

  • Selegiline

The use of this medication alongside any of the following medicines is not typically recommended. However, it some cases, the drug combination may be required. If you're prescribed both medications at once, your doctor may alter the dose or frequency in which you use either medication.

  • Suvorexant

The use of this medication alongside any of the following medications can increase your risk of specific side effects. However, in some cases, the use of both drugs may be the best treatment option for you. If you are prescribed both medications, your doctor may alter the dose or frequency in which you use either medication.

  • Escitalopram

Other interactions

Some medications cannot be should at the time of eating or when eating specific foods as it can increase the risk of interactions. The use of tobacco or alcohol with some medication can also cause interactions.

The use of this medication alongside any of the following is not recommended. However, in some cases, it may be unavoidable. If you use these substances together, your doctor may change the frequency in which you use your medication or the dose. Or, they may give you special instructions for the use of tobacco, food or alcohol.

  • Grapefruit juice

Other medical problems

If you suffer from other medical conditions it could affect the use of this medication. You could let your doctor know of any other medical conditions you may suffer from including:

  • Enlarged prostate ( prostatic hypertrophy, BPH)


Before committing to a medication it's important you weigh up the potential benefits against the risks alongside consideration of other factors.


You should inform your healthcare professional or doctor of any unusual reactions you've had to this drug in the past or similar medication. It's also important to make them aware of any other allergies you may suffer from such as to animals, preservatives, foods or dyes.

Pediatric population

The use of this drug combination has not been indicated in children younger than eighteen years old. Therefore efficacy and safety have not yet been established.

Geriatric population

The appropriate studies performed to date have not indicated a geriatric-specific problem that could limit the effectiveness of pseudoephedrine, hydrocodone, and guaifenesin combination in the geriatric population. However, older patients are more likely to suffer from age-related kidney issues which could require a degree of caution and a dose adjustment in those patients receiving this medication.

Pregnancy and breastfeeding

This drug combination is under FDA pregnancy category C. If you use hydrocodone whilst you are pregnant, your unborn child could become dependent on the drug. This could lead to life-threatening withdrawal symptoms in the infant after it is born. Babies who are born with dependence on habit-forming medication may need special medical attention and treatment for several weeks. You should let your doctor know if you are currently pregnant or intend on becoming pregnant.

Pseudoephedrine and Hydrocodone can pass into breast milk whilst breastfeeding; however, the effects this has on the child is unknown. Decongestants can also slow down breast milk production. It is advised that you do not breastfeed whilst taking this medication. If you have any concerns or questions, consult with your doctor.


It's extremely important that your doctor monitors your progress whilst you are receiving this medication. This will allow them to test for side effects and to determine whether the medication is working correctly. You should contact your doctor if your symptoms do not improve or if they become worse.

Don't use this medication if you have used an MAO inhibitor such as Marplan®, Eldepryl®, Nardil®, or Parnate® within the past fourteen days.

This medication could cause dependence. If you feel like your medication is not working well, do not increase your prescribed dose. Instead, contact your doctor for advice and instructions.

If you think you or someone else could have taken an overdose of this medication, you should seek emergency help immediately.

Signs of an overdose include:

  • Troubled, difficult or irregular breathing

This medication could make you feel drowsy or dizzy. Ensure you are aware how you react to this medication before you begin driving, use machinery or do any other activity that requires you to be alert.

This medication will add to the effects of CNS depressants or alcohol. Some examples of CNS depressants are:

  • Antihistamines or medication for colds or allergies or colds

The use of this medication could cause severe constipation. To help prevent this, your doctor may direct you to drink lots of fluids, take laxatives, or increase the amount of fiber you are consuming. Ensure you follow the directions carefully as continued constipation can lead to more serious issues.

Don't take other medications unless they have been discussed with your doctor.


This medication should be kept concealed in a closed container at room temperature. It should be stored away from direct light, moisture and heat. Prevent this medication from freezing. Ensure this medication is kept out of the reach of children. Don't keep any medication you no longer require or has passed its expiry date. You should seek advice from your local pharmacist for the best way to dispose of medication you no longer need.


When used correctly, this drug combination of Hydrocodone, Pseudoephedrine, and Guaifenesin is successful in relieving various symptoms that are caused by the common cold. However, due to a large number of interactions possible with this medication, it is vital that you let your doctor know about all the medications you are taking. This should include all prescription, nonprescription drugs, vitamins supplements and herbal products. The use of this drug is not permitted in children under the age of 18. You should make your doctor aware if you are pregnant with the use of this drug could cause dependence in the unborn baby. You should not breastfeed whilst you use this medication. Let your doctor know if your symptoms do not begin to improve after a short period of time. Do not increase your dose of this medication without consulting with your doctor first. If you require any further information about the practical uses of this medication or have any other questions, you should contact your local healthcare professional or doctor for advice.