Hydrocodone and Chlorpheniramine
Mechanism :
chlorpheniramine is a histamine (H1) antagonist. It blocks receptors present in the respiratory and gastrointestinal tracts, and blood vessels. Hydrocodone us an opioid agonist; it causes medullary cough suppression, has an antitussive action, alters the response and perception to pain, and cause overall CNS depression.
Indication :
- Cough/Rhinorrhea
- Upper respiratory symptoms
Contraindications :
• Hypersensitivity
• Use of extended release capsules in children younger than 6 years of age
• Acute/severe bronchial asthma in a setting which is unmonitored or when there are no available resuscitative measures
• Suspected/known paralytic ileus and other gastrointestinal obstructive disorders
• Do not use along with other opioid agonists/CNS depressants
• Caution in case of acute pancreatitis, diseases of the gall bladder, pseudomembranous enterocolitis, gastrointestinal surgery, impairment of the hepatic/renal function, myxoedema, urethral strictures, prostatic hypertrophy, hypercapnia, emphysema, asthma, cardiac arrhythmias, Addison disease, seizures (may increase frequency of seizure in patients with seizure disorders), narrow-angle glaucoma, emotional lability, toxic psychosis, acute alcoholism
• The combination of these drugs can result in extreme drowsiness, respiratory/CNS depression
• There is no data available to establish the presence of drug-associated risk, however, it is not recommended for use in pregnancy
• Drugs are distributed in breast milk, also they could supress lactation if used before nursing. Hence, caution in case of breastfeeding
Dosing :
Dosage forms:
Extended release capsules: 4 mg/5 mg (half strength), 8 mg/10 mg (full strength)
Oral suspension: (8 mg/10 mg)/5ml.
Cough/Rhinorrhea:
6-12 years half strength ER capsule: 1 capsule orally every 12 hours, maximum dose being 2 capsules/24 hours.
>12 years full strength ER capsule: 1 capsule orally every 12 hours, maximum dose being 2 capsules/24 hours.
6-12 years oral suspension: 2.5 ml orally every 12 hours, maximum dose being 5 ml/24 hours.
>12 years oral suspension: 5 ml orally every 12 hours, maximum dose being 10 ml/24 hours.
Safety and efficacy not established for oral solution in patients <18 years.
Adverse Effect :
Undefined frequency: tightness in the chest, respiratory depression, circulatory depression, shock, coma, syncope, dizziness, fainting, agitation, mental clouding, sedation, seizures, depression, euphoria, dysphoria, nervousness, restlessness, vision disturbances, blurry vision, diplopia, xerostomia, flushing, pruritis, urticaria, sweating, face/neck/upper thorax warmness, constipation, vomiting, nausea, dysuria, urinary retention, ureteral spasm
Interaction :
Hepatic Dose :
Caution in case of severe impairment of hepatic function