Exo-Tuss

Generic Name: chlorpheniramine, hydrocodone, and phenylephrine (KLOR fe NEER a meen, HYE droe KOE done, FEN il EFF rin)
Brand Names: Endagen-HD, Histinex HC, Histussin-HC, Hydro-PC II, Poly-Tussin, Relacon-HC NR, Vanex-HD

What is Exo-Tuss (chlorpheniramine, hydrocodone, and phenylephrine)?

Chlorpheniramine is an antihistamine that reduces the natural chemical histamine in the body. Histamine can produce symptoms of sneezing, itching, watery eyes, and runny nose.

Hydrocodone is a narcotic. It is a pain reliever and a cough suppressant.

Phenylephrine is a decongestant that shrinks blood vessels in the nasal passages. Dilated blood vessels can cause nasal congestion (stuffy nose).

The combination of chlorpheniramine, hydrocodone, and phenylephrine is used to treat runny or stuffy nose, sinus congestion, and cough caused by the common cold or flu.

Chlorpheniramine, hydrocodone, and phenylephrine may also be used for other purposes not listed in this medication guide.

What is the most important information I should know about Exo-Tuss (chlorpheniramine, hydrocodone, and phenylephrine)?

This medication can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert. Avoid drinking alcohol. It can increase some of the side effects of chlorpheniramine, hydrocodone, and phenylephrine. Cold or allergy medicine, narcotic pain medicine, sleeping pills, muscle relaxers, and medicine for seizures, depression or anxiety can add to sleepiness caused by chlorpheniramine, hydrocodone, and phenylephrine. Tell your doctor if you regularly use any of these medicines, or any other cough and cold medications. Hydrocodone may be habit-forming and should be used only by the person it was prescribed for. Hydrocodone should never be shared with another person, especially someone who has a history of drug abuse or addiction. Keep the medication in a secure place where others cannot get to it.

What should I discuss with my healthcare provider before taking Exo-Tuss (chlorpheniramine, hydrocodone, and phenylephrine)?

Do not that this medication if you have used an MAO inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate) within the past 14 days. Serious, life-threatening side effects can occur if you take chlorpheniramine, hydrocodone, and phenylephrine before the MAO inhibitor has cleared from your body. You should not use this medication if you are allergic to chlorpheniramine, hydrocodone, or phenylephrine, or to other antihistamines, decongestants, or narcotic medications.

Before taking chlorpheniramine, hydrocodone, and phenylephrine, tell your doctor if you are allergic to any drugs, or if you have:

  • asthma, COPD, sleep apnea, or other breathing disorders;

  • liver or kidney disease;
  • heart disease or high blood pressure;

  • diabetes;

  • a thyroid disorder;

  • curvature of the spine;

  • a history of head injury or brain tumor;

  • epilepsy or other seizure disorder;

  • low blood pressure;

  • glaucoma;

  • gallbladder disease;

  • Addison's disease or other adrenal gland disorders;

  • enlarged prostate, urination problems;

  • mental illness; or

  • a history of drug or alcohol addiction.

If you have any of these conditions, you may need a dose adjustment or special tests to safely take chlorpheniramine, hydrocodone, and phenylephrine.

Hydrocodone may be habit-forming and should be used only by the person it was prescribed for. This medication should never be shared with another person, especially someone who has a history of drug abuse or addiction. Keep the medication in a secure place where others cannot get to it. FDA pregnancy category C. Chlorpheniramine, hydrocodone, and phenylephrine may be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. It is not known whether this medication passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

How should I take Exo-Tuss (chlorpheniramine, hydrocodone, and phenylephrine)?

Take this medication exactly as prescribed by your doctor. Do not take it in larger amounts or for longer than recommended. Follow the directions on your prescription label.

You may take this medication with or without food.

Measure liquid medicine with a special dose-measuring spoon or cup, not a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist for one.

Store the medication at room temperature away from moisture and heat. Keep track of how much of the medicine has been used from each new bottle. Hydrocodone is a drug of abuse and you should be aware if any person in the household is using this medicine improperly or without a prescription.

What happens if I miss a dose?

Take the missed dose as soon as you remember. If it is almost time for your next dose, wait until then to take the medicine and skip the missed dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention if you think you have used too much of this medicine. An overdose of hydrocodone can be fatal.

Overdose symptoms may include dizziness, extreme drowsiness, feeling restless or nervous, nausea, vomiting, stomach pain, dry mouth, warmth or tingly feeling, seizure (convulsions), pinpoint pupils, confusion, cold and clammy skin, weak pulse, shallow breathing, fainting, or breathing that stops.

What should I avoid while taking Exo-Tuss (chlorpheniramine, hydrocodone, and phenylephrine)?

This medication can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert. Avoid drinking alcohol. It can increase some of the side effects of chlorpheniramine, hydrocodone, and phenylephrine. Cold or allergy medicine, narcotic pain medicine, sleeping pills, muscle relaxers, and medicine for seizures, depression or anxiety can add to sleepiness caused by chlorpheniramine, hydrocodone, and phenylephrine. Tell your doctor if you regularly use any of these medicines, or any other cough and cold medications.

Exo-Tuss (chlorpheniramine, hydrocodone, and phenylephrine) side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Stop using this medication and call your doctor at once if you have a serious side effect such as:
  • severe dizziness, anxiety, restless feeling, or nervousness;

  • fast, pounding, or uneven heartbeats;

  • shallow breathing, slow heartbeat;

  • confusion, hallucinations, unusual thoughts or behavior;

  • feeling like you might pass out;

  • urinating less than usual or not at all;

  • easy bruising or bleeding, unusual weakness, fever, chills, body aches, flu symptoms;

  • increased blood pressure (severe headache, blurred vision, trouble concentrating, chest pain, numbness, seizure); or

  • nausea, stomach pain, low fever, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).

Less serious side effects may include:

  • nausea, vomiting, upset stomach, constipation;

  • dry mouth;

  • blurred vision;

  • dizziness, drowsiness;

  • problems with memory or concentration;

  • sleep problems (insomnia);

  • restless or excitability (especially in children);

  • ringing in your ears;

  • warmth, tingling, or redness under your skin; or

  • skin rash or itching.

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect.

See also: Side effects (in more detail)

What other drugs will affect Exo-Tuss (chlorpheniramine, hydrocodone, and phenylephrine)?

Tell your doctor about all other medications you use, especially:

  • blood pressure medication;

  • cimetidine (Tagamet);

  • rifampin (Rifadin, Rifater, Rifamate, Rimactane);

  • zidovudine (Retrovir, AZT);

  • an antidepressant;

  • a diuretic (water pill);

  • medication to treat irritable bowel syndrome;

  • bladder or urinary medications such as oxybutynin (Ditropan, Oxytrol) or tolterodine (Detrol);

  • aspirin or salicylates (such as Disalcid, Doan's Pills, Dolobid, Salflex, Tricosal, and others);

  • seizure medication such as phenytoin (Dilantin) or phenobarbital (Luminal, Solfoton);

  • a beta-blocker such as atenolol (Tenormin), carteolol (Cartrol), metoprolol (Lopressor, Toprol), nadolol (Corgard), propranolol (Inderal), sotalol (Betapace), timolol (Blocadren), and others; or

  • medicines to treat psychiatric disorders, such as chlorpromazine (Thorazine), haloperidol (Haldol), mesoridazine (Serentil), pimozide (Orap), or thioridazine (Mellaril).

This list is not complete and there may be other drugs that can interact with chlorpheniramine, hydrocodone, and phenylephrine. Tell your doctor about all your prescription and over-the-counter medications, vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start a new medication without telling your doctor.

Where can I get more information?

  • Your pharmacist can provide more information about chlorpheniramine, hydrocodone, and phenylephrine.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.
Copyright 1996-2006 Cerner Multum, Inc. Version: 2.04. Revision Date: 03/28/2008 4:20:03 PM.
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