Hydrocodone Bitartrate / Guaifenesin
Pronouncation: (HIGH-droe-KOE-dohn by-TAR-trate/GWHY-fen-ah-sin)Class: Antitussive and expectorant combination
Trade Names:
Pneumotussin 2.5
- Cough Syrup 2.5 mg hydrocodone bitartrate and 200 mg guaifenesin
Trade Names:
Pneumotussin
- Tablets 2.5 mg hydrocodone bitartrate and 300 mg guaifenesin
Trade Names:
Codiclear DH
- Syrup 3.5 mg hydrocodone bitartrate and 300 mg guaifenesin
Trade Names:
Hycotuss Expectorant
- Syrup 5 mg hydrocodone bitartrate and 100 mg guaifenesin
Trade Names:
Hydrocodone GF
- Syrup 5 mg hydrocodone bitartrate and 100 mg guaifenesin
Trade Names:
Kwelcof
- Liquid 5 mg hydrocodone bitartrate and 100 mg guaifenesin
Trade Names:
Vitussin
- Syrup 5 mg hydrocodone bitartrate and 100 mg guaifenesin
Pharmacology
Suppresses cough reflex; stimulates opiate receptors in the CNS and peripherally blocks pain impulse generation.
GuaifenesinMay enhance output of respiratory tract fluid by reducing adhesiveness and surface tension, enhancing removal of viscous mucus, and making nonproductive coughs more productive and less frequent.
Indications and Usage
Symptomatic relief of irritating nonproductive cough associated with upper and lower respiratory congestion.
Contraindications
Hypersensitivity to any component of product; known hypersensitivity to other opioids; patients with increased intraocular pressure; depressed ventilatory function.
Dosage and Administration
AdultPO 2.5 mg to 5 mg hydrocodone every 4 to 6 hours (max, 30 mg in 24 hr; max single dose, 15 mg).
Children older than 12 yr of agePO Start with 2.5 mg to 5 mg hydrocodone (max single dose, 10 mg).
Children 6 to 12 yr of agePO Start with 2.5 mg hydrocodone (max single dose, 5 mg).
General Advice
Measure and administer prescribed dose of syrup using dosing syringe, dosing spoon, or dosing cup.
Storage/Stability
Store syrup at controlled room temperature (59° to 86°F). Keep tightly capped.
Drug Interactions
Alcohol, CNS depressants, general anesthetics, other narcotic analgesics, phenothiazines, sedative-hypnotics, tranquilizersCNS depression may be increased.
Laboratory Test Interactions
Guaifenesin may interfere with the interpretation of the test for urinary 5-hydroxyindoleacetic acid for the diagnosis of carcinoid syndrome.
Adverse Reactions
Cardiovascular
Hypertension; postural hypotension; palpitations.
CNS
Sedation; drowsiness; mental clouding; lethargy; impairment of mental performance; impairment of physical performance; anxiety; fear; dysphoria; dizziness; psychic dependence; mood change.
EENT
Blurred vision.
GI
Nausea; vomiting.
Genitourinary
Urethral spasms; spasm of vesical sphincters; urinary retention.
Respiratory
Respiratory depression.
Precautions
Pregnancy
Category C .
Lactation
Undetermined.
Children
Not recommended for children younger than 6 yr of age.
Dependence
Hydrocodone has abuse potential; may be habit forming.
Overdosage
Symptoms
Respiratory depression, extreme somnolence progressing to stupor and coma, skeletal muscle flaccidity, cold and clammy skin.
Patient Information
- Advise patient to take prescribed dose up to every 4 h as needed for cough, but to not take more than 6 times/day.
- Advise caregiver to use dosing spoon or syringe when giving liquid to children.
- Advise patient to take with food or milk if GI upset occurs.
- Advise patient that if a dose is missed to take as soon as remembered unless it is nearing time for the next dose. Caution patient not to double the dose to catch up.
- Advise patient that if cough is not controlled not to increase the dose of medication but to inform health care provider.
- Advise patient to inform health care provider if any of the following occur: cough associated with fever, rash, persistent headache, or bothersome adverse reactions.
- Caution patient that drug may cause drowsiness and to use caution while driving or performing other tasks requiring mental alertness until tolerance is determined.
- Advise patient to avoid alcohol and other CNS depressants because of risk of excessive sedation.
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