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Hydrocodone and chlorpheniramine (Oral)

hye-droe-KOE-done bye-TAR-trate, klor-fen-IR-a-meen MAL-ee-ate

Oral route(Solution)

Warning: Addiction, Abuse, and Misuse; Life-Threatening Respiratory Depression, Accidental Ingestion, Medication Errors; Cytochrome P450 3A4 Interaction; Concomitant Use with Benzodiazepines or Other CNS Depressants; Interaction with Alcohol; Neonatal Opioid Withdrawal SyndromeHydrocodone bitartrate/chlorpheniramine maleate exposes users to risks of addiction, abuse, and misuse, which can lead to overdose and death. Assess patient’s risk before prescribing and monitor closely for these behaviors and conditions.Serious, life-threatening, or fatal respiratory depression may occur. Monitor closely, especially upon initiation or when used in patients at higher risk.Accidental ingestion of hydrocodone bitartrate/chlorpheniramine maleate, especially by children, can result in a fatal overdose of hydrocodone.Ensure accuracy when prescribing, dispensing, and administering hydrocodone bitartrate/chlorpheniramine maleate. Dosing errors can result in accidental overdose and death.Concomitant use with CYP3A4 inhibitors (or discontinuation of CYP3A4 inducers) can result in a fatal overdose of hydrocodone. Avoid the use of hydrocodone bitartrate/chlorpheniramine maleate in patients taking CYP3A4 inhibitors or inducers. Concomitant use of opioids with benzodiazepines or other central nervous system (CNS) depressants, including alcohol, may result in profound sedation, respiratory depression, coma, and death. Avoid the use of hydrocodone bitartrate/chlorpheniramine maleate in patients taking benzodiazepines, other CNS depressants, or alcohol.Instruct patients not to consume alcohol or any products containing alcohol while taking hydrocodone bitartrate/chlorpheniramine maleate because co-ingestion can result in fatal plasma hydrocodone levels.Hydrocodone bitartrate/chlorpheniramine maleate is not recommended for use in pregnant women. Prolonged use of hydrocodone bitartrate/chlorpheniramine maleate during pregnancy can result in neonatal opioid withdrawal syndrome, which may be life-threatening if not recognized and treated. If hydrocodone bitartrate/chlorpheniramine maleate is used for a prolonged period in a pregnant woman, advise the patient of the risk of neonatal opioid withdrawal syndrome and ensure that appropriate treatment will be available .

Medically reviewed on Oct 4, 2018

Commonly used brand name(s)

In the U.S.

  • Vituz

Available Dosage Forms:

  • Solution
  • Liquid

Therapeutic Class: Antitussive, Opioid/Antihistamine Combination

Pharmacologic Class: Chlorpheniramine

Chemical Class: Hydrocodone

Uses For hydrocodone and chlorpheniramine

Hydrocodone and chlorpheniramine combination is used to relieve cough and nasal congestion (stuffy nose) associated with the common cold or allergy in adults.

Hydrocodone is a narcotic antitussive (cough suppressant). It acts directly on the cough center in the brain to relieve cough. Chlorpheniramine is an antihistamine, which is used to relieve or prevent symptoms of an allergy.

When hydrocodone is used for a long time, it may become habit-forming, causing mental or physical dependence. Physical dependence may lead to withdrawal side effects if treatment is stopped suddenly.

Hydrocodone and chlorpheniramine is available only with your doctor's prescription.

Before Using hydrocodone and chlorpheniramine

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For hydrocodone and chlorpheniramine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to hydrocodone and chlorpheniramine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

The use of hydrocodone in children younger than 6 years old has caused serious breathing problems, sometimes causing death. Hydrocodone and chlorpheniramine combination is not indicated for use in children younger than 18 years of age. Safety and efficacy have not been established.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of hydrocodone and chlorpheniramine combination in the elderly. However, elderly patients are more likely to develop age-related kidney, liver, or heart problems, which may require caution and an adjustment in the dose for patients receiving hydrocodone and chlorpheniramine.

Breast Feeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking hydrocodone and chlorpheniramine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using hydrocodone and chlorpheniramine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

  • Nalmefene
  • Naltrexone
  • Safinamide
  • Tranylcypromine

Using hydrocodone and chlorpheniramine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Acepromazine
  • Alfentanil
  • Almotriptan
  • Alprazolam
  • Amineptine
  • Amiodarone
  • Amisulpride
  • Amitriptyline
  • Amitriptylinoxide
  • Amobarbital
  • Amoxapine
  • Amphetamine
  • Amprenavir
  • Anileridine
  • Aprepitant
  • Aripiprazole
  • Armodafinil
  • Asenapine
  • Atazanavir
  • Baclofen
  • Benperidol
  • Benzhydrocodone
  • Benzphetamine
  • Boceprevir
  • Bosentan
  • Bromazepam
  • Bromopride
  • Brompheniramine
  • Buprenorphine
  • Bupropion
  • Buspirone
  • Butabarbital
  • Butorphanol
  • Carbamazepine
  • Carbinoxamine
  • Carisoprodol
  • Carphenazine
  • Ceritinib
  • Chloral Hydrate
  • Chlordiazepoxide
  • Chlorpheniramine
  • Chlorpromazine
  • Chlorzoxazone
  • Ciprofloxacin
  • Citalopram
  • Clarithromycin
  • Clobazam
  • Clomipramine
  • Clonazepam
  • Clopidogrel
  • Clorazepate
  • Clozapine
  • Cobicistat
  • Cocaine
  • Codeine
  • Conivaptan
  • Crizotinib
  • Cyclobenzaprine
  • Cyclosporine
  • Darunavir
  • Dasabuvir
  • Delavirdine
  • Desipramine
  • Desmopressin
  • Desvenlafaxine
  • Dexamethasone
  • Dexmedetomidine
  • Dextroamphetamine
  • Dextromethorphan
  • Dezocine
  • Diazepam
  • Dibenzepin
  • Dichloralphenazone
  • Difenoxin
  • Dihydrocodeine
  • Diltiazem
  • Diphenhydramine
  • Diphenoxylate
  • Dolasetron
  • Donepezil
  • Doxepin
  • Doxylamine
  • Dronedarone
  • Droperidol
  • Duloxetine
  • Efavirenz
  • Eletriptan
  • Enflurane
  • Enzalutamide
  • Erythromycin
  • Escitalopram
  • Eslicarbazepine Acetate
  • Estazolam
  • Eszopiclone
  • Ethchlorvynol
  • Ethopropazine
  • Ethylmorphine
  • Etravirine
  • Fentanyl
  • Flibanserin
  • Fluconazole
  • Fluoxetine
  • Fluphenazine
  • Flurazepam
  • Fluspirilene
  • Fluvoxamine
  • Fosamprenavir
  • Fosaprepitant
  • Fosnetupitant
  • Fosphenytoin
  • Fospropofol
  • Frovatriptan
  • Furazolidone
  • Glycopyrrolate
  • Glycopyrronium Tosylate
  • Granisetron
  • Halazepam
  • Haloperidol
  • Halothane
  • Hexobarbital
  • Hydrocodone
  • Hydromorphone
  • Hydroxytryptophan
  • Hydroxyzine
  • Idelalisib
  • Imatinib
  • Imipramine
  • Indinavir
  • Iproniazid
  • Isocarboxazid
  • Isoflurane
  • Itraconazole
  • Ivacaftor
  • Ketamine
  • Ketazolam
  • Ketobemidone
  • Ketoconazole
  • Levomilnacipran
  • Levorphanol
  • Linezolid
  • Lisdexamfetamine
  • Lithium
  • Lofepramine
  • Lofexidine
  • Lomitapide
  • Lopinavir
  • Lorazepam
  • Lorcaserin
  • Loxapine
  • Lumacaftor
  • Meclizine
  • Melitracen
  • Melperone
  • Meperidine
  • Mephobarbital
  • Meprobamate
  • Meptazinol
  • Mesoridazine
  • Metaxalone
  • Methadone
  • Methamphetamine
  • Methdilazine
  • Methocarbamol
  • Methohexital
  • Methotrimeprazine
  • Methylene Blue
  • Metoclopramide
  • Mibefradil
  • Midazolam
  • Mifepristone
  • Milnacipran
  • Mirtazapine
  • Mitotane
  • Moclobemide
  • Modafinil
  • Molindone
  • Moricizine
  • Morphine
  • Morphine Sulfate Liposome
  • Nafcillin
  • Nalbuphine
  • Naratriptan
  • Nefazodone
  • Nelfinavir
  • Netupitant
  • Nevirapine
  • Nialamide
  • Nicomorphine
  • Nilotinib
  • Nitrazepam
  • Nitrous Oxide
  • Nortriptyline
  • Olanzapine
  • Ombitasvir
  • Ondansetron
  • Opipramol
  • Opium
  • Opium Alkaloids
  • Orphenadrine
  • Oxazepam
  • Oxcarbazepine
  • Oxycodone
  • Oxymorphone
  • Palbociclib
  • Palonosetron
  • Papaveretum
  • Paregoric
  • Paritaprevir
  • Paroxetine
  • Pentazocine
  • Pentobarbital
  • Perampanel
  • Perazine
  • Periciazine
  • Perphenazine
  • Phenelzine
  • Phenobarbital
  • Phenytoin
  • Piperacetazine
  • Pipotiazine
  • Piritramide
  • Posaconazole
  • Prazepam
  • Prednisone
  • Primidone
  • Procarbazine
  • Prochlorperazine
  • Promazine
  • Promethazine
  • Propofol
  • Protriptyline
  • Quazepam
  • Quetiapine
  • Ramelteon
  • Ranitidine
  • Ranolazine
  • Rasagiline
  • Remifentanil
  • Remoxipride
  • Rifabutin
  • Rifampin
  • Rifapentine
  • Ritonavir
  • Rizatriptan
  • Saquinavir
  • Secobarbital
  • Secretin Human
  • Selegiline
  • Sertindole
  • Sertraline
  • Sibutramine
  • Sodium Oxybate
  • St John's Wort
  • Sufentanil
  • Sulpiride
  • Sumatriptan
  • Suvorexant
  • Tapentadol
  • Telaprevir
  • Telithromycin
  • Temazepam
  • Thiethylperazine
  • Thiopental
  • Thiopropazate
  • Thioridazine
  • Tianeptine
  • Tilidine
  • Tiotropium
  • Tizanidine
  • Tolonium Chloride
  • Topiramate
  • Tramadol
  • Tranylcypromine
  • Trazodone
  • Triazolam
  • Trifluoperazine
  • Trifluperidol
  • Triflupromazine
  • Trimeprazine
  • Trimipramine
  • Tryptophan
  • Venlafaxine
  • Verapamil
  • Vilazodone
  • Voriconazole
  • Vortioxetine
  • Zaleplon
  • Ziprasidone
  • Zolmitriptan
  • Zolpidem
  • Zopiclone
  • Zotepine

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using hydrocodone and chlorpheniramine with any of the following is usually not recommended, but may be unavoidable in some cases. If used together, your doctor may change the dose or how often you use hydrocodone and chlorpheniramine, or give you special instructions about the use of food, alcohol, or tobacco.

  • Ethanol
  • Grapefruit Juice

Other Medical Problems

The presence of other medical problems may affect the use of hydrocodone and chlorpheniramine. Make sure you tell your doctor if you have any other medical problems, especially:

  • Acute pancreatitis (swelling of the pancreas) or
  • Addison's disease (adrenal gland problem) or
  • Alcohol abuse, or history of or
  • Drug dependence, especially narcotic abuse or dependence, or history of or
  • Enlarged prostate (eg, BPH, prostatic hypertrophy) or
  • Gallbladder disease or
  • Increased pressure in the head or
  • Lung or breathing problems (eg, COPD) or
  • Problems with passing urine or
  • Thyroid disease—Use with caution. May make these conditions worse.
  • Asthma, acute or severe or
  • Stomach or bowel blockage (eg, paralytic ileus), known or suspected or
  • Respiratory depression (very slow breathing)—Should not be used in patients with these conditions.
  • Brain tumor or
  • Head injuries or
  • Increased pressure in the head or
  • Stomach problems, acute—Some of the side effects of hydrocodone can cause serious problems in people who have these conditions.
  • Kidney disease, severe or
  • Liver disease, severe—Use with caution. The effects may be increased because of slower removal of the medicine from the body.

Proper Use of hydrocodone and chlorpheniramine

Take hydrocodone and chlorpheniramine only as directed by your doctor. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered. If too much of hydrocodone and chlorpheniramine is taken for a long time, it may become habit-forming (causing mental or physical dependence) or cause an overdose.

Hydrocodone and chlorpheniramine should come with a Medication Guide. Read and follow the instructions carefully. Ask your doctor if you have any questions.

Measure the oral liquid correctly using the marked measuring spoon, oral syringe, or medicine cup. The average household teaspoon may not hold the right amount of liquid. Ask your pharmacist for instructions for measuring the correct dose of hydrocodone and chlorpheniramine.

Dosing

Tell your doctor if you have ever had any unusual or allergic reaction to hydrocodone and chlorpheniramine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

  • For oral dosage form (solution):
    • For relief of cough, sneezing, or runny or stuffy nose:
      • Adults—5 milliliters (mL) every 4 to 6 hours as needed. Do not take more than 4 doses (20 mL) in 24 hours.
      • Children—Use and dose must be determined by your doctor.

Missed Dose

If you miss a dose of hydrocodone and chlorpheniramine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Precautions While Using hydrocodone and chlorpheniramine

It is very important that your doctor check your progress while you are using hydrocodone and chlorpheniramine. This will allow your doctor to see if the medicine is working properly and to decide if you should continue to take it. If your cough does not improve or if it gets worse within 5 days, call your doctor.

Do not use hydrocodone and chlorpheniramine if you are using or have used an MAO inhibitor (MAOI) such as Eldepryl®, Marplan®, Nardil®, or Parnate® within the past 14 days.

Hydrocodone and chlorpheniramine may be habit-forming. If you feel that the medicine is not working as well, do not use more than your prescribed dose. Call your doctor for instructions.

Hydrocodone and chlorpheniramine may make you dizzy or drowsy. Do not drive or do anything else that could be dangerous until you know how hydrocodone and chlorpheniramine affects you.

Check with your doctor before using hydrocodone and chlorpheniramine with alcohol or other medicines that affect the central nervous system (CNS). The use of alcohol or other medicines that affect the CNS may worsen the side effects of hydrocodone and chlorpheniramine, such as dizziness, poor concentration, drowsiness, unusual dreams, and trouble with sleeping. Some examples of medicines that affect the CNS are antihistamines or medicine for allergies or colds, sedatives, tranquilizers, or sleeping medicines, medicine for depression, medicine for anxiety, prescription pain medicine or narcotics, medicine for attention deficit and hyperactivity disorder, medicine for seizures or barbiturates, muscle relaxants, or anesthetics, including some dental anesthetics.

If you think you or someone else may have taken an overdose of hydrocodone and chlorpheniramine, get emergency help at once. Symptoms of an overdose include extreme dizziness or weakness, slow heartbeat or breathing, seizures, trouble breathing, and cold, clammy skin. Call your doctor right away if you notice these symptoms.

Using this medication can cause severe constipation. To prevent this, your doctor may direct you to take laxatives, drink a lot of fluids, or increase the amount of fiber in your diet. Be sure to follow the directions carefully, because continuing constipation can lead to more serious problems.

Dizziness, lightheadedness, or fainting may occur when you get up suddenly from a lying or sitting position. Getting up slowly may help lessen this problem. Also, lying down for a while may relieve the dizziness or lightheadedness.

Using hydrocodone and chlorpheniramine while you are pregnant may cause serious unwanted effects, including neonatal opioid withdrawal syndrome in your newborn baby. Tell your doctor right away if you think you are pregnant or if you plan to become pregnant while using hydrocodone and chlorpheniramine.

Hydrocodone and chlorpheniramine may cause adrenal insufficiency. Check with your doctor right away if you have darkening of the skin, diarrhea, dizziness, fainting, loss of appetite, mental depression, nausea, skin rash, unusual tiredness or weakness, or vomiting.

If you are especially sensitive to the effects of hydrocodone and chlorpheniramine, do not suddenly stop using it without first checking with your doctor. Your doctor may want you to gradually reduce the amount you are using before stopping it completely. This may help reduce the possibility of withdrawal symptoms, such as abdominal or stomach cramps, anxiety, fever, nausea, runny nose, sweating, tremors, or trouble sleeping.

Using too much of hydrocodone and chlorpheniramine may cause infertility (unable to have children). Talk with your doctor before using hydrocodone and chlorpheniramine if you plan to have children.

Make sure any doctor or dentist who treats you knows that you are using hydrocodone and chlorpheniramine.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

Hydrocodone and chlorpheniramine Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

Incidence not known

  • Bloating
  • constipation
  • decrease in the frequency or amount of urination
  • difficulty in passing urine (dribbling)
  • spasm of the throat
  • stomach cramps or pain
  • tightness of the chest
  • trouble breathing
  • vomiting

Get emergency help immediately if any of the following symptoms of overdose occur:

Symptoms of overdose

  • Blurred vision
  • chest pain or discomfort
  • cold and clammy skin
  • confusion
  • dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
  • extreme sleepiness or unusual drowsiness
  • irregular, fast or slow, or shallow breathing
  • no muscle tone or movement
  • pale or blue lips, fingernails, or skin
  • slow or irregular heartbeat
  • sweating
  • unusual tiredness or weakness

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

  • Anxiety or irritability
  • dizziness
  • drowsiness
  • dry mouth
  • headache
  • irregular heartbeat
  • nausea
  • sleepiness or unusual drowsiness

Incidence not known

  • Chills
  • fast heartbeat
  • fever
  • flushing or redness of the skin
  • hives or welts, itching skin, or rash
  • stomach discomfort or upset

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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