chlorpheniramine and hydrocodone, Tussionex (cont.)

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Medical and Pharmacy Editor:

Chlorpheniramine also can intensify the drying effects (due to decreased production of mucus) of other medications with anticholinergic properties (for example, dicyclomine [Bentyl], bethanechol [Urecholine], Probanthine).

PREGNANCY: Antihistamines are typically not recommended for use in pregnancy, especially during the third trimester, because of a risk of seizures in the fetus. The risk for depressed breathing in the newborn infant when the mother ingests hydrocodone is greatest in premature infants who are particularly sensitive to the effects of hydrocodone. Physicians may decide to prescribe chlorpheniramine and hydrocodone during pregnancy if the benefits to the mother are deemed to outweigh the risks to the fetus and newborn.

NURSING MOTHERS: Chlorpheniramine and hydrocodone both are secreted in breast milk. Owing to the risk in infants of antihistamines causing hyperexcitability and even seizures, particularly in newborns and premature infants, the combination of chlorpheniramine and hydrocodone is not recommended for use in nursing mothers.

SIDE EFFECTS: The most frequent side effects of chlorpheniramine and hydrocodone include lightheadedness, dizziness, sedation, nausea, vomiting, disturbed coordination, and drying and thickening of oral and other respiratory secretions. Other side effects include dyspepsia (indigestion), constipation, spasm of the ureter (which can lead to difficulty urinating), palpitations, increased heart rate, confusion, drowsiness, anxiety, nervousness, irritability, blurred vision, double vision, and tremor.

Hydrocodone can depress breathing, and should be used with caution in elderly, debilitated patients, and in patients with serious lung disease. Hydrocodone can impair thinking and the physical abilities required for driving or operating machinery. Hydrocodone may be habit forming. Mental and physical dependence can occur but are unlikely when used for short-term relief of pain.

Reference: FDA Prescribing Information

Last Editorial Review: 9/28/2011

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