Hydrocodone/Pseudoephedrine/Guaifenesin

DEA Class; Rx

Common Brand Names; Hycofenix

Hydrocodone: Antitussive; narcotic agonist analgesic

Pseudoephedrine: Decongestant; alpha adrenergic agonist

Guaifenesin: Reduces viscosity of secretions by increasing amount of respiratory tract fluid

Documented hypersensitivity

Patients receiving MAOI therapy or within 14 days of stopping such therapy

Narrow angle glaucoma

Urinary retention

Severe hypertension

Severe coronary artery disease

Hydrocodone

• Respiratory depression

• Drug dependence

• Increased intracranial pressure

• Decreased mental alertness with impaired mental and/or physical abilities

• Paralytic ileus

Pseudoephedrine

• CNS effects (eg, insomnia, dizziness, weakness, tremor, or convulsions)

• Cardiovascular system effects (eg, arrhythmias, or increased blood pressure), cardiovascular collapse with accompanying hypotension

Hydrocodone produces dose-related respiratory depression by directly acting on brain stem respiratory centers

Hydrocodone can produce drug dependence and tolerance may develop upon repeated administration; prescribe with same degree of caution as use of other opioid drugs

Respiratory depression effects of opioids and their capacity to elevate cerebrospinal fluid pressure may be markedly exaggerated in the presence of head injury, other intracranial lesions, or a pre-existing increase in intracranial pressure

Hydrocodone may produce marked drowsiness and impair mental and physical abilities required for hazardous activities (eg, driving); concurrent use with alcohol or other CNS depressants should be avoided

Caution in patients with acute abdominal conditions; hydrocodone may obscure the diagnosis or clinical course of acute abdominal illness

Concurrent use of anticholinergics with hydrocodone may cause paralytic ileus

Use of MAOIs or TCAs with hydrocodone may increase the effect of either the antidepressant or hydrocodone; do not use with MAOIs or within 14 days of stopping an MAOI

Pseudoephedrine can produce cardiovascular and CNS effects in some patients (eg, insomnia, dizziness, weakness, tremor, or arrhythmias); CNS stimulation with convulsions or cardiovascular collapse with accompanying hypotension has also been reported

Do not for persistent or chronic cough (eg, associated with smoking, asthma, chronic bronchitis, or emphysema), or where cough is accompanied by excessive phlegm

Measure dose with accurate milliliter measuring device to avoid overdose

Caution with diabetes, thyroid disease, Addison disease, prostatic hypertrophy, urethral stricture, and asthma

Caution with severe renal or hepatic impairment

Pregnancy category: C

Caution; hydrocodone and pseudoephedrine are known to be excreted in human milk; no studies have been performed to determine if guaifenesin is excreted into breastmilk