Hydrocodone and chlorpheniramine (oral route)


    Brand Name

    US Brand Name

    Vituz


    Description

    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 an opioid 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 symptoms if treatment is stopped suddenly.

    This medicine is available only with your doctor's prescription.


    Before Using

    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 this medicine, the following should be considered:

    Allergies

    Tell your doctor if you have ever had any unusual or allergic reaction to this medicine 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 this medicine.

    Breastfeeding

    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.

    Drug Interactions

    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 this medicine, 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 this medicine 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.

    • Naltrexone
    • Potassium Citrate
    • Safinamide
    • Samidorphan
    • Tranylcypromine

    Using this medicine 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.

    • Abametapir
    • Acepromazine
    • Aclidinium
    • Alfentanil
    • Almotriptan
    • Alprazolam
    • Amantadine
    • Amifampridine
    • Amiloride
    • Amineptine
    • Amiodarone
    • Amitriptyline
    • Amitriptylinoxide
    • Amobarbital
    • Amoxapine
    • Amphetamine
    • Amprenavir
    • Anileridine
    • Apalutamide
    • Aprepitant
    • Aripiprazole
    • Aripiprazole Lauroxil
    • Armodafinil
    • Asenapine
    • Atazanavir
    • Atropine
    • Avacopan
    • Baclofen
    • Belladonna
    • Belzutifan
    • Bemetizide
    • Bendroflumethiazide
    • Benperidol
    • Bentazepam
    • Benzhydrocodone
    • Benzphetamine
    • Benzthiazide
    • Benztropine
    • Berotralstat
    • Biperiden

    Other Interactions

    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 this medicine 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 this medicine, 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 this medicine. 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 use disorder, or history of or
    • Drug dependence, especially opioid use disorder 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

    Take this medicine 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 this medicine is taken for a long time, it may become habit-forming (causing mental or physical dependence) or cause an overdose.

    This medicine 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 this medicine.

    Dosing

    Tell your doctor if you have ever had any unusual or allergic reaction to this medicine 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 this medicine, 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.

    Drop off any unused opioid medicine at a drug take-back location right away. If you do not have a drug take-back location near you, flush any unused opioid medicine down the toilet. Check your local drug store and clinics for take-back locations. You can also check the DEA web site for locations. Here is the link to the FDA safe disposal of medicines website: www.fda.gov/drugs/resourcesforyou/consumers/buyingusingmedicinesafely/ensuringsafeuseofmedicine/safedisposalofmedicines/ucm186187.htm


    Precautions

    It is very important that your doctor check your progress while you are using this medicine. 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 this medicine if you are using or have used an MAO inhibitor (MAOI) such as Eldepryl®, Marplan®, Nardil®, or Parnate® within the past 14 days.

    This medicine 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.

    This medicine may make you dizzy or drowsy. Do not drive or do anything else that could be dangerous until you know how this medicine affects you.

    Check with your doctor before using this medicine 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 this medicine, 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 opioids, 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 this medicine, get emergency help at once. Your doctor may also give naloxone to treat an overdose. Naloxone is a medicine that temporarily reverses the effects of an overdose. If you have been prescribed naloxone, make sure household members know how to use this on you in the event of an overdose or suspected overdose. Emergency medical attention is still needed after naloxone is used because the reversal effects are only temporary. Symptoms of an overdose include extreme dizziness or weakness, dark urine, trouble breathing, irregular, fast or slow, or shallow breathing, nausea or vomiting, pain in the upper stomach, pale or blue lips, fingernails, or skin, pinpoint pupils of the eyes, or yellow eyes or skin.

    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 this medicine 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 this medicine.

    This medicine 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 this medicine, 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 this medicine may cause infertility (unable to have children). Talk with your doctor before using this medicine if you plan to have children.

    Make sure any doctor or dentist who treats you knows that you are using this medicine.

    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.


    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.






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