Hydrocodone-Chlorpheniramine-Pseudoephedrine

Hydrocodone-Chlorpheniramine-Pseudoephedrine is a combination medication used for the relief of cough and nasal congestion associated with common cold or allergies in adults. 

• Hydrocodone-Chlorpheniramine-Pseudoephedrine is available under the following different brand names: Zutripro.

Common side effects of Hydrocodone-Chlorpheniramine-Pseudoephedrine include:

• Drowsiness,
• Dizziness,
• Lack of energy,
• Coordination problems,
• Headache,
• Confusion,
• Dry mouth,
• Nausea,
• Vomiting,
• Constipation,
• Tremors,
• Fast or irregular heart rate,
• Anxiety,
• Restlessness,
• Nervousness, and
• Irritableness  

Serious side effects of Hydrocodone-Chlorpheniramine-Pseudoephedrine include:

• Hives,
• Difficulty breathing,
• Swelling of the face, lips, tongue, or throat,
• Slow breathing with long pauses,
• Blue-colored lips,
• Difficult to wake up,
• Noisy breathing,
• Sighing,
• Shallow breathing,
• Slow or fast heart rate,
• Weak pulse,
• Dizziness,
• Weakness,
• Trouble sleeping,
• Seizure,
• Lightheadedness,
• Severe constipation,
• Little or no urination,
• Nausea,
• Vomiting,
• Loss of appetite,
• Dizziness,
• Worsening tiredness,
• Weakness,
• Agitation,
• Hallucinations,
• Fever,
• Sweating,
• Shivering,
• Muscle stiffness,
• Twitching,
• Loss of coordination, and
• Diarrhea

Rare side effects of Hydrocodone-Chlorpheniramine-Pseudoephedrine include:

• None 

Seek medical care or call 911 at once if you have the following serious side effects:

• Severe headache, confusion, slurred speech, arm or leg weakness, trouble walking, loss of coordination, feeling unsteady, very stiff muscles, high fever, profuse sweating, or tremors;
• Serious eye symptoms such as sudden vision loss, blurred vision, tunnel vision, eye pain or swelling, or seeing halos around lights;
• Serious heart symptoms include fast, irregular, or pounding heartbeats; fluttering in the chest; shortness of breath; sudden dizziness, lightheadedness, or passing out.

This is not a complete list of side effects and other serious side effects or health problems that may occur because of the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may report side effects or health problems to FDA at 1-800-FDA-1088.

Adult dosage

Oral solution: Schedule II

• (5 mg/4 mg/60 mg)/5 mL

Cough/Cold/Allergies

Adult dosage

• 5 mL orally every 4-6 hours or as needed; not to exceed 4 doses (20 mL) in 24 hours.

Dosage Considerations – Should be Given as Follows: 

• See “Dosages”

If your medical doctor is using this medicine to treat your pain, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider, or pharmacist first.

• Hydrocodone-Chlorpheniramine-Pseudoephedrine has severe interactions with the following drugs:
  • alvimopan
  • dihydroergotamine
• Hydrocodone-Chlorpheniramine-Pseudoephedrine has serious interactions with at least 158 other drugs.
• Hydrocodone-Chlorpheniramine-Pseudoephedrine has moderate interactions with at least 366 other drugs.
• Hydrocodone-Chlorpheniramine-Pseudoephedrine has minor interactions with the following drugs:
  • acetazolamide
  • anastrozole
  • ashwagandha
  • cyclophosphamide
  • brimonidine
  • cyclophosphamide
  • desmopressin
  • eucalyptus

This information does not contain all possible interactions or adverse effects. Visit the RxList Drug Interaction Checker for any drug interactions. Therefore, before using this product, tell your doctor or pharmacist about all your products. Keep a list of all your medications with you and share this information with your doctor and pharmacist. Check with your healthcare professional or doctor for additional medical advice, health questions, or concerns.

Contraindications

Hypersensitivity

• Coadministration with MAOIs or within 14 days of discontinuing MAOIs; may increase the risk of hypertensive crisis.
• Narrow-angle glaucoma
• Urinary retention
• Severe hypertension or severe coronary artery disease

Effects of drug abuse

• None

Short-Term Effects

• See “What Are Side Effects Associated with Using Hydrocodone-Chlorpheniramine-Pseudoephedrine?”

Long-Term Effects

• See “What Are Side Effects Associated with Using Hydrocodone-Chlorpheniramine-Pseudoephedrine?”

Cautions

• May cause dose-related respiratory depression; use with caution.
• Hydrocodone can cause drug dependence; prescribe with caution that is appropriate to the use of other opioids.
• Avoid use in patients with head injury or elevated ICP; opioids decrease respiratory depression and may increase ICP.
• May cause drowsiness; avoid engaging in hazardous tasks requiring complete mental alertness such as driving or operating machinery.
• Elicits CNS depressant effects; avoid concurrent use of alcohol or other central nervous system depressants.
• Use with caution with acute abdominal conditions; opioids may obscure diagnosis and anticholinergics may increase the risk of paralytic ileus.
• Coexisting conditions: Use with caution with diabetes, thyroid disease, Addison’s disease, prostatic hypertrophy or urethral stricture, or asthma.
• Use with TCAs may increase the effects of hydrocodone or TCAs.
• Pseudoephedrine components may increase the risk of hypertension.
• Observational studies have demonstrated that concomitant use of opioid analgesics and benzodiazepines increases the risk of drug-related mortality compared to the use of opioids alone; because of similar pharmacologic properties, it is reasonable to expect similar risk with concomitant use of opioid cough medications and benzodiazepines, other CNS depressants, or alcohol.

Pregnancy and Lactation

• Use with caution if the benefits outweigh the risks during pregnancy.
• Lactation
  • Hydrocodone, chlorpheniramine, and pseudoephedrine are distributed in breast milk; caution advised, chlorpheniramine may suppress lactation is used before nursing.