Dosing and uses of Tussigon (hydrocodone/homatropine)
Adult dosage forms and strengths
hydrocodone/homatropine
tablet: Schedule II
- 5mg/1.5mg
Cough
5 mg/1.5 mg (1 tablet) PO q4-6hr
Not to exceed 30 mg/9 mg (6 tablets) in 24 hr
Administration
Administer liquid with special measuring device for accurate dose
Administer with food if GI upset occurs
Pediatric dosage forms and strengths
hydrocodone/homatropine
tablet: Schedule II
- 5mg/1.5mg
Cough
<6 years: Safety and efficacy not established
6-12 years: 2.5 mg/0.75 mg (1/2 tablet) PO q4-6hr, up to 15 mg/4.5 mg (3 tablets) in 24 hr
>12 years: 5 mg/1.5 mg (1 tablet) PO q4-6hr, up to 30 mg/9 mg (6 tablets) in 24 hr
Tussigon (hydrocodone/homatropine) adverse (side) effects
Frequency not defined
Hydrocodone
- Bradycardia, anticholinergic effects (dry mouth, palpitation, tachycardia)
- Angina, arrhythmias, cardiac arrest, myocardial infarction, QT-interval prolongation, pectoris, syncope, severe cardiac ST segment elevation, ventricular tachycardia
- Agitation, coma, dizziness, mental clouding/depression, dysphoria, euphoria, faintness, restlessness, nervousness, weakness, sedation, seizures, visual disturbances
- Flushing, sweating, pruritus, urticaria, warmness of the face/neck/upper thorax
- Constipation, nausea, vomiting
- Urinary retention, oliguria
- Respiratory/circulatory depression, respiratory arrest, shock, cardiac arrest
Homatropine
- Edema
- Vascular congestion
- Exudate
- Eczematoid dermatitis
- Increased IOP
- Follicular conjunctivitis
Warnings
Contraindications
Hydrocodone
- Absolute: acute abdominal condition, diarrhea associated with toxins, paralytic ileus, pseudomembranous colitis, respiratory depression
- Relative: asthma (acute), cardiac arrhythmia, cardiac disease, congestive heart failure, coronary artery DX, bladder outlet obstruction, GI tract obstruction, glaucoma (open & closed), hemorrhage, hiatal hernia, inflammatory bowel disease, intestinal atony, mitral valve stenosis, myasthenia gravis, obstructive uropathy, prostatic hypertrophy, reflux esophagitis, respiratory impairment, tachycardia, ulcerative colitis, urinary retention
Homatropine
- Sensitivity to homatropine, primary glaucoma or a predisposition to glaucoma
Cautions
Hydrocodone
- Autonomic neuropathy, brain damage in children, cardiac arrhythmias, chronic lung disease, Down Syndrome, drug abuse/dependence, emotional liability, gallbladder disease, head injury, hepatic impairment, hypertension, hyperthyroidism, increased intracranial pressure, renal impairment, seizures with epilepsy, spastic paralysis in children, toxemia of pregnancy, urethral stricture, urinary tract surgery, xerostomia
Homatropine
- Discontinue the drug if signs or symptoms of sensitivity occur during treatment or if irritation persists or increases
- Use with extreme caution in infants and young children because of increased susceptibility to systemic effects
Pregnancy and lactation
Pregnancy category: C
Lactation: undetermined; not recommended
Pregnancy categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.
C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.
D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.
X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.
NA: Information not available.
Pharmacology of Tussigon (hydrocodone/homatropine)
Mechanism of action
Hydrocodone: Antitussive; narcotic agonist analgesic
Homatropine: Anticholinergic agent adjunct to hydrocodone bitartrate added in subtherapeutic amount to suppress deliberate overdosage
Pharmacokinetics
Hydrocodone
- Half-life: 3.3-4.4 hr
- Duration of action: 4-8 hr
- Peak plasma time: 1.3 hr
- Metabolism: liver (O-demethylation, N-demethylation, 6-keto reduction); hepatic P450 enzyme CYP2D6
- Excretion: Urine (mainly)
Homatropine
- Duration of action: 6 hr
- Excretion: Urine
