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    DEA Class; Rx

    Common Brand Names; Zutripro

    • Antitussives, Narcotic Combos

    Oral sedating antihistamine, opiate agonist antitussive, and decongestant combination
    Used to relieve cough and congestion due to allergies, acute or chronic bronchitis, colds, and other acute respiratory infections
    Not indicated in pediatric patients under 18 years of age; contraindicated in neonates, infants and children less than 6 years of age

    Indicated for relief of cough and nasal congestion associated with common cold or allergies in adults


    Coadministration with MAOIs or within 14 ays of discontinuing MAOIs; may increase risk of hypertensive crisis

    Narrow angle glaucoma

    Urinary retention

    Severe hypertension or severe coronary artery disease

    Hydrocodone, an opioid, may result in respiratory depression, drug dependence, increased ICP, decreased mental alertness, or paralytic ileus

    Pseudoephedrine, a sympathomimetic, may result in CNS effects (eg, insomnia, dizziness, weakness, tremor, convulsions or cardiovascular effects (eg, arrhythmias, increased blood pressure)

    Chlorpheniramine, an antihistamine, may result in decreased mental alertness or anticholinergic effects (urinary retention, ileus)

    Common adverse effects include sedation, somnolence, mental clouding, lethargy, impairment of mental and physical performance, anxiety, fear, dysphoria, dizziness, psychic dependence, mood changes, nervousness, or sleeplessness; blurred, double, or other visual disturbances; confusion, headache, euphoria, facial dyskinesia, feeling faint, lightheadedness, agitation, restlessness, insomnia, irritability, and tremor

    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 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 effects of hydrocodone or TCAs

    Pseudoephedrine component may increase risk for hypertension

    Observational studies have demonstrated that concomitant use of opioid analgesics and benzodiazepines increases risk of drug-related mortality compared to 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 Category: C

    Lactation: Hydrocodone, chlorpheniramine, and pseudoephedrine are distributed in breast milk; caution advised, chlorpheniramine may suppress lactation is used prior to nursing

    NOTE: Do not exceed recommended dosage limits for the specific product prescribed.


    Chlorpheniramine 16 mg/day PO; hydrocodone 20 mg/day PO; pseudoephedrine 240 mg/day PO.


    Chlorpheniramine 16 mg/day PO; hydrocodone 20 mg/day PO; pseudoephedrine 240 mg/day PO.


    Safety and efficacy have not been established.


    6 years and older: Safety and efficacy have not been established.
    Less than 6 years: Use is contraindicated.


    Use is contraindicated.


    oral solution: Schedule II

    • (5mg/4mg/60mg)/5mL