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Hydrocodone/Homatropine

    DEA Class; Rx

    Common Brand Names; Tussigon

    • Antitussives, Narcotic Combos

    Semisynthetic opiate agonist antitussive combined with a subtherapeutic amount of homatropine, an anticholinergic agent, to deter abuse
    Used as an antitussive for the treatment of cough in adults
    Not indicated in pediatric patients under 18 years of age; contraindicated in neonates, infants and children less than 6 years of age

    Indicated for cough suppression.

    Children <6 years

    Significant respiratory depression

    Acute or severe bronchial asthma in an unmonitored setting or in the absence of resuscitative equipment

    Known or suspected gastrointestinal obstruction, including paralytic ileus

    Hypersensitivity to hydrocodone, homatropine, or any of inactive primary glaucoma or a predisposition to glaucoma

    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

    The hydrocodone in the medication may increase the frequency of seizures in patients with seizure disorders, and may increase risk of seizures occurring in other clinical settings associated with seizures; monitor patients with a history of seizure disorders for worsened seizure control during therapy

    Not recommended for use in pregnant women, including during or immediately prior to labor; prolonged use of opioids during pregnancy may cause neonatal opioid withdrawal syndrome

    Because of potential for serious adverse reactions, including excess sedation, respiratory depression, and death in a breastfed infant, advise patients that breastfeeding is not recommended during treatment

    Adults

    30 mg/day PO of hydrocodone; 9 mg/day homatropine.

    Geriatric

    30 mg/day PO of hydrocodone; 9 mg/day homatropine.

    Adolescents

    Safety and efficacy have not been established.

    Children

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

    Infants

    Use is contraindicated.

    hydrocodone/homatropine methylbromide

    tablet: Schedule II

    • 5mg/1.5mg (Tussigon)
    • Generic available

    oral solution: Schedule II

    • (5mg/1.5mg)/5mL (Hydromet)
    • Generic available