chlorpheniramine/ hydrocodone

Addiction, Abuse, and Misuse

Schedule II controlled substance combination containing an opioid agonist with risk of addiction, abuse, and misuse, which can lead to overdose and death; reserve for use in adult patients with adequate assessment of cough etiology for whom benefits of cough suppression outweigh risks; assess opioid abuse or addiction risk prior to prescribing; prescribe for shortest duration consistent with tx goals and only refill after reevaluation of need for continued tx; regularly reassess all patients for misuse, abuse, and addiction

Respiratory Depression

serious, life-threatening, or fatal cases may occur; monitor for respiratory depression, especially during tx initiation or in high risk patients

Accidental Ingestion

accidental ingestion of even one dose, especially by children, can result in fatal hydrocodone overdose

Medication Error Risk

ensure accuracy when prescribing, dispensing, and administering; dosing errors can result in accidental overdose and death; always use accurate mL measuring device when measuring and administering oral liquid forms

CYP450 Interactions

concomitant use with CYP450 3A4 inhibitors or D/C of concomitant CYP450 3A4 inducers may incr. hydrocodone concentration which may incr. or prolong adverse effects including potentially fatal respiratory depression; monitor patients receiving any concomitant CYP450 3A4 inhibitor or inducer

Risks from Concomitant Use with Benzodiazepines, CNS Depressants

concomitant opioid use with benzodiazepines or other CNS depressants, including alcohol, may result in profound sedation, respiratory depression, coma, and death; avoid use of opioid cough medications in patients taking benzodiazepines, other CNS depressants, or alcohol

Avoid Alcohol

instruct patients not to consume alcoholic beverages or use alcohol-containing prescription or non-prescription medications; alcohol consumption during tx may result in incr. plasma levels and potentially fatal hydrocodone overdose

Neonatal Opioid Withdrawal Syndrome

use not recommended in pregnant patients; advise pregnant patients with extended opioid use of risk of potentially life-threatening neonatal opioid withdrawal syndrome; ensure tx by neonatology experts available at delivery