homatropine/hydrocodone (Hycodan)

Indication: symptomatic relief of cough Contraindications: 1) increased intracranial pressure 2) depressed ventilation Dosage: 1) adults & children > 12 years of age: a) 5-10 mL or 1-2 tablets (5-10 mg hydrocodone) every 4-6 hours PRN b) maximum: 15 mg/dose (adults); 10 mg (children) 2) children 2-12 years of age: a) 2.5 mL or 1/2 tablet (2.5 mg hydrocodone) every 4-6 hours PRN b) maximum: 5 mg/dose 3) children < 2 years of age: - 1.25 mL (1.25 mg hydrocodone) every 4-6 hours PRN Syrup: hydrocodone bitartrate 5 mg & homatropine methylbromide 1.5 mg/5 mL Tabs: hydrocodone bitartrate 5 mg & homatropine methylbromide 1.5 mg Averse effects: 1) common (> 10%) - lightheadedness, dizziness, sedation, drowsiness, weakness, tiredness, hypotension 2) less common (1-10%) - shortness of breath, troubled breathing, confusion, diminished urination, nausea/vomiting, bradycardia, tachycardia 3) uncommon (< 1%) - hallucinations, hypertension, double vision, dry mouth, anorexia, miosis, biliary or urinary spasm, histamine release, hot & dry skin, impaired GI motility, mydriasis, blurred vision 4) other - rash - blood dyscrasias - nephrotoxicity with chronic use - hepatotoxicity - respiratory depression is dose & tolerance-related - tolerance & dependence - constipation Drug interactions: 1) naloxone is a direct opiate antagonist 2) CNS depressants 3) phenothiazines 4) tricyclic antidepressants (TCA)

General

pharmacologic combination antitussive agent

References

Kaiser Permanente Northern California Regional Drug Formulary, 1998

Components

homatropine (Isopto Homatropine) hydrocodone; dihydrocodeinone (Zohydro ER, Hysingla ER)