homatropine/hydrocodone (Hycodan)

Indications

symptomatic relief of cough

Contraindications

• increased intracranial pressure
• depressed ventilation

Dosage

• adults & children > 12 years of age:
  • 5-10 mL or 1-2 tablets (5-10 mg hydrocodone) every 4-6 hours PRN
  • maximum: 15 mg/dose (adults); 10 mg (children)
• children 2-12 years of age:
  • 2.5 mL or 1/2 tablet (2.5 mg hydrocodone) every 4-6 hours PRN
  • maximum: 5 mg/dose
• 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:

• common (> 10%)
  • lightheadedness, dizziness, sedation, drowsiness, weakness, tiredness, hypotension
• less common (1-10%)
  • shortness of breath, troubled breathing, confusion, diminished urination, nausea/vomiting, bradycardia, tachycardia
• 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
• other
  • rash
  • blood dyscrasias
  • nephrotoxicity with chronic use
  • hepatotoxicity
  • respiratory depression is dose & tolerance-related
  • tolerance & dependence
  • constipation

Drug interactions

• naloxone is a direct opiate antagonist
• CNS depressants
• phenothiazines
• tricyclic antidepressants (TCA)

More general terms

• pharmacologic combination
• antitussive agent

Components

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