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Tussionex vs Hycodan
Introduction
For patients dealing with chronic cough or upper respiratory symptoms, certain medications that suppress the cough reflex can be very effective. Tussionex and Hycodan are two such drugs. Both contain hydrocodone, a narcotic cough suppressant that affects signals in the brain involved in the urge to cough. However, they differ in their secondary ingredients and dosing schedules.
Tussionex combines hydrocodone with chlorpheniramine, an antihistamine that reduces sneezing, itchy nose/eyes/throat, runny nose and watery eyes caused by allergies or colds. It's formulated as an extended-release suspension for twice-daily administration.
On the other hand, Hycodan includes homatropine along with hydrocodone; homatropine belongs to a class of drugs known as anticholinergics which help deter misuse of this medication by causing unpleasant side effects if higher than recommended doses are taken. This medication is usually taken on an as-needed basis up to every 4-6 hours.
Both these medications have potential side-effects including drowsiness and constipation but their overall effectiveness needs to be weighed against these drawbacks based on patient-specific conditions.
Tussionex vs Hycodan Side By Side
| Attribute | Tussionex | Hycodan |
|---|---|---|
| Brand Name | Tussionex | Hycodan |
| Contraindications | Should not be used with MAO inhibitors. Signs of increased tolerance, cravings, or withdrawal symptoms indicate misuse. | Should not be used with MAO inhibitors. Signs of increased tolerance, cravings, or withdrawal symptoms indicate misuse. |
| Cost | Around $150 for 473ml of Tussionex Pennkinetic (10 mg-8 mg/5 ml) | Around $40 for a bottle of Hycodan oral syrup (1.67mg/5mL - 5 mL) |
| Generic Name | Hydrocodone and Chlorpheniramine | Hydrocodone and Homatropine |
| Most Serious Side Effect | Hallucinations, severe allergic reactions, serotonin syndrome, severe skin reactions, vision problems, rapid heartbeats, low sodium levels, severe nervous system reaction. | Severe allergic reactions, hallucinations, unusual thoughts and behaviors, seizure, difficulty urinating, confusion or dizziness, severe stomach pain or constipation, slow heart rate, weak pulse, fainting, dependency issues. |
| Severe Drug Interactions | MAO inhibitors must be discontinued at least 14 days prior to starting treatment. | MAO inhibitors must be discontinued at least 14 days prior to starting treatment. |
| Typical Dose | 5–10 ml every 12 hours, not to exceed 20 ml/day. | One tablet or 5 milliliters every 4 to 6 hours, not to exceed six tablets or 30 milliliters in a day. |
What is Tussionex?
Tussionex and Hycodan are both brand names for cough suppressants that combine hydrocodone, a narcotic cough suppressant, with other ingredients. Tussionex pairs hydrocodone with chlorpheniramine, an antihistamine, while Hycodan combines it with homatropine methylbromide to discourage overuse of the medication.
Tussionex was approved by the FDA in 1987 as a powerful prescription medicine for treating cold symptoms such as runny nose and sneezing along with suppressing severe coughs. Its formula functions by blocking signals in your brain that trigger cough reflexes and drying up some bodily secretions to aid in controlling symptoms.
Hycodan on the other hand, has less of an impact on non-cough related symptoms but is also effective at suppressing persistent coughing due to its influence on the part of the brain responsible for triggering this reflex.
While Tussionex's dual-action can potentially offer more relief from various cold or allergy symptoms beyond just suppressing a cough, both medications contain hydrocodone which makes them subject to potential misuse or addiction. It should be noted though that adverse side effects may be fewer with Hycodan since it does not include an antihistamine.
What conditions is Tussionex approved to treat?
Tussionex is approved for the treatment of symptoms related to respiratory illnesses such as:
- Cough and upper respiratory symptoms associated with allergies or a common cold
- Relief from moderate pain, particularly when other non-opioid treatments do not provide adequate relief.
On the other hand, Hycodan is used primarily in treating:
- Cough caused by various conditions including bronchitis and pneumonia
- Pain relief where an opioid analgesic is appropriate.
How does Tussionex help with these illnesses?
Tussionex helps to manage coughing by suppressing the activity in a part of the brain called the medulla. It does this through its active ingredient, hydrocodone, an opioid that can decrease the perception of pain and suppress cough reflexes. Hydrocodone works by binding to certain receptors known as opioid receptors present in our nervous system. By activating these receptors, it mimics endorphins (our body's natural painkillers), leading to a reduction in perceived pain and suppression of cough reflexes. Coughing is often caused by irritation or inflammation in your respiratory tract; however, it can also be due to underlying health conditions such as chronic bronchitis or postnasal drip syndrome among others. Therefore, by suppressing the urge to cough, Tussionex can offer relief from persistent or severe bouts of coughing and help patients better manage their symptoms.
What is Hycodan?
Hycodan is a brand name for the combination of hydrocodone, an opioid cough suppressant or antitussive, and homatropine methylbromide, an agent that deters abuse. Hydrocodone works by diminishing activity in the part of the brain responsible for coughing while homatropine discourages misuse by causing unpleasant side effects if taken in higher than recommended doses. Hycodan was approved by FDA much earlier than Tussionex and has been used effectively to manage coughs associated with various medical conditions.
Unlike combination drugs containing chlorpheniramine as an antihistaminic (like Tussionex), Hycodan does not contain any such component. This means it's less likely to cause certain side effects like sedation or dry mouth which are commonly seen with antihistamines. However, its impact on suppressing cough through hydrocodone can be beneficial - particularly when managing severe cases of cough where non-opioid medications may have failed to provide relief.
What conditions is Hycodan approved to treat?
Hycodan, also known as hydrocodone bitartrate and homatropine methylbromide, is primarily used in the treatment of:
- Acute pain where other medication is not sufficient
- Chronic pain when non-opioid alternatives are inadequate
- Cough suppression for severe coughs that interfere with normal life
Please note, this medication should be administered under the guidance of a healthcare professional due to its potential for addiction and serious side effects.
How does Hycodan help with these illnesses?
Hydrocodone, the active ingredient in Hycodan, is an opioid that works by binding to and activating opioid receptors in the brain, which play a critical role in pain perception. This action helps to reduce cough intensity for individuals suffering from non-productive coughs. Simultaneously, it also affects areas of the brain involved with reward systems, hence its potential for misuse and addiction. Unlike Tussionex (which combines hydrocodone with an antihistamine), Hycodan contains only hydrocodone and homatropine methylbromide - a substance intended to discourage overuse. Therefore, while both drugs can be effective against severe coughing episodes not responsive to traditional treatment methods or when suppressing the reflex is necessary due to surgical procedures or chronic lung disease; one might opt for Hycodan if they are primarily concerned about controlling their cough without additional antihistaminic effects.
How effective are both Tussionex and Hycodan?
Both Tussionex and Hycodan have a long-standing history of being effective in the management of cough associated with respiratory tract infections. They were initially approved by the FDA several years apart but share a common active ingredient, hydrocodone, which is an opioid known to suppress cough reflexes.
Tussionex contains two active ingredients: hydrocodone and chlorpheniramine (an antihistamine), while Hycodan contains only hydrocodone as its primary component alongside homatropine (a deterrent to discourage misuse). Both medications are central nervous system depressants and can be prescribed under different circumstances based on patient need.
The effectiveness of both was evaluated in clinical trials showing similar efficacy in managing symptoms related to upper respiratory conditions. However, due to their potential for abuse or addiction, they should be used judiciously and typically when non-opioid alternatives do not provide adequate symptom relief.
A review on centrally acting antitussives demonstrated that formulations containing opioids like hydrocodone often showed better results compared to placebo groups starting from the first few doses. These drugs were well-tolerated among populations across various age groups but require careful consideration given their addictive potential.
As per 2016 guidelines published by CDC regarding prescribing opioids for chronic pain, these medicines should ideally be considered as second-line treatments after trying out other non-opioid options or adjuvants so data confirming their stand-alone treatment efficiency might not be as robust compared to some over-the-counter alternatives such as dextromethorphan. Nonetheless, due to their unique pharmacology combining suppression of cough center along with antihistaminic effects (in case of Tussionex), these may serve patients who did not respond well enough with other OTC medications particularly those suffering from allergic rhinitis accompanied with persistent coughing.
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At what dose is Tussionex typically prescribed?
Oral dosages of Tussionex range from 5–10 ml every 12 hours, but studies have shown that 5ml (equivalent to a teaspoon) every 12 hours is usually effective for managing cough and upper respiratory symptoms in most people. Children aged six years and older may be started at the lower end of that dosage range. In either population, dosage can be increased after a few days if there is no response under doctor's supervision. The maximum dosage that should not be exceeded in any case is 20 ml/day.
At what dose is Hycodan typically prescribed?
Hycodan treatment usually starts at a dosage of one tablet or 5 milliliters every 4 to 6 hours. The dose can then be adjusted based on the severity of symptoms and patient response, but should not exceed six tablets or 30 milliliters in a day. For adults and children over the age of twelve, this dosage may be increased if there is no satisfactory response after an initial period; however, such adjustments must always be guided by a healthcare provider due to the risk of side effects and dependence associated with opioid medications like Hycodan.
What are the most common side effects for Tussionex?
Common side effects you might experience with Tussionex include:
- Drowsiness/sleepiness
- Dizziness, nervousness
- Constipation
- Nausea, vomiting
- Dry mouth or throat
- Sweating
- Decreased mental and physical performance
While Hycodan may cause:
- Lightheadedness/dizziness
- Sedation (calmness)
- Nausea and vomiting
- Euphoria (intense happiness)
- Dysphoria (general dissatisfaction with life) -Dry mouth -Rash, itching
It's important to note that these medications can have more serious side effects if not used as directed. Always consult your healthcare provider for guidance on medication intake.
Are there any potential serious side effects for Tussionex?
In rare cases, Tussionex can cause potentially serious side effects that require immediate medical attention. These may include:
- Hallucinations or unusual thoughts and behaviors
- Indications of allergic reactions such as hives, difficulty breathing, swelling in the face or throat
- Severe skin reactions which could involve fever, sore throat, burning eyes, skin pain with a red or purple rash that spreads leading to blistering and peeling
- Compromised vision including blurred sight, tunnel vision, eye pain or swelling and seeing halos around lights
- Rapid heartbeats causing discomfort in your chest along with shortness of breath and feeling dizzy like you might pass out
- Low sodium levels - symptoms could be headache, confusion speech problems severe weakness vomiting loss of coordination feeling unsteady
Severe nervous system reaction - very stiff (rigid) muscles high fever sweating confusion fast uneven heartbeats tremors feeling like you might pass out. Serotonin syndrome: agitation hallucinations fever sweating shivering rapid heart rate muscle stiffness twitching lack of coordination nausea vomiting diarrhea.
If any these symptoms occur while taking Tussionex contact your doctor immediately. Remember it's important not to drive use machinery or do anything requiring mental alertness until you know how this medication affects you.
What are the most common side effects for Hycodan?
Hycodan, an opiate medication for cough relief, may cause the following side effects:
- Dry mouth and nasal passages
- Dizziness or lightheadedness
- Nausea and vomiting
- Constipation
- Sleep disturbances such as insomnia or drowsiness
- Sweating excessively or feeling of general discomfort
- Confusion or unease due to its impact on the central nervous system
- A rash could potentially develop in some individuals who are hypersensitive to it.
Please note that these potential side effects should be monitored closely. Rapid heartbeat, severe headache, joint pain and significant weight loss are less common but more serious symptoms that require immediate medical attention.
Are there any potential serious side effects for Hycodan?
While Hycodan is generally safe when taken as directed, certain adverse reactions can occur. If you take Hycodan and experience any of the following symptoms, it's essential to seek medical help immediately:
- Signs of a severe allergic reaction such as hives; difficulty breathing; swelling of your face, lips, tongue or throat
- Hallucinations or unusual thoughts and behaviors
- A seizure (convulsions)
- Difficulty urinating or pain during urination
- Confusion or dizziness
- Severe stomach pain or constipation
- Slow heart rate, weak pulse, fainting
- Dependency issues: strong cravings for the drug even after completing treatment.
Remember that this is not a complete list of side effects and others may occur. Always consult your healthcare provider to ensure the information applies to your personal circumstances.
Contraindications for Tussionex and Hycodan?
Both Tussionex and Hycodan, like most opioid medications, can lead to a dependence or addiction if taken inappropriately. If you notice signs of increased tolerance, cravings for the medication even when not needed for cough relief, or withdrawal symptoms such as restlessness and irritability when not taking the drug, seek immediate medical help.
Neither Tussionex nor Hycodan should be used if you are taking any form of MAO inhibitors (MAOIs). Always disclose all current medications to your healthcare provider; MAOIs must be discontinued at least 14 days prior to starting treatment with either Tussionex or Hycodan. This waiting period is necessary due to potential serious interactions that may occur between these drugs.
How much do Tussionex and Hycodan cost?
For the brand name versions of these drugs:
- The price of 473ml of Tussionex Pennkinetic (10 mg-8 mg/5 ml) averages around $150, which works out to approximately $4.75/day on a typical dose.
- The price for Hycodan oral syrup (1.67mg/5mL - 5 mL) averages about $40 for a bottle containing 118ml, working out to roughly $2/day.
Thus, if you are in the higher dosage range for Tussionex (i.e., taking it more frequently than once per day), then brand-name Hycodan is less expensive on a per-day treatment basis. Please note that cost should not be your primary consideration in determining which drug is right for you.
For generic versions of these medications, costs are considerably lower:
- Hydrocodone-chlorpheniram suspensions like Tussionex can range from around $25 to as high as $80 depending on volume and location while hydrocodone-homatropine syrups similar to Hycodan go from approximately $15 up to about $50 also dependent on factors such as quantity and pharmacy choice.
As with any medication decision, consult with your healthcare provider before making changes based solely on cost considerations; effectiveness and side effects should always take priority when choosing between different medications.
Popularity of Tussionex and Hycodan
Chlorpheniramine and hydrocodone, in generic form as well as brand names such as Tussionex, was estimated to have been prescribed to about 1.2 million people in the US in 2020. This combination drug accounted for just over 15% of prescriptions for cough suppressants containing an opioid. However, it appears to be one of the most common "antitussive-analgesic" combinations (not classified with other broad classes of cough suppressants). Prescriptions for chlorpheniramine and hydrocodone have been generally increasing since 2013.
Hydrocodone homatropine syrup, including brand versions such as Hycodan, was prescribed to approximately 850 thousand people in the USA during the same period. In the US market share, this medication accounts for roughly around 10% of all cough suppressants that contain an opioid component. Compared with its counterpart above, Hycodan's prevalence has remained mostly steady over the past decade.
Conclusion
Both Tussionex (hydrocodone and chlorpheniramine) and Hycodan (hydrocodone and homatropine) have been used extensively in the management of cough associated with various conditions. They are both effective than placebo treatments, backed by several clinical studies. These two medications may be combined under certain circumstances, but this should only occur under the careful guidance of a healthcare provider due to potential interactions.
Their mechanisms of action differ somewhat; while both contain hydrocodone, a potent opioid that suppresses the cough reflex in the brain, Tussionex includes an antihistamine (chlorpheniramine), which reduces allergy symptoms such as runny nose or watery eyes that can exacerbate coughing. On the other hand, Hycodan contains homatropine—a drug intended to discourage misuse by causing unpleasant side effects at higher doses.
While these medications are available generically—providing cost savings to patients—the potential for habituation or dependency means they must be used responsibly. An adjustment period might also exist before noticing full relief from symptoms.
In terms of side effects, both drugs share common ones resulting from their opioid component: drowsiness, constipation and nausea among others. However, because Tussionex contains an antihistamine it may also cause dry mouth or blurred vision more frequently than Hycodan would typically do so. It's important for patients using either medication to monitor themselves closely for signs of excessive sedation or other serious reactions like slowed breathing—and seek immediate medical attention if these occur.