Hydrocodone Bitartrate / Homatropine Methylbromide	(HIGH-droe-KOE-dohn by-TAR-trate/hoe-MAT-troe-peen METH-ill-BROE-mide)
Trade Name(s):	Hydrocodone/Homatropine   ·Syrup 5 mg hydrocodone bitartrate and 1.5 mg homatropine methylbromide   Tussigon   ·Tablets 5 mg hydrocodone bitartrate and 1.5 mg homatropine methylbromide Indicates Canadian Trade Name.
Class:	Antitussive combination
Action:
	Hydrocodone Suppresses cough reflex; stimulates opiate receptors in the CNS and peripherally blocks pain impulse generation.
	Atropine Inhibits action of acetylcholine or other cholinergic stimuli at postganglionic cholinergic receptors.
Indications:	Symptomatic relief of cough.
Contraindications:	Hypersensitivity to any component of product.
Interactions:
	Alcohol, antianxiety agents, antihistamines, antipsychotic agents, CNS depressants, narcotics CNS depressant effects may be increased.
	MAOIs, tricyclic antidepressants Effects of these agents or hydrocodone may be increased.
Lab Test Interferences:	None well documented.
Adverse Reactions:
	cns: Sedation; drowsiness; mental clouding; lethargy; impairment of mental and physical performance; anxiety; fear; dysphoria; dizziness; psychic dependence; mood change.
	dermatologic: Skin rash; pruritus.
	gi: Nausea; vomiting; constipation.
	gu: Ureteral spasm; spasm of vesicle sphincters; urinary retention.
	respiratory: Dose-related respiratory depression.
Precautions:
	Pregnancy: Category C .
	Lactation: Undetermined.
	Children: Safety and efficacy in children younger than 6 yr of age not established.
	Special risk patients: Use with caution in elderly or debilitated patients and in those with hepatic or renal function impairment, hypothyroidism, Addison disease, prostatic hypertrophy or urethral stricture, asthma, and narrow-angle glaucoma.
	Acute abdominal conditions Diagnosis may be obscured.
	Dependence Hydrocodone has abuse potential; may be habit forming.
	Head injury or increased intracranial pressure Diagnosis of adverse reactions may be obscured; respiratory depression properties and capacity to elevate cerebrospinal fluid pressure of hydrocodone may be markedly exaggerated.
Overdosage:	Signs & symptoms Respiratory depression, extreme somnolence progressing to stupor and coma, skeletal muscle flaccidity, cold and clammy skin, bradycardia, hypotension, apnea, circulatory collapse, cardiac arrest, death.
Patient/Family Education:	Review dosing schedule for prescribed dose form (ie, syrup or tablet). Advise caregiver to use dosing spoon or syringe when giving syrup to children. Advise patient to take with food or milk if GI upset occurs. Advise patient that if a dose is missed to take as soon as remembered unless it is nearing time for the next dose. Caution patient not to double the dose to catch up. Advise patient that if cough is not controlled not to increase the dose of medication but to inform health care provider. Advise patient to inform health care provider if any of the following occur: cough associated with fever, rash, persistent headache, or bothersome adverse reactions. Caution patient that drug may cause drowsiness and to use caution while driving or performing other tasks requiring mental alertness until tolerance is determined. Advise patient to avoid alcohol and other CNS depressants because of risk of excessive sedation.