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Tussionex – Prescription Cough Syrup Containing Opioid

Tussionex is a combination of two medications, hydrocodone and chlorpheniramine. They work as a cough suppressant and antihistamine.

  • It is most often prescribed for patients suffering from allergies or a common cold.

The opioid hydrocodone is a cough suppressant, known as an antitussive. It effects the region of the brain that causes the urge to cough.

  • It is manufactured by UCB Pharma, Inc.

Chlorpheniramine is the antihistamine, which helps dry up a runny nose, watery and itchy eyes, as well as provide some relief from sneezing.

There are several brand names for it, which including;

  • TussiCaps
  • S-T Forte 2
  • Vituz
  • Tussionex Pinnkinetic ER

Tussionex Pennkinetic is the extended release version.

Federal Drug Administration

“The FDA advises healthcare professionals to reassure parents that cough due to a cold or upper respiratory tract infection is self-limited and generally does not need to be treated,” writes Medscape contributor Megan Brooks.

The same is true for adults. There are potentially safer alternatives, such as drinking enough healthy fluids, using a humidifier and saline nose drops or spray can help ease the symptoms of allergies or a cold.

Side Effects

Even used as prescribed, this drug can come with serious side effects that include some of the following:

  • Light headedness, dizziness, feeling as if you’re going to pass out
  • Severe drowsiness
  • Decrease in heart rate, shallow breathing
  • Fogginess and confusion
  • Severe constipation
  • Nausea, vomiting, loss of appetite and exhaustion


Patients with existing breathing problems should avoid the medication and, as the Food and Drug Administration (FDA) ruled, this type of medication is not safe for children under the age of 18.

  • Life-threatening respiratory depression in patients with chronic pulmonary disease or in elderly, cachectic, or debilitated patients: Monitor closely, particularly during initiation of therapy.
  • Activities requiring mental alertness: Avoid engaging in hazardous tasks requiring mental alertness such as driving or operating machinery.
  • Risks of use in patients with head injury, impaired consciousness, increased intracranial pressure, or brain tumors: Avoid use. May increase intracranial pressure and obscure the clinical course of head injuries.
  • Seizures in patients with seizure disorders: Monitor during therapy.
  • Severe hypotension: Monitor during initiation of therapy. Avoid use in patients with circulatory shock.
  • Adrenal insufficiency: If diagnosed, treat with physiologic replacement of corticosteroids, and wean patient off of the opioid.
  • Not indicated for pediatric patients under 18 years of age.


Abuse or misuse, such as using more than the prescribed dose, mixing it with other stimulants and taking it for longer than necessary, can lead to addiction.

Because of its opioid makeup, there is a potential for it to suppress the cardiovascular system, especially if misused or abused.

“Given the epidemic of opioid addiction, we’re concerned about unnecessary exposure to opioids, especially in young children,” FDA Commissioner Dr. Scott Gottlieb said in a statement. “We know that any exposure to opioid drugs can lead to future addiction. It’s become clear that the use of prescription, opioid-containing medicines to treat cough and cold in children comes with serious risk that don’t justify their use in this vulnerable population.”

This drug is not the only prescription cough and cold medication that contains opioids, like hydrocodone. Codeine is another common opioid used in these kinds of cold and allergy prescription drugs.

These types of opioid combination drugs come with a high risk for abuse, overdose, addiction and withdrawal, especially with long-term use. Where this and other opioid cough and allergy meds get very dangerous is when they’re mixed with other drugs, such as alcohol. People in recovery from drugs and alcohol should let their physicians know before accepting these types of prescriptions because there are alternatives to managing cold and allergy symptoms.

Addiction to opioid medication is serious. In some cases, physicians will gradually lower a patients dose to relieve their symptoms. Though in other situations, it may be necessary for a person to seek inpatient treatment for detox and their addiction.

Once addicted, painful withdrawal symptoms can kick-in, making it difficult to stop taking the medication. Withdrawal symptoms may include some of the following:

  • Nausea, constipation and muscle aches
  • Runny nose and eyes
  • Clammy, sweaty skin to the touch
  • Feeling ill and restless

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