Tussionex, a prescription cough medicine, contains a mixture of hydrocodone (an opioid pain reliever) and chlorpheniramine (an antihistamine). In 2008, the FDA issued an alert regarding the dangers of misusing Tussionex, stating that abusing it can lead to several adverse effects, including overdose and death in high doses 1.
Tussionex should not be given to children under the age of 6 and should only be used as prescribed 1. Taking higher doses or dosing more frequently than every 12 hours can be dangerous. Mixing liquids with Tussionex (e.g., pouring the syrup into soda or juice) should be avoided, because the fluids can increase the release rate of the medication and lead to an accidental overdose 2. Because the cough medicine contains the addictive painkiller hydrocodone, it has a high potential for abuse and should be taken with caution.
Is Tussionex Harmful?
When used as prescribed by a doctor, Tussionex is a safe and effective cough medication. However, when misused, abused, or combined with other drugs, there is an increased risk of negative physical and mental health effects. These problematic patterns of drug use behaviors can also lead to marked physical dependence, tolerance, and eventually, addiction.
Addiction is a complex condition which occurs when Tussionex use becomes problematic and interferes with the ability to function and maintain one’s daily life.
People can develop tolerance to Tussionex after taking it over a period of time. As the human body and brain become accustomed to the presence of the medication, it may no longer be as effective at the same dose. When this occurs, people usually have to increase the frequency and/or amount of the drug taken to achieve the desired effect.
The repeated increase in doses of Tussionex used can lead to physical dependence over time. Someone who is physically dependent on this medication cannot function normally without it and withdrawal symptoms may occur if a dose is missed or decreased. Misusing or abusing Tussionex can increase the likelihood that a person will become physically dependent on the drug, a mechanism which can ultimately lead to addiction.
Physical dependence, however, is not the same thing as addiction. A person can be physically dependent on a drug and need it to function normally without demonstrating maladaptive and compulsive use. Addiction is a complex condition which occurs when Tussionex use becomes problematic and interferes with the ability to function and maintain one’s daily life. While physical dependence and addiction differ greatly, dependence can fuel addiction as a person may seek out the drug and engage in addictive behaviors to relieve or prevent withdrawal symptoms.
While Tussionex can be beneficial medication, some people may abuse the drug for the “high” that hydrocodone gives them. The short-term, desired effects include 3,4:
- Decreased perception of pain.
Some people may use Tussionex to deal with stress or unwanted emotions, while others may abuse it in recreational settings, such as at parties or with friends. Those who suffer from chronic pain may misuse and abuse a hydrocodone-containing medication to alleviate pain. No matter the reason someone uses Tussionex, abusing it can bring about severe and detrimental side effects.
If you or someone you know abuses Tussionex or other drugs, call our helpline at 1-888-744-0069 for assistance in finding treatment.
Although Tussionex may relieve coughing and pain, misusing or abusing this medication can produce many adverse physical and psychological effects.
Some physical side effects associated with the regular abuse of Tussionex include 3,5,6,7:
Alert: Watch Out for These Symptoms
Some potentially serious side effects that may also occur in association with Tussionex use and misuse include 5:
- Irregular menstruation.
- Decreased libido.
- Chest pain.
- Rapid heartbeat.
- Swelling of mouth, eyes, lips, throat, etc.
- Difficulty swallowing or breathing.
Those who experience any of the aforementioned adverse effects should contact their doctor or seek medical help, as they could be indications of an adverse drug reaction.
- Slowed breathing.
- Stomach pain.
- Back pain.
- Urinary retention and/or painful urination.
- Muscle tightness.
- Tinnitus (ringing in the ears).
- Uncontrollable shaking.
- Swelling of the ankles, feet, or legs.
Some adverse psychological side effects that may occur are 3,5,6,7:
- Mood swings.
- Drug cravings.
- Dysphoria (a state of unease or dissatisfaction).
- Mental clouding.
Long-Term Effects of Abuse
Abusing Tussionex on a long-term basis can lead to several physical and mental health effects. Frequent use of the drug can cause increased tolerance and dependence with withdrawal symptoms occurring when use is stopped or decreased. This can lead to the development of addiction and make it difficult for users to stop taking Tussionex, despite the negative consequences it may cause in their lives.
Some of the physical and psychological consequences of long-term Tussionex use include 1,2,3,6,8:
- Exacerbation of side effects listed above.
- Unpleasant withdrawal symptoms when use is stopped or reduced.
- Intense cravings.
- Physical and psychological dependence.
- Increased risk of overdose (slowed breathing, coma, death).
- Bowel obstruction.
- Deterioration of white matter in the brain, impacting decision-making, behavioral regulation, and stress response.
- Brain damage due to oxygen deprivation (in association with periods of slowed or stopped breathing).
Some of the personal, social, and legal consequences of long-term Tussionex abuse and addiction may include:
- Impaired work or school performance.
- Excessive tardiness or absences at school and/or work.
- Relationship and familial problems.
- Child neglect.
- Financial issues.
- Job loss.
- Suspension or expulsion from school.
- Legal problems (fines, arrests, etc.).
Because Tussionex contains hydrocodone, a potent opioid painkiller, it has a high potential for abuse and addiction. Hydrocodone is the most frequently prescribed opioid medication in the United States and is associated with more abuse than any other opioid, according to the Drug Enforcement Administration (DEA) 3.
Addiction is characterized by an inability to control drug use, cravings, and drug-seeking behaviors despite negative consequences. This problematic pattern of use results in significant impairment and distress in the user’s life. Due to the hydrocodone component, Tussionex addiction can be classified as an opioid use disorder. The signs and symptoms of this condition include 9:
- Tussionex is often taken in greater doses or over a longer period of time than intended.
- Attempts to quit or cut down on use are unsuccessful.
- A large amount of time is spent acquiring and using it, as well as recovering from its effects.
- Strong cravings to use itare present.
- Repeated Tussionex use leads to failure to fulfill work, school, or home responsibilities.
- Its use continues despite physical, psychological, or interpersonal problems worsened or caused by use.
- Tussionex use takes precedence over important recreational activities or hobbies.
- It is routinely used in hazardous situations.
- Tolerance, or a need for increasing amounts to feel the desired effects, develops.
- Withdrawal symptoms appear when Tussionex use is stopped or reduced.
If you suffer from an addiction to Tussionex and/or another substance, call 1-888-744-0069 to speak to a treatment support specialist about rehab options.
Opioid withdrawal syndrome refers to a set of symptoms that occurs when a person discontinues the use of opioids or reduces use. Withdrawal symptoms occur as a result of physical dependence on the medication. When use is stopped or decreased, the body must adjust to the changes and it will take time to recover normal functioning.
Opioid withdrawal can begin within a few hours to a few days after the user has quit or decreased use 9,10. Since Tussionex is a long-acting, extended-release medication, symptoms may not appear for a couple days 9. Some common withdrawal symptoms include
Some common Tussionex withdrawal symptoms include 9, 10:
- Dysphoric mood.
- Stomach cramps.
- Runny nose.
- Watery eyes.
- “Goose bumps.”
- Excessive sweating.
- Dilated pupils.
- Increased sensitivity to pain.
- Muscle aches.
Although acute withdrawal symptoms may dissipate after a week or so, some withdrawal symptoms, such as insomnia, anxiety, dysphoria, and anhedonia (the inability to feel pleasure), may last for weeks or even months 9.
Because withdrawal symptoms can be quite uncomfortable, they can easily lead to relapse, even in those determined to quit. People may decide to take another dose of Tussionex in order to reduce or alleviate withdrawal symptoms. For this reason, many users can benefit from a professional detox program.
Detox programs can help people slowly wean off of Tussionex under medical supervision. Medications can be given to help ease symptoms and make the patient more comfortable. Some medications that may be used include the following 10:
- Clonidine: Helps to reduce agitation, anxiety, sweating, runny nose, and muscle pain, although it doesn’t decrease cravings.
- Methadone: Reduces intensity of physical withdrawal symptoms, reduces drug cravings, and helps with detox. Because it is an opioid, it can be used as long-term maintenance to prevent relapse.
- Buprenorphine: Treats withdrawal symptoms, decreases urges to use, and shortens length of detox. Like methadone, it can also be used as long-term maintenance and may be given in combination with naloxone (as Suboxone).
- Naltrexone: Blocks the euphoric effects of Tussionex and helps to prevent relapse.
- Other medications: Your physician may prescribe other medicines to help with insomnia, vomiting, and diarrhea.
If you or someone you love is struggling with Tussionex abuse or addiction, help is available. For information on detox programs and treatment centers, contact one of our support representatives by phone for assistance at 1-888-744-0069 .
- Kelly, C. & Cruzan, S. (April 15, 2013). FDA Issues Alert on Tussionex, a Long-Acting Prescription Cough Medicine Containing Hydrocodone: Agency gives new safety information on proper use of Tussionex as a cough suppressant.
- FDA: US Food and Drug Administration. (March 11, 2008). Information for Healthcare Professionals: Long-Acting Hydrocodone-Containing Cough Product (marketed as Tussionex Pennkinetic Extended-Release Suspension).
- Drug Enforcement Administration. Drug Fact Sheet: Hydrocodone.
- Drug Enforcement Administration. Hydrocodone.
- U.S National Library of Medicine. (August 15, 2016). Hydrocodone.
- U.S. National Library of Medicine. (2014). Hydrocodone polistirex and chlorpheniramine polistirex pennkinetic.
- Toxicology Data Network. (2003). Chlorpheniramine.
- National Institute on Drug Abuse. (2014). What are the possible consequences of opioid abuse?
- American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
- Heller, J. (April 20, 2016). U.S. National Library of Medicine. Opiate and Opioid Withdrawal.