How does this medication work? What will it do for me?

Hydrocodone - pyrilamine - phenylephrine - ammonium chloride is no longer being manufactured for sale in Canada and is no longer available under any brand names. This article is being kept available for reference purposes only. If you are using this medication, speak with your doctor or pharmacist for information about your treatment options.

This medication contains four different medicinal ingredients. Hydrocodone belongs to the family of medications known as antitussives (cough suppressants). It helps to suppress cough by affecting the cough centre in the brain.

Phenylephrine belongs to the family of medications called decongestants (congestion relievers). It works by narrowing blood vessels in the nasal passages, helping to relieve nasal stuffiness.

Pyrilamine belongs to the family of medications called antihistamines. Pyrilamine works by drying up the excess fluid that leads to runny nose and watery eyes.

Together, these three ingredients help to control cough and relieve congestion due to colds and bacterial infections. Ammonium chloride is an expectorant that helps make mucus easier to cough up.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. As well, some forms of this medication may not be used for all of the conditions discussed here. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

What form(s) does this medication come in?

Hycomine is no longer being manufactured for sale in Canada. For brands that may still be available, search under hydrocodone - pyrilamine - phenylephrine - ammonium chloride. This article is being kept available for reference purposes only. If you are using this medication, speak with your doctor or pharmacist for information about your treatment options.

How should I use this medication?

Hycomine (adults): The recommended dose is 5 mL after meals and at bedtime with food or a glass of milk, at intervals of not less than 4 hours. The maximum daily dose is 30 mL. The maximum single dose is 15 mL.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important to take this medication exactly as prescribed by your doctor. If you miss a dose, take it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store this medication at room temperature, protect it from light, and keep it out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

Who should NOT take this medication?

Do not take this medication if you:

  • are allergic to hydrocodone, phenylephrine, pyrilamine, ammonium chloride, or any ingredients of the medication
  • are allergic to antihistamines (e.g., chlorpheniramine)
  • are allergic to any of the other "opioid"-type medications (e.g., morphine, codeine)
  • are allergic to sympathetic amines (e.g., epinephrine, pseudoephedrine)
  • are having difficulty breathing
  • take a monoamine oxidase (MAO) inhibitor (e.g., phenelzine, tranylcypromine)
  • have an intracranial (inside the head) lesion associated with increased pressure inside the head
  • have heart disease, high blood pressure, diabetes, or overactive thyroid

What side effects are possible with this medication?

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

  • constipation (more common with long-term use)
  • decrease in amount of urine
  • difficult or painful urination
  • difficulty sleeping
  • dizziness, lightheadedness, or feeling faint
  • drowsiness
  • dry mouth
  • false sense of well-being
  • frequent urge to urinate
  • general feeling of discomfort or illness
  • headache
  • loss of appetite
  • nausea or vomiting
  • nervousness or restlessness
  • nightmares or unusual dreams
  • stomach cramps or pain
  • unusual tiredness or weakness

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

  • blurred or double vision, or other changes in vision
  • depression or other mood or mental changes
  • fast, slow, or pounding heartbeat
  • feelings of unreality
  • hallucinations
  • hives, itching, or skin rash
  • increased sweating
  • irregular breathing
  • redness or flushing of face
  • ringing or buzzing in the ears
  • shortness of breath, wheezing, or troubled breathing
  • swelling of face
  • trembling or uncontrolled muscle movements
  • unusual excitement or restlessness

Stop taking the medication and seek immediate medical attention if any of the following occur:

  • cold, clammy skin
  • confusion
  • convulsions (seizures)
  • dizziness (severe)
  • drowsiness (severe)
  • low blood pressure
  • nervousness or restlessness (severe)
  • pinpoint-sized pupils of eyes
  • slow heartbeat
  • slow or troubled breathing
  • weakness (severe)

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Are there any other precautions or warnings for this medication?

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

HEALTH CANADA ADVISORY

July 28, 2016

Health Canada has issued new restrictions concerning the use of prescription hydrocodone. To read the full Health Canada Advisory, visit Health Canada's web site at www.hc-sc.gc.ca.

Constipation: Hydrocodone may cause constipation or worsen existing constipation. If you have chronic constipation, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Drowsiness/reduced alertness: Because this medication can cause drowsiness, do not drive or engage in activities that require alertness and physical coordination until you can be sure that the medication does not affect you in this way.

Drug dependence: Hydrocodone can produce drug dependence and therefore has the potential to be abused. Psychological dependence, physical dependence, and tolerance may develop after long-term use.

Medical conditions: If you have glaucoma, an enlarged prostate, or breathing problems, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Sedation with other medications: Since the sedating effects (i.e., drowsiness) of this medication are additive to those of other sedating drugs, those using this medication are cautioned against drinking alcohol or taking sleeping pills, sedatives, psychotherapeutic agents, or other medications with sedating effects. Tell your doctor about all of the medications you take.

Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.

Breast-feeding: It is not known if this medication passes into breast milk. If you are a breast-feeding mother and are taking this medication, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of using this medication have not been established for children.

What other drugs could interact with this medication?

There may be an interaction between hydrocodone - pyrilamine - phenylephrine - ammonium chloride and any of the following:

  • alcohol
  • antidiabetes medications (e.g., insulin, glyburide)
  • antiglaucoma medications (e.g., timolol, betaxolol)
  • benzodiazepines (e.g., diazepam, lorazepam)
  • beta-blockers (e.g., metoprolol, atenolol)
  • indomethacin
  • MAO inhibitors (e.g., phenelzine, tranylcypromine)
  • medications for reducing high blood pressure (e.g., hydrochlorothiazide, ramipril)
  • other nartoics (e.g., codeine, morphine)
  • other sedating medications (other medications that cause drowsiness, such as lorazepam)
  • phenothiazines (e.g., chlorpromazine)
  • thyroid medications (e.g., levothyroxine)
  • tricyclic antidepressants (e.g., amitriptyline, desipramine)

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

  • stop taking one of the medications,
  • change one of the medications to another,
  • change how you are taking one or both of the medications, or
  • leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.