HYDROCODONE-CHLORPHENIRAMNE ER (HYDROCODONE POLISTIREX/CHLORPHENIRAMINE POLISTIREX)

Moderate

• Acid Reducer (cimetidine)

• Acid Relief (cimetidine)

• aprepitant

• atazanavir

• Buprenex

• buprenorphine

• buprenorphine-naloxone

• butorphanol tartrate

• Butrans

• Calan

• Calan Sr

• Cardizem

• Cardizem Cd

• Cardizem La

• Cartia Xt

• cimetidine

• Cipro

• Cipro In D5W

• Cipro Xr

• ciprofloxacin

• ciprofloxacin (mixture)

• ciprofloxacin in D5W

• darunavir

• Dilacor Xr

• Dilt-xr

• diltiazem HCl

• dronedarone

• Emend

• Fanatrex

• fosamprenavir

• fosaprepitant

• gabapentin

• gabapentin enacarbil

• Gleevec

• Gralise

• Gralise 30-day Starter Pack

• Heartburn Relief

• Horizant

• imatinib

• isoniazid-rifamp-pyrazinamide

• Lexiva

• Matzim La

• Multaq

• nalbuphine

• Neurontin

• Prezista

• Reyataz

• Rifadin

• Rifamate

• rifampin

• rifampin-isoniazid

• Rifater

• Suboxone

• Tagamet Hb

• Tarka

• Taztia Xt

• Tiazac

• trandolapril-verapamil

• verapamil

• Verelan

• Verelan Pm

• Zubsolv

Moderate

• Acute abdominal pain

• Biliary spasm

• Chronic obstructive pulmonary disease

• Constipation

• Disease of liver

• Drug dependence

• Gallbladder disease

• Hypertension

• Hyperthyroidism

• Kidney disease with reduction in GFR

• Mood changes

• Untreated hypothyroidism

Chlorpheniramine

• Severity Level:

  2

• Additional Notes: Insufficient data available; neonate risk of seizures;avoid during 3rd trimester

Hydrocodone

• Severity Level:

  C

• Additional Notes: Neonatal withdrawal/resp.depress. w/chronic or high dose; small teratogenic risk

Contraindicated

None

Precaution Exists

Chlorpheniramine

Insufficient data available; may cause sedation and inhibit lactation

Monitor for changes in respiration, gi effects, sedation, feeding patterns

Hydrocodone

Insufficient data available; may cause sedation and inhibit lactation

Monitor for changes in respiration, gi effects, sedation, feeding patterns

No Known Risk

None

Contraindicated

None

Precaution Exists

Chlorpheniramine

Neuro/Psych-Anticholinergic effects may cause sedation, worsen cognitive impairment and increase fall risk. Non-sedating antihistamine preferred. Gastrointestinal-May cause or worsen pre-existing constipation. Genitourinary-Best avoided in patients with urinary retention from any cause.

Pulmonary-Respiratory depression is more likely to occur in elderly due to altered pharmacokinetics (poor fat stores, muscle wasting, or altered clearance). Consider naloxone Rx. Neuro/Psych-Risk for confusion, delirium and falls. Avoid treatment with 3 or more CNS active agents. Gastrointestinal-Constipation risk. Renal-Impaired function may lead to increased toxicity due to accumulation of parent compound and metabolites. Cardiovascular-Monitor for hypotension with high doses.

BEERS: Y     HEDIS: Y     STOPP: Y

Hydrocodone

Neuro/Psych-Anticholinergic effects may cause sedation, worsen cognitive impairment and increase fall risk. Non-sedating antihistamine preferred. Gastrointestinal-May cause or worsen pre-existing constipation. Genitourinary-Best avoided in patients with urinary retention from any cause.

Pulmonary-Respiratory depression is more likely to occur in elderly due to altered pharmacokinetics (poor fat stores, muscle wasting, or altered clearance). Consider naloxone Rx. Neuro/Psych-Risk for confusion, delirium and falls. Avoid treatment with 3 or more CNS active agents. Gastrointestinal-Constipation risk. Renal-Impaired function may lead to increased toxicity due to accumulation of parent compound and metabolites. Cardiovascular-Monitor for hypotension with high doses.

BEERS: Y     HEDIS: N     STOPP: Y

No Known Risk

None