Polistirex

Hydrocodone Hydrocodone is an opioid agonist with relative selectivity for the mu-opioid receptor, although it can interact with other opioid receptors at higher doses. The precise mechanism of action of hydrocodone and other opiates is not known; however, hydrocodone is believed to act centrally on the cough center.

• Hydrocodone Polistirex and Chlorpheniramine Polistirex Extended-Release Suspension is indicated for the temporary relief of cough and upper respiratory symptoms associated with allergy or the common cold in patients 18 years of age and older. Important Limitations of Use : • Not indicated for pediatric patients under 18 years of age [ see Use in Specific Populations (8.4 ) ].ICD-10: J00, R05.9

• Hydrocodone Polistirex and Chlorpheniramine Polistirex is contraindicated for: All children younger than 6 years of age [ see Warnings and Precautions (5.2 , 5.3 ), Use in Specific Populations (8.4) ]. Hydrocodone Polistirex and Chlorpheniramine Polistirex is also contraindicated in patients with: Significant respiratory depression [ see Warnings and Precautions (5.2) ].contraindicated

Adults 18 years of age and older : 5 mL every 12 hours as needed, not to exceed 2 doses (10 mL) in 24 hours. ( 2.2 ) Measure Hydrocodone Polistirex and Chlorpheniramine Polistirex with an accurate milliliter measuring device. ( 2.1 , 5.5 ) Do not increase the dose or dosing frequency. ( 2.1 ) Prescribe for the shortest duration consistent with treatment goals. (2.3 ) Reevaluate patients with unresponsive cough in 5 days or sooner for possible underlying pathology. ( 2.3 ) Reevaluate patient prior to refilling. ( 2.3 ) 2.1 Important Dosage and Administration Instructions Administer Hydrocodone Polistirex and Chlorpheniramine Polistirex Extended-Release Suspension by the oral route only. Hydrocodone Polistirex and Chlorpheniramine Polistirex Extended-Release Suspension can be taken with or without food. Shake well before using. Do not mix Hydrocodone Polistirex and Chlorpheniramine Polistirex Extended-Release Suspension with other liquids or medicines. Mixing may change how Hydrocodone Polistirex and Chlorpheniramine Polistirex Extended-Release Suspension works. Always use an accurate milliliter measuring device when administering Hydrocodone Polistirex and Chlorpheniramine Polistirex Extended-Release Suspension to ensure that the dose is measured and administered accurately. A household teaspoon is not an accurate measuring device and could lead to overdosage [ see Warnings and Precautions (5.5) ]. The dosing cup is provided with the 3 oz (70 mL) and 4 oz (115 mL) packaged product. The dosing cup fills for 2.5 mL dose and for 5 mL dose.

See Boxed WARNINGS Life-threatening respiratory depression in patients with chronic pulmonary disease or in elderly, cachectic, or debilitated patients : Monitor closely, particularly during initiation of therapy. ( 5.4 ) Activities requiring mental alertness : Avoid engaging in hazardous tasks requiring mental alertness such as driving or operating machinery. ( 5.6 ) 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. ( 5.10 ) Seizures in patients with seizure disorders: Monitor during therapy. ( 5.11 ) Severe hypotension : Monitor during initiation of therapy. Avoid use in patients with circulatory shock. ( 5.12 ) Adrenal insufficiency : If diagnosed, treat with physiologic replacement of corticosteroids, and wean patient off of the opioid. ( 5.14 ) 5.1 Addiction, Abuse, and Misuse Hydrocodone Polistirex and Chlorpheniramine Polistirex contains hydrocodone, a Schedule II controlled substance. As an opioid, Hydrocodone Polistirex and Chlorpheniramine Polistirex exposes users to the risks of addiction, abuse, and misuse [ see Drug Abuse and Dependence (9 ) ], which can lead to overdose and death [ see Overdosage (10) ]. Reserve Hydrocodone Polistirex and Chlorpheniramine Polistirex Extended-Release Suspension for use in adult patients for whom the benefits of cough suppression are expected to outweigh the risks, and in whom an adequate assessment of the etiology of the cough has been made.

The following serious adverse reactions are described, or described in greater detail, in other sections: • Addiction, abuse, and misuse [ see Warnings and Precautions (5.1) , Drug Abuse and Dependence (9.3) ] • Life-threatening respiratory depression [ see Warnings and Precautions (5.2 , 5.3 , 5.4 , 5.8 ), Overdosage (10) ] • Accidental overdose and death due to medication errors [ see Warnings and Precautions (5.5) ] • Decreased mental alertness with impaired mental and/or physical abilities [ see Warnings and Precautions (5.6) ] • Interactions with benzodiazepines and other CNS depressants [ see Warnings and Precautions (5.8) , Drug Interactions (7.1 , 7.5 ) ] • Paralytic ileus, gastrointestinal adverse reactions [ see Warnings and Precautions (5.9) ] • Increased intracranial pressure [ see Warnings and Precautions (5.10 ) ] • Obscured clinical course in patients with head injuries [ see Warnings and Precautions (5.10) ] • Seizures [ see Warnings and Precautions (5.11) ] • Severe hypotension [ see Warnings and Precautions (5.12) ] • Neonatal Opioid Withdrawal Syndrome [ see Warnings and Precautions (5.13) ] • Adrenal insufficiency [ see Warnings and Precautions (5.14) ] The following adverse reactions have been identified during clinical studies, in the literature, or during post-approval use of hydrocodone and/or chlorpheniramine. Because these reactions may be reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure.

Pregnancy : Avoid use in pregnant women. May cause fetal harm. ( 8.1 ) Lactation : Breastfeeding not recommended. ( 8.2 ) Renal Impairment : Use with caution in patients with severe renal impairment. ( 8.6 ) Hepatic Impairment : Use with caution in patients with severe hepatic impairment. ( 8.7 ) 8.1 Pregnancy Risk Summary Hydrocodone Polistirex and Chlorpheniramine Polistirex is not recommended for use in pregnant women, including during or immediately prior to labor. Prolonged use of opioids during pregnancy may cause neonatal opioid withdrawal syndrome [ see Warnings and Precautions (5.13) , Clinical Considerations ]. There are no available data with Hydrocodone Polistirex and Chlorpheniramine Polistirex use in pregnant women to inform a drug-associated risk for adverse developmental outcomes. Published studies with hydrocodone have reported inconsistent findings and have important methodological limitations ( see Data ). Reproductive toxicity studies have not been conducted with Hydrocodone Polistirex and Chlorpheniramine Polistirex; however, studies are available with individual active ingredients or related active ingredients ( see Data ).

Metabolism

Absorption Following multiple dosing with Hydrocodone Polistirex and Chlorpheniramine Polistirex, hydrocodone mean (S.D.) peak plasma concentrations of 22.8 (5.9) ng/mL occurred at 3.4 hours. Food has no significant effect on the extent of absorption of hydrocodone.

Clinical Presentation Hydrocodone Acute overdose with hydrocodone is characterized by respiratory depression (a decrease in respiratory rate and/or tidal volume, Cheyne-Stokes respiration, cyanosis), extreme somnolence progressing to stupor or coma, skeletal muscle flaccidity, cold and clammy skin, constricted pupils, and, in some cases, pulmonary edema, bradycardia, partial or complete airway obstruction, atypical snoring, hypotension, circulatory collapse, cardiac arrest, and death. Hydrocodone may cause miosis, even in total darkness. Pinpoint pupils are a sign of opioid overdose but are not pathognomonic (e.g., pontine lesions of hemorrhagic or ischemic origin may produce similar findings). Marked mydriasis rather than miosis may be seen with hypoxia in overdose situations [ see Clinical Pharmacology (12.2) ]. Chlorpheniramine Signs and symptoms of chlorpheniramine overdosage may vary from central nervous system depression to stimulation. Central toxic effects are characterized by agitation, anxiety, delirium, disorientation, hallucinations, hyperactivity, sedation, and seizures. Severe overdosage may produce coma, medullary paralysis, and death.

• Oct 1, 2010ANDAANDA091632Tris Pharma Inc
• May 25, 2012ANDAANDA091135Tris Pharma Inc
• Jul 28, 2017ANDAANDA203133Amneal
• Apr 15, 2026ANDAANDA218417Aurobindo Pharma Ltd

1. 1Dependence82548%
2. 2Overdose47628%
3. 3Drug Ineffective29117%
4. 4Death18811%
5. 5Diarrhoea804.6%
6. 6Dizziness502.9%
7. 7Depression492.8%
8. 8Nausea492.8%
9. 9Ill-defined Disorder412.4%
10. 10Anxiety382.2%
11. 11Drug Effect Incomplete352.0%
12. 12Withdrawal Syndrome352.0%
13. 13Hypersensitivity331.9%
14. 14Somnolence331.9%
15. 15Vomiting321.9%

The 4 most recently updated of 4 ClinicalTrials.gov registrations naming Polistirex as an intervention. Registration is not evidence of efficacy or safety — reference crosswalk only.

• NT0102 in the Treatment of Children With Attention Deficit Hyperactivity Disorder (ADHD)
  Completed · Phase 3 · Interventional · 87 enrolled · Neos Therapeutics, Inc
  NCT01835548updated 2018-01-17
• Fasting Study of Chlorpheniramine Polistirex and Hydrocodone Polistirex Capsules and Tussionex® Pennkinetic® Extended Release Oral Suspension
  Completed · Phase 1 · Interventional · 42 enrolled · Mallinckrodt
  NCT00853294updated 2016-10-19
• Fed Study of Chlorpheniramine Polistirex and Hydrocodone Polistirex Capsules and Tussionex® Pennkinetic® Extended Release Oral Suspension
  Completed · Phase 1 · Interventional · 43 enrolled · Mallinckrodt
  NCT00853190updated 2016-10-19
• Trial of Dextromethorphan in Rett Syndrome
  Terminated · Phase 2 · Interventional · 38 enrolled · Hugo W. Moser Research Institute at Kennedy Krieger, Inc.
  NCT00593957updated 2014-04-23

Frequently asked questions

How does Polistirex work?

Hydrocodone Hydrocodone is an opioid agonist with relative selectivity for the mu-opioid receptor, although it can interact with other opioid receptors at higher doses. The precise mechanism of action of hydrocodone and other opiates is not known; however, hydrocodone is believed to act centrally on the cough center.

What is Polistirex used for?

According to FDA labeling, Polistirex carries indications including: Hydrocodone Polistirex and Chlorpheniramine Polistirex Extended-Release Suspension is indicated for the temporary relief of cough and upper respiratory symptoms associated with allergy or the common cold in patients 18 years of age and older. Important Limitations of Use : • Not indicated for pediatric patients under 18 years of age [ see Use in Specific Populations (8.4 ) ].. This is a reference summary of labeled uses, not medical advice or a treatment recommendation.

What are the contraindications for Polistirex?

Polistirex labeling lists contraindications including: Hydrocodone Polistirex and Chlorpheniramine Polistirex is contraindicated for: All children younger than 6 years of age [ see Warnings and Precautions (5.2 , 5.3 ), Use in Specific Populations (8.4) ]. Hydrocodone Polistirex and Chlorpheniramine Polistirex is also contraindicated in patients with: Significant respiratory depression [ see Warnings and Precautions (5.2) ].. Always consult the full prescribing information and a clinician.