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Generic Name: diphenhydramine, hydrocodone, and phenylephrine (dye fen HYE dra meen, hye droe KOE dohn, feh nill EH frin)
Brand Names: Endal HD, Tussinate

What is diphenhydramine, hydrocodone, and phenylephrine?

Diphenhydramine is an antihistamine. It blocks the effects of the naturally occurring chemical histamine in the body and reduces congestion.

Hydrocodone is a narcotic. It is a pain reliever and a cough suppressant.

Phenylephrine is a decongestant. It works by constricting (shrinking) blood vessels (veins and arteries) in the body. Constriction of blood vessels in the sinuses and nose decreases congestion.

Diphenhydramine, hydrocodone, and phenylephrine is used to treat cough and nasal congestion associated with upper respiratory tract infections and allergies.

Diphenhydramine, hydrocodone, and phenylephrine may also be used for purposes other than those listed in this medication guide.

What is the most important information I should know about diphenhydramine, hydrocodone, and phenylephrine?

Diphenhydramine, hydrocodone, and phenylephrine may increase the effects of other drugs that cause drowsiness, including antidepressants, alcohol, antihistamines, sedatives (used to treat insomnia), pain relievers, anxiety medicines, seizure medicines, and muscle relaxants. Tell your doctor about all medicines that you are taking, and do not take any other medicine without first talking to your doctor.

What should I discuss with my healthcare provider before taking diphenhydramine, hydrocodone, and phenylephrine?

Do not take diphenhydramine, hydrocodone, and phenylephrine if you have taken a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), phenelzine (Nardil), or tranylcypromine (Parnate) in the last 14 days. A dangerous drug interaction could occur, leading to serious side effects.

Before taking diphenhydramine, hydrocodone, and phenylephrine, tell your doctor if you have

• epilepsy or another seizure disorder;

• been diagnosed with sleep apnea (periods of not breathing during sleep);

• thyroid problems;

• asthma;

• gallbladder disease;

• a head injury;

• Addison's disease;

• diabetes;

• glaucoma;

• an ulcer or an obstruction in the stomach;

• bladder problems or difficulty urinating;

• an enlarged prostate;

• high blood pressure, irregular heartbeats, or any type of heart disease;

• kidney problems; or
• liver problems.

You may not be able to take diphenhydramine, hydrocodone, and phenylephrine, or you may require a dosage adjustment or special monitoring during treatment if you have any of the conditions listed above.

How should I take diphenhydramine, hydrocodone, and phenylephrine?

Take diphenhydramine, hydrocodone, and phenylephrine exactly as directed by your doctor. If you do not understand the directions on your prescription bottle, ask your pharmacist, nurse, or doctor to explain the instructions to you.

Diphenhydramine, hydrocodone, and phenylephrine can be taken with or without food.

To ensure that you get a correct dose, measure the liquid form of diphenhydramine, hydrocodone, and phenylephrine with a special dose-measuring spoon or cup, not with a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist where you can get one.

What happens if I miss a dose?

Take the missed dose as soon as you remember. However, if it is almost time for the next dose, skip the missed dose and take only the next regularly scheduled dose. Do not take a double dose of this medication unless otherwise directed by your doctor.

What happens if I overdose?

Symptoms of a diphenhydramine, hydrocodone, and phenylephrine overdose may include severe drowsiness, dizziness, headache, seizures, dry mouth, cold and clammy skin, flushing, nausea, vomiting, difficulty or decreased breathing, and unconsciousness.

What should I avoid while taking diphenhydramine, hydrocodone, and phenylephrine?

Diphenhydramine, hydrocodone, and phenylephrine may increase the effects of other drugs that cause drowsiness, including antidepressants, alcohol, antihistamines, sedatives (used to treat insomnia), pain relievers, anxiety medicines, seizure medicines, and muscle relaxants. Tell your doctor about all medicines that you are taking, and do not take any other medicine without first talking to your doctor.

What are the possible side effects of diphenhydramine, hydrocodone, and phenylephrine?

• an allergic reaction (difficulty breathing; closing of the throat; swelling of the lips, tongue, or face; or hives); or

• confusion, hallucinations, or unusual behavior.

Other, less serious side effects may be more likely to occur. Continue to take diphenhydramine, hydrocodone, and phenylephrine and talk to your doctor if you experience

• dizziness, drowsiness, or sleepiness;

• restlessness or irritability;

• blurred vision;

• constipation;

• dry mouth, nausea, vomiting, or decreased appetite;

• muscle twitches;

• sweating;

• itching;

• decreased urination;

• increased sensitivity to sunlight.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect diphenhydramine, hydrocodone, and phenylephrine?

Do not take diphenhydramine, hydrocodone, and phenylephrine if you have taken a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), phenelzine (Nardil), or tranylcypromine (Parnate) in the last 14 days. A dangerous drug interaction could occur, leading to serious side effects.

Diphenhydramine, hydrocodone, and phenylephrine may increase the effects of other drugs that cause drowsiness, including antidepressants, alcohol, sedatives (used to treat insomnia), pain relievers, anxiety medicines, and muscle relaxants. Tell your doctor about all medicines that you are taking, and do not take any medicine without first talking to your doctor.

Drugs other than those listed here may also interact with diphenhydramine, hydrocodone, and phenylephrine. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines, including vitamins, minerals, and herbal products.

Where can I get more information?

• Your pharmacist has more information about diphenhydramine, hydrocodone, and phenylephrine written for health professionals that you may read.

What does my medicine look like?

Diphenhydramine, hydrocodone, and phenylephrine is available with a prescription under the brand name Endal HD. Other brand or generic formulations may also be available. Ask your pharmacist any questions you have about this medication, especially if it is new to you.

• Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed
• Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.