Please check your internet connection and try again.
**Drug:** TUSQ OD
## Overview
TUSQ OD is a brand name for a combination product containing **Hydrocodone Bitartrate** and **Acetaminophen**. It is an opioid analgesic and antipyretic.
## Primary Indications
* Relief of moderate to moderately severe pain.
## Adult Dosing
* **Typical Dose:** 1-2 tablets (containing 5 mg hydrocodone bitartrate/325 mg acetaminophen or 10 mg hydrocodone bitartrate/325 mg acetaminophen per tablet) every 4-6 hours as needed.
* **Maximum Daily Dose (Hydrocodone Component):** Generally limited by acetaminophen toxicity. The maximum daily dose of acetaminophen should not exceed 4000 mg per 24 hours. Consult product labeling for specific hydrocodone limits per dose and day, which are typically driven by the acetaminophen component's safety profile.
## Pediatric Dosing
* **TUSQ OD is not recommended for use in pediatric patients.** Safety and efficacy have not been established.
## Dose Adjustments
* **Hepatic Impairment:** Use with caution. Dosage reduction may be necessary. Monitor closely for adverse effects.
* **Renal Impairment:** Use with caution. Dosage reduction may be necessary. Monitor closely for adverse effects.
## Contraindications
* Known hypersensitivity to hydrocodone bitartrate, acetaminophen, or any component of the formulation.
* Significant respiratory depression.
* Acute or severe bronchial asthma or hypercapnia.
* Concurrent use with certain other medications (see Key Drug Interactions).
## Adverse Effects
* **Common:** Drowsiness, dizziness, nausea, vomiting, constipation, pruritus, lightheadedness, sedation.
* **Serious:** Respiratory depression, apnea, circulatory depression, hypotension, bradycardia, overdose (potentially leading to liver failure due to acetaminophen, and severe CNS and respiratory depression from hydrocodone).
## Key Drug Interactions
* **CNS Depressants:** Increased risk of sedation, respiratory depression, and profound CNS depression, potentially fatal. Includes alcohol, benzodiazepines, other opioids, sedatives, hypnotics, muscle relaxants, antihistamines with sedative properties, and antipsychotics.
* **CYP3A4 Inhibitors:** May increase hydrocodone plasma concentrations.
* **CYP3A4 Inducers:** May decrease hydrocodone plasma concentrations.
* **MAO Inhibitors and within 14 days of MAO Inhibitor use:** Risk of severe CNS depression or exaggerated pressor response.
* **Anticholinergic drugs:** Increased risk of urinary retention and severe constipation.
## Monitoring
* Pain relief effectiveness.
* Signs and symptoms of respiratory depression (rate, depth, rhythm).
* Sedation level.
* Bowel function.
* Signs and symptoms of liver toxicity (especially with chronic or high-dose use of acetaminophen).
* Signs of hypersensitivity reactions.
## Clinical Pearls
* TUSQ OD contains acetaminophen. Be aware of the maximum daily acetaminophen dose (4000 mg) to prevent hepatotoxicity. Counsel patients on the risk of combining with other acetaminophen-containing products.
* Hydrocodone is an opioid and carries a risk of dependence and abuse.
* Advise patients to avoid alcohol while taking this medication.
* If bowel irregularities occur, advise increased fluid and fiber intake, or consider a laxative.
* Dosing is often guided by individual patient response and tolerance, as well as local institutional protocols.
***
**Disclaimer:** This information is intended for clinical use and does not substitute for professional medical advice. Always consult the most current prescribing information and product labeling, and consider individual patient factors before making treatment decisions.
