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## TUSQ-D
### Overview
TUSQ-D is a combination medication containing hydrocodone bitartrate (an opioid antitussive) and guaifenesin (an expectorant). It is used for the temporary relief of cough and to help loosen mucus.
### Primary Indications
* Cough associated with the common cold.
* Cough associated with bronchitis.
### Adult Dosing
* **Tus%2525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252520qd oral solution:** 5 mL to 10 mL every 4 to 6 hours as needed.
* **Maximum dose:** Not to exceed 6 doses in 24 hours. Specific maximum dose based on hydrocodone content is dependent on the formulation strength.
### Pediatric Dosing
* **Tus%2525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252525252520qd oral solution:** Dosing is typically weight-based or age-based. Refer to product labeling or local pediatric dosing guidelines. For children 6 to <12 years, common dosing is 5 mL every 4 to 6 hours. Not recommended for children under 6 years unless directed by a physician.
### Dose Adjustments
* **Hepatic Impairment:** Use with caution. Dose reduction may be necessary.
* **Renal Impairment:** Use with caution. Dose reduction may be necessary.
### Contraindications
* Hypersensitivity to hydrocodone, guaifenesin, or any component of the formulation.
* Acute or severe asthma or other respiratory depression.
* Gastrointestinal obstruction or ileus.
* Use in children < 6 years of age with products containing codeine or hydrocodone is generally contraindicated due to risk of respiratory depression.
### Adverse Effects
* **Common:** Drowsiness, dizziness, constipation, nausea, vomiting, dry mouth.
* **Serious:** Respiratory depression, CNS depression, abuse, dependence, allergic reactions.
### Key Drug Interactions
* **CNS Depressants (e.g., alcohol, benzodiazepines, sedatives):** Increased risk of sedation, respiratory depression, and death.
* **MAO Inhibitors:** Potential for hypertensive crisis.
* **Anticholinergics:** Increased risk of constipation and urinary retention.
### Monitoring
* Monitor for effectiveness (cough suppression, mucus clearance).
* Monitor for adverse effects, particularly drowsiness and constipation.
* Assess for signs of abuse or dependence.
### Clinical Pearls
* This medication contains an opioid and has potential for abuse and dependence.
* Due to its opioid content, it may impair mental and/or physical abilities required for the performance of potentially hazardous tasks.
* Advise patients to avoid alcohol and other CNS depressants while taking this medication.
* Ensure adequate fluid intake to help loosen mucus.
***
**Disclaimer:** This information is for educational purposes only and does not constitute medical advice. Always consult with a qualified healthcare provider to determine the best course of treatment for your specific condition and to ensure the most up-to-date prescribing information.
