Tussionex Formulation Components
The yellow liquid in Tussionex is the suspension vehicle that carries the medication, while the white beads are ion-exchange resin complexes (polistirex) containing the active drugs hydrocodone and chlorpheniramine designed for extended release over 12 hours.
Understanding the Extended-Release Delivery System
The white beads are drug-resin complexes where hydrocodone bitartrate and chlorpheniramine are bound to sulfonated styrene-divinylbenzene copolymer (polistirex resin), creating particles that slowly release medication as they pass through the gastrointestinal tract 1.
The yellow liquid serves as the suspension medium that keeps these drug-containing beads evenly distributed throughout the formulation, similar to other extended-release bead technologies used in various medications 1.
Clinical Significance of the Formulation
This polistirex technology provides sustained drug release over approximately 12 hours, allowing for twice-daily dosing rather than every 4-6 hours dosing required with immediate-release hydrocodone formulations 2, 3.
The beads must remain intact to function properly - crushing, chewing, or dissolving the beads destroys the extended-release mechanism and can lead to rapid release of a potentially fatal dose of hydrocodone 4.
Important Safety Considerations
Tussionex is contraindicated in patients under 18 years of age due to lack of efficacy data and serious safety concerns including respiratory depression and death in pediatric populations 2.
The formulation contains hydrocodone, a Schedule II opioid with significant risks of addiction, abuse, misuse, respiratory depression, and overdose that require careful patient selection and monitoring 4, 5.
Hydrocodone is metabolized to hydromorphone, which contributes to both therapeutic effects and toxicity risk, particularly in cases of overdose 3.