Tussionex Beads Do Not Require Liquid to Work
The extended-release beads in Tussionex suspension are designed to function as a suspension formulation and should remain in liquid form for proper dosing, stability, and drug delivery—removing them from the liquid vehicle compromises dose uniformity and the intended pharmacokinetic profile.
Understanding Tussionex Formulation
Tussionex is an extended-release hydrocodone suspension containing polymer-coated beads that provide sustained drug release over 12 hours. The beads are specifically formulated to remain suspended in the liquid vehicle, which serves critical functions beyond simple drug delivery 1, 2.
Critical Role of the Suspension Vehicle
Dose uniformity depends on the liquid vehicle: Pharmaceutical suspensions require the liquid medium to ensure uniform distribution of drug particles, allowing accurate measurement of each dose 2, 3.
The vehicle prevents settling and caking: Properly formulated suspension vehicles maintain pseudo-plastic behavior—they become thinner with agitation (allowing easy pouring) but thicker at rest (slowing particle settlement) 2.
Redispersibility requires the liquid medium: Suspensions must be redispersible by shaking before each use to ensure the active ingredient is homogeneously distributed, which is impossible without the liquid vehicle 3, 4.
Why Separating Beads from Liquid Is Problematic
Loss of Controlled Release Properties
The beads are designed for oral suspension administration: Extended-release hydrocodone formulations like Hysingla ER (a related product) are engineered with specific physicochemical properties that depend on the intact dosage form 5.
Manipulation compromises drug delivery: Physical manipulation of extended-release formulations—including separating beads from their vehicle—can alter the intended pharmacokinetic profile and potentially increase abuse potential 5.
Dosing Accuracy Cannot Be Maintained
Particle size affects suspension stability: The Stokes equation demonstrates that particle characteristics, liquid density, and viscosity all determine suspension behavior—removing the liquid eliminates the ability to predict or control drug distribution 4.
Flocculation and deflocculation are vehicle-dependent: The suspension vehicle controls whether particles remain dispersed or form aggregates, which directly impacts dose uniformity 4.
Practical Implications
If the beads are removed from the liquid vehicle, you lose:
- The ability to measure accurate doses (no way to ensure uniform drug distribution)
- The extended-release characteristics designed into the formulation
- Protection against dose dumping and altered pharmacokinetics
- The manufacturer's intended safety profile
Common Pitfall to Avoid
- Never attempt to separate the beads from Tussionex suspension for administration: This practice eliminates all quality control measures built into the formulation, including dose uniformity, redispersibility, and controlled drug release 2, 3, 4.
The suspension must be shaken well before each use and administered as the complete liquid formulation to ensure safe, effective, and predictable drug delivery 3.