A couple weeks ago I was really sick and the doctor prescribed me Azithromycin tablets and Hydromet cough syrup. After doing my due diligence in researching these medications I learned there was a potential for recreational abuse with the cough medicine. I want to be clear and say that I’ve never abused drugs but there was some literature that made me curious. My questions to you are this:

a.) There is an ingredient added to the cough syrup to discourage the abuse of the drug… (Homotropine is what I believe it is called)... What is this and how does it work??

b.) Is it common for pharmaceutical companies to add fillers to discourage drug abuse??

c.) The medicine made my whole body itch, does this mean that I am allergic to this medicine??

Hello,

The cough medicine you were given sounds like the generic of Hycodan cough syrup. The homotropine in the syrup is not included as a means of preventing abuse, but does have that effect due to anticholingeric effects. The quick way to remember what they are is a little rhyme I learned in school. “No see, no pee, no spit, no shi…” The medicine can cause blurry vision by pupil dilation, urinary retention, dry mouth, and some constipation. Homotropine does this by means of blocking muscarinic acetylcholine receptors. It can reverse the CNS effects of the hydrocodone in the syrup, thus limiting the “euphoric” condition. It’s main purpose in the medicine is to reduce mucus production, though.

Itching is sometimes seen by people to take hydrocodone. It is not technically seen as an allergic reaction. If a rash also was present an allergy is more likely. Rather, the itch is a histiminc reaction caused by the CNS effects of the drug in some people that use it.

Of course, it’s possible your reaction is due to the azithromycin. This medicine is in the class with erythromycin, known as the macrolide antibiotics. Allergy to azithromycin is somewhat rare, but would most likely present with a bad rash.

I hope you are feeling better soon. It’s no fun being sick during the summer.

Hey thanks for sharing your knowledge… This was some time ago so I am feeling better now… I just knew that your expertise could cure my curiosity and provide me with a good reference for the future.

Thanks again.