Don’t play with Tussionex

Late last night, I kept coughing due to a passing cold. After taking several doses of other cough syrups during the evening, which had obviously not done their job, I decided to take some Tussionex — my ultimate weapon against coughing. I try to use it only when I absolutely need it, because it’s fairly expensive and it’s also hard to get (it can only be prescribed by a doctor). But after three days of coughing through the night and keeping my wife and myself awake, I figured the time had come. I took a teaspoon, waited a half hour, and nothing happened. I took another, waited another half hour, and still the coughing continued. I began to worry: had the syrup expired? Was my coughing so bad that I needed to take more? I took another teaspoon. Bad idea!

Tussionex

Soon after that, I started to feel the effects. Tussionex contains a codeine derivative, which means that, along with stopping my cough, it usually gives me a warm and fuzzy feeling that wears off in a couple of hours or so. This time, because I’d unwittingly (and stupidly) overdosed, the effect was very pronounced, and it was mixed with a sensation of nausea. I found it hard to sit up or stand up and went to bed, where I fell asleep immediately.

Here’s the full list of side effects for Tussionex, from the PDR (Physician’s Desk Reference):

“Anxiety, constipation, decreased mental and physical performance, difficulty breathing, difficulty urinating, dizziness, drowsiness, dry throat, emotional dependence, exaggerated feeling of depression, extreme calm (sedation), exaggerated sense of well-being, fear, itching, mental clouding, mood changes, nausea, rash, restlessness, sluggishness, tightness in chest, vomiting.”

I guess I should be thankful the only side effect I’d experienced before this was the “exaggerated sense of well-being”, along with a slight headache which occurred a few hours after taking the medication. Things were going to be very different now.

I woke up early in the morning, around 6 am, feeling rested and alert. I figured the effects of the overdose had worn off. They hadn’t. I got up to go about my business, and shortly after that, a general, overpowering feeling of nausea swept over me. I could not stand up. I couldn’t keep my balance at all. I felt sick, wasn’t seeing straight, I couldn’t control my movements and had trouble putting words together. It didn’t take long after that for me to experience a fuller spectrum of the side effects: decreased mental and physical performance, dizziness, drowsiness, mental clouding, nausea and finally, vomiting. That’s right, I did it again… I vomited more often in these past few months than in the past several years, and I don’t like it.

I’m still in bed as I write this. The moment I stand or sit upright, the nausea comes back, my face turns white, etc. I’ll be in bed for a while, hopefully not the whole day. All this fun gave me a chance to think about the situation. It’s clear that this wouldn’t have occurred if I hadn’t overdosed. The recommended dosage is one teaspoon every 12 hours. The PDR says: “The usual dose is 1 teaspoonful (5 milliliters) every 12 hours. Do not take more than 2 teaspoonfuls in 24 hours.”

I took three teaspoons within 1 ½ hours. That was incredibly stupid and irresponsible of me, and truthfully, I should be thankful I’m still alive. Here’s what one should expect from a Tussionex overdose:

“Blue skin color due to lack of oxygen, cardiac arrest, cold and clammy skin, decreased or difficult breathing, extreme sleepiness leading to stupor or coma, low blood pressure, muscle flabbiness, slow heartbeat, temporary cessation of breathing”

There it is, in black and white: cardiac arrest, stupor or coma. Instead of getting up from my bed last night and doing a quick search for this info last night, I overdosed like a dummy. My wife could have woken up next to my corpse. Thank God that didn’t happen!

I found out this morning that the FDA, since 2008, is also cautioning healthcare providers, pharmacists and patients, to guard against Tussionex overdose. After my own accidental brush with death, I agree with them.

Recommended Site: Many have become so addicted to certain cough medicine brands that prescription drug abuse treatment has become necessary for them. 

Still, I’m not sorry I took Tussionex. I’m definitely sorry I overdosed though. I’ve used many cough syrups over the years, and none stops my coughing like Tussionex. Here’s a sample of the stuff I tried in only the past few months:

Ketof

Coughend Sirop

Stodal

Ketof is the only other cough syrup that helps me marginally. The rest are garbage, particularly that Coughend Sirop. I also used a syrup called Prospan (not pictured here) in the last few days, which I found did a good job at clearing my throat. It tastes great, but still, it doesn’t stop my coughing. And of course I tried plenty of American cough syrups over the years, none of which helped.

Don’t think I cough all the time, either. But I’m stubborn like a mule, and will often go outside when it’s cold and I’m not dressed adequately. So naturally, I catch colds, and when I do, I cough a lot.

This experience also got me thinking about drugs and their effects on the body. Our bodies, you see, are endowed with the capability to heal themselves. That capability works better or worse in people, depending on how well they take care of themselves (diet, exercise, regular sleep, etc.) Drugs will usually only mask the symptoms of a disease, not cure it. Even though I’m not coughing now, that doesn’t mean Tussionex cured my cough and sore throat. It only stopped my coughing. Here’s what the PDR says about it:

“Tussionex Extended-Release Suspension is a cough-suppressant/antihistamine combination used to relieve coughs and the upper respiratory symptoms of colds and allergies. Hydrocodone, a mild narcotic similar to codeine, is believed to work directly on the cough center. Chlorpheniramine, an antihistamine, reduces itching and swelling and dries up secretions from the eyes, nose, and throat.”

You see, it’s used to “relieve” coughs and other symptoms, not “cure” them. They’re not even sure how it works. They “believe” the codeine derivative in it works directly on the cough center. The human body’s internal chemistry is so complex that I don’t know if we’ll ever figure it out properly. Right now, we’re still just stabbing in the dark when it comes to medicating people. We give them a drug and then, oops, we realize the effect isn’t the desired one, or that it interacts with other drugs and causes undesirable side effects. The PDR says about Tussionex that its “side effects cannot be anticipated”. And there’s also a section dedicated to its possible food and drug interactions. Here’s what that says:

“Tussionex may increase the effects of alcohol. Do not drink alcohol while taking this medication. If Tussionex is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Tussionex with the following:

  • Antispasmodic medications such as Bentyl and Cogentin
  • Major tranquilizers such as Thorazine and Compazine
  • MAO inhibitor drugs (antidepressant drugs such as Nardil and Parnate)
  • Medications for anxiety such as Xanax and Valium
  • Medications for depression such as Elavil and Prozac
  • Other antihistamines such as Benadryl
  • Other narcotics such as Percocet and Demerol”

You see, this is what medicine has become these days: the chemistry of drug interactions. Every physician that works in a field where they prescribe lots of medications has to know drug interactions perfectly, or they will put their patients’ lives at risk. Sadly, most do not know all they need to know, because the interactions are so complex.

My dad is a psychiatrist. He made it a point to know all the psychiatric drug interactions and those of common drugs administered by other doctors, such as primary care providers or internal medicine specialists. He studies them all the time and keeps up to date with all the latest medications. He meets plenty of other doctors who aren’t as well prepared as he is, and he’s told me often how shocked he is to find these people are prescribing drugs that readily conflict with others, creating undesired and potentially lethal side effects. The sad part is that when he tries to let them know about it, they usually brush him off. And then we wonder why so many patients do poorly in hospitals… Isn’t it to be expected when most doctors are ill-prepared to prescribe medications for their patients?

I think the takeaway lesson from all this is that prescription drugs can be very dangerous. They are not to be treated lightly, like I treated Tussionex — even though its nature is supposedly benign — it is, after all, “only” a cough syrup, right? A drug’s side effects and its interactions with other drugs need to be known not only by the doctor but also by the patient, so that each of us is aware of what we are putting inside our bodies. The consequences — if we don’t do this — can be fatal at times. I may not realize it fully right now, but I might not have been around today, and it was all because I self-medicated carelessly.

Updated 1/11/10: I’ve gotten a number of rude comments since I wrote this article, none of which were published, where dorm room heroes and couch potato experts called me all sorts of names, all because the dosage that I took was too low by their standards. They’d have been satisfied if I drank a whole bottle of Tussionex and woken up a month later out of a coma, or if I hadn’t woken up at all. What can I say, other than your mileage may vary. People react differently to different dosages. I suppose if my body had been addled by years of alcohol and prescription drug abuse, my tolerance level for the drug would have been higher, and three teaspoons wouldn’t have done much for me. However, when you lead a clean life and are in full possession of your senses, you tend to be much more sensitive to these situations. So please stop criticizing the article. I wrote it not to draw attention to myself, but to put up a warning sign about prescription drug abuse.


163 thoughts on “Don’t play with Tussionex”

  1. Thank you for your article. I am recovering from pneumonia and just picked up the Tussinex prescription as I am miserable with this cough. I may have made that same dangerous mistake if I had not read this!

  2. I’ve tried so many different otc and prescription cough meds, and Tussionex is the only one that works for me when I get uncontrollable fits of coughing after a cold. But I only take 1/2 tsp twice a day if I REALLY need it. I made the mistake once of having a glass of wine with it (I figured I had taken half a dose in the morning, and I was drinking 12 hours later — it had probably worn off). I was sick to my stomach — cramping and vomiting. Won’t make that mistake again. The half dosage was mostly to make it last longer — due to the high price and also I don’t like asking for a refill because my doctor seems to question if I’m a junkie. I’m very careful with this stuff already, but I’m glad I stumbled upon this article and the comments so I can take it even more seriously. I’m not against recreational drugs, but I’d much rather stick to recreation drugs for my recreational drug use — not this stuff. ;) Oh also — my coworker is also prone to uncontrollable coughing and was complaining that nothing works for her. I let her try some of my Tussionex, and it stopped her coughing, but she broke out in a full body rash. :(

  3. I’m thinking if you cough as much as you say you do, a trip to the dr may be in order. Contrary to belief, colds are NOT caused by not dressing adequately in cold weather, they are caused by a virus. You may have silent reflux or any number of lung related issues.

  4. Wow. People can be really cruel. I for one enjoyed your telling of your experience. I’m taking Tussionex right now and stumbled across your blog. Keep writing

  5. Took 1/2 teaspoon last night for flu symptoms, and I fainted twice. First time I hit my head and husband had to pull me off the bathroom floor. Horrible feeling I never want to experience again.

  6. Sorry to hear about your not so good of a time with tussionex. I’ve noticed effects can take up to an hour, possibly because of the other stuff to make it extended release due to this fact people take more because they don’t think it’s kicked in. It’s hits you like a train. My first time with this stuff I did half the bottle. I was flipping GONEE, it was warm and euphoric at first but it just turned into a puking fest with the toliet. People do not mess with this stuff and if your gonna do it anyways don’t drink half of a 4 oz like I did.

  7. U are lucky! First time user I could see the mistake. Plus desperation to stop coughing. I wanted to let u know- in case you don’t know- there is a generic drug that came out in 2011. Cost is significantly cheaper but doesn’t taste as good but works the same. I will tell u this as a person who hoboes about this drug indepth. Next time take the tsp amount and get in bed within 15mins. Don’t read or anything. Just relax and close your eyes. When it starts to kick in your body will be ready and you will find that you will get the best 8-10 hrs of sleep. Keep water by your bed bc it will make your mouth dry. Again this doesn’t cure the problem of your cough but does prevent pleurisy and allows your lungs to relax. :) good for u for blocking those haters. Hope this helps (even though u posted a long time ago)

  8. Thank you for this article. Hydrocodone is great, at the correct dosage! I have wondered what more would do

    1. Attention – the directions on the lable are there for a reason. You read what is on the label before you take anything; if you are illiterate have someone else read it for you. This is the only drug that will help with my runny nose and cough when I get a bad cold. You take it as directed and you will be fine. Do not take hydrodone pills with it or after it though. That is in the instructions too. A drug should not be attacked here and given as the reasons for deaths, simply because the person that took it could not bother to read the directions. You can overdose on tylenol and almost die from liver failure, you going to blame the tylenol too? Wake up people!

      1. Gabby, maybe you should re-read the blog, he did NOT blame the Tussionex, he clearly states he took too much; however as a reformed addict I can understand, it is easy to OD on this stuff. I got a bottle today and even I measure the dose. The chlorpheniram also has some nasty side effects.

  9. Your update was spot on. My father and I both are grateful for tissionex when we get coughs that persist thru the night but even a 1/2 tsp for me taken too late in the evening will render me useless too early in the morning. Woke today to take kids to school and while groggy thought I was fine until the nausea hit and I knew it wasn’t out of my system yet. I have no idea what a dangerous amount is. Only that less than a tsp is more than powerful!! A drug that should be respected and used wisely.

  10. hey man,
    are you sure the strong dosage wasn’t from the other medications,
    you had taken previously that might have increased the potency of tussionex?

    1. I would like to add my comment on this cough syrup. I am a senior citizen now, but I have had the gross missfortune to live with a family of drug overdosers. My son who is now dead of liver failure could drink, at least 8 oz. of this stuff and probabvly more. I was never around him when this hard to spell stuff was in my life. HIs wife a lady outlaw from Oregon introduced me to it a few years ago, during a trip from CA to Texas. A friend of mine was along also but he was spared. I did not want to go on said trip, but I had to. The evening we started from N. CA, I was feeling so down that my daughter in law, handed me a large bottle she had just picked up a Drug store and chugalugged all but about an inch from the bottom, “Drink this.” she demanded, “you will feel better.” And she was right, I immediately felt happy and full of enthusiasm. I knew what it was. Cough syrup was a common high in those days due to Codiene. but, this did not even have a bad taste. She and I kept this up for a week or two, until we left her with friends in Texas. I felt down for a few days, but not bad. She would get a chest Xray every day to get her prescription. And drink down the whole bottle except for my share, which was 1/2 inch deep, surely more than 3 teaspoons. I drove all the way. She is still alive in Ore, and is the mother of my grandaughter. I have known more than one of these overdosers. I do not know what to say about them. Her husband, my son, died when he was thirty six after ingesting 16 percodan (oxycodone) He did that all the time. This the truth, and I don’t know what to think. I guess I am lucky to be alive. I thought I should contribute this.

  11. Tussionex Pennkinetic, when used as directed, is a wonderful drug and antidote to coughing and congestion. I generally get a bad cold/infection every other year. Tussionex really, really helps suppress painful coughing, aids congestion, and importantly, helps patients sleep at night. And getting sleep is critically important to defeating infection.

    In addition to antibiotics, I believe Tussionex is one of the best tools for fighting persistent coughs and congestion, and can really speed the healing process. As well as allowing one’s spouse to have some semblance of peace.

    I’ve never found it to be addicting. Nor does it have serious side effects — again, as long as you follow directions. Take it once every twelve hours, don’t take alcohol, stay out of the car, and have regular meals and fluids, and you’ll be on your way to recovery with the aid of this medicine.

    Tussionex is *not* too dangerous. So long as people follow directions, they will be fine taking Tussionex. I hasten to add any drug can be dangerous if you overdose. Swallow a bottle of aspirin, and you are going to do damage.

    So a big thumbs up for Tussionex, a great drug for those of us who suffer from the occasional bout of serious coughing and congestion, and looking for effective relief and sleep so we can get better.

    1. Hi Jack – I read your note and agree with you – it is a very effective tool – I’ve actually “have” to take it up to 3X a day for a condition that I have had since 2003 – a few areas I think you may be mistaken is about taking it before going to sleep – it causes insomnia in most people including myself unless taken about 6 hours before going to bed. As for addiction – it is highly addictive. I discontinued for about 4-months – the first week to two weeks were absolute misery. Your body become dependant and you will go through withdrawals – not fun. Sweats, shaking insomnia – all the classic symptoms of narcotic withdrawal. If you follow the directions even for short periods say for a few weeks you may still have some of these effects. After being off it for this amount of time my coughing condition got exceptionally worse so the doctors put me back on. So bottom line – be careful with this stuff – there are a lot of downsides…

      All my best – Lad

    2. Thank you. I could not agree more with this statement. Use the medication as PRESCRIBED and you will be fine. It works wonders.

  12. Hi, I’m glad I read your article because I recently thought about using tussionex as a recreational drug. Normally I stick to non prescription cough syrups or the occasional good bud, but I certainly don’t want to end up in a coma. I’ve researched on the ingredient dextromethamorphan, used in American cough syrups like Delsym and NyQuil. Delsym is by far the safest thing you can abuse (obviously nothing is… Safe safe, but for medical side effects, there are none other than if you have extremely prolonged use or overextended dosage). Maybe you could write an article about delsym? Pure dextromethamorphan is the safest, because it doesn’t react well with other ingredients (like in NyQuil, some of that stuff kills your liver faster than you can say “I think my liver just failed.” Obviously, people are going to experiment, so if and when they decide to, isn’t it better to be as smart and safe as possible? (I know, that’s a contradiction to drug users, but…) I am incapable of writing long articles, or really anything. I have ADHD and OCD. It took me 2 hours to write this. But as I was saying, the safest is delsym, pure DMX, from dosages to 100mL to about 700mL or 1000mL. Please do, I hate to see people doing the wrong things and suffering liver problems or anything. By the way, I also have persistent cough problems. I used to take Delsym because it actually did handle my cough… At first. I grew resistant to it, but still wanted it. Not a physical addiction, more a mental one. And I had extremely prolonged use. Maybe… Oh a month. A half to full bottle a day. That’s about 450mL to 900. I stopped and went through a one week withdrawal phase where I stayed home from work, college, and any social events. It wasn’t fun. So when I say recreational, I mean. Once or twice a month at most. To be safe, less is best. But on my cough problem, doctors think its acid reflux disease. I also have stomach inflammation and had H.Pylori. Nasty. Maybe you should ask about acid reflux. I’ve been taking 2 prilosec OTC a day and my cough vanished. Still have the occasional bad cough but not like it used to be. Good luck and I wish the best of luck to all.

    1. It seems to me that with your health problems, you shouldn’t be indulging in overdoses. You should instead be focusing on cleaning up your life and your diet, exercising and trying to gain some focus into your life. But to each his or her own. Just know that there will be consequences for your actions, as you’ve already seen (in part).

    2. Using this as a recreational drug is NOT what it is intended for. Are you crazy? This is very dangerous. The medicine should only be used as prescribed.

    3. Just wanted to add some information here: Overdosing (taking more than intended) of dextromethorphan whether Hbr or Polystirex is not the safest OTC recreational drug.

      I don’t condone OTC recreational drug use,.. but I DO not pass
      judgement on those who wish to ingest whatever substance, be it be bleach or water — we are supposedly ‘free’ and while harm reduction information should be available,.. people should be able to do what they want as long as it doesn’t pose a threat to others.

      That said,.. Dextromethorphan,.. aka: Robotripping, etc is highly toxic in the doses required for the effect at the “upper plateaus” especially as one grows tolerance to the DXM. I know that in itself isn’t much of a deterrent, but it can and does cause brain damage in some individuals. Generally the more chronic, high dose users who become tolerant.

      You have to remember this isn’t a situation where you wake up one day and feel ‘brain damaged’ it is an effect over time.

      Luckily, our brains are highly plastic, (ie: Neuroplasticity), and can adapt to a substantial amount of damage, but this takes time. Though you can never depend on neuroplasticity as a reason not to worry about ingesting high doses of something that can be so devastating.

      I respect your hedonistic choice to ingest the substance for an
      ‘effect’,.. I really do. Just be careful, and there are safer recreational choices available.

      The only intention was to inform of a very real danger of DXM use.

      Take care,

    4. Delsym has an extended release version of Dextromethorphan called Dextromethorphan polistirex, so it is not a good cough syrup to be abusing like you are. I’ll spare you the ‘you shouldn’t be abusing drugs speech, because I doubt you would pay any attention to it’. Obviously if you are abusing Dextromethorphan you are trying to get to a high enough dose that produces it’s dissociative effects. I’m not going to tell you the name of the OTC medication, but you should be looking for an instant release Dextromethorphan medication that only contains that one drug.

  13. My husband died last year (2011) in his sleep after taking Tussionex. It put him under for good. He went to the doctor the afternoon before. His doctor diagnosed him with bronchitis. He gave him an antibotic prescription plus this serious narcotic. All year long his asthma had been continuously blocking his breathing passages. In the past, he had seldomly used his inhaler, but he was needing a new prescription every month. His doctor didn’t pay attention to this. My husband never woke up when he needed to and he probably experienced all of those other side effects that were previously described. This drug is just too risky, too dangerous. There are other drugs to take care of a cough that will work and are effective without killing the patient.

    1. I am truly sorry for your loss – was an autopsy performed to verify this was the cause? I am one of those select few unfortunate people who has been prescribed this as a long term solution. After being seen by 7 separate specialists and a series of tests, I have actually been taking this daily since September of 2003. I hate the stuff – too expensive but unfortunately there is nothing that can be done except a more costly surgery (that I am considering) The drug taken as directed should not have been the sole reason for his passing but could have definitely been a contributing factor. Again Carolyn – I am sorry for your loss – all my best – Lad

      1. Hey – hopefully by now u have been told of the generic version of tussinex. The cost is way less compared to tussinex. Taste a tad different but works the exact same way. Came out last year!! I have to take it every time I start coughing due to a cold bc I have copd. If I don’t I will get pleurisy easy and we found out this year I have severe pectoral deformity in my chest. Being a female u would never know except I have great cleavage. Hahaha! But due to that it effects my right lung by pushing in on that lung. So I I cough for several days straight I’m in a lot of pain. While this doesn’t cure my cold it prevents pleurisy and allows me to have comfort until I get over the cold.

    2. I am sorry for your loss, but it sounds like your husband had other health problems likely related to his passing. It’s highly unlikely that Tussionex was the sole reason why you have suffered this loss. My condolences.

  14. I have been taking tussionex for a few days now, 15 – 20 ml a day. Today I didn’t take any I could barely get of bed. I don’t feel sick anymore. I do not know what is causing this extreme fatigue. I wish it would stop.

    1. Jake – sorry about your fatigue but I have to ask – I see your post came in at 3:45 in the morning? After an extended period of taking this medication your body could be going through a slight withdrawal – I think extra fluids and a warm drink with some caffeine (coffee or tea) would help to get you back on track. I know about having to take this for extended periods – I have been taking this since September of 2003. I personally hate this stuff but it is the only medication I can take to stop the violent coughing I have. I did stop taking it once (mistake) and do remember the difficulty in getting the day started – all the best – it will pass soon – Ladd

  15. I’ve read many of the comments & wanted to say, it is true, that the way hydrocodone affects people differently is based on several things (such as tolerance, genetics, & other food or chemicals that may be in ur body.
    For instance, I had a spinal injury & was treated with 10mg hydrocodone for several years, & due to the tolerance I built up, & due to my high metabolism, I was up to being prescribed 10-12 a day. Due to this, now if I ever have to take Tussionex or regular Vicodin, is does absolutely nothing (except maybe work like weak aspirin).
    Luckily after my surgery & PT, I don’t have to take opiates on a regular bases now! :)

  16. Just got this last night for U.R.I.

    When I took it out of the bag, they included a syringe. I thought, “what am I, an infant?”

    Apparently, they have a precision applicator for a reason. That stuff is no joke. One tp and I could feel the effects. For some reason, my bottle says 2x a day. There’s no way I could take that stuff and go to work!

    1. Sorry but you gave me a good laugh!! I started taking this stuff 15 yrs ago. They use to give me a 12 ounce bottle. No joke for a 30 day supply. It would last me like a yr. now u get this “infant” size bottle. Too bad those who abused it made it harder for those of us who have to have it

  17. I’m wondering if it’s the “synergistic” effect of antihistamine and hydrocodone or the antihistamine itself that is responsible for your extreme reaction. I recently took 2 teaspoonfuls of Tussionex by mistake and also had quite an effect. But then I once took 30 mg of oxycodone (roughly the effect of 100 mg of hydrocodone). The oxycodone had a definite effect, though nothing compared to the Tussionex. Strange that you can’t find info on the internet about this.

    1. Now I see I’ve mis-calculated. I took 15 mg of oxycodone (equivalent to about 50 mg of hydrocodone). Still the effect was mild relative to the two teaspoonfuls of Tussionex I’d taken by mistake.

  18. Thank you soooo mu haven’ taken my dose yet Thanks for this information….I just got this script and haven’ taken my dos yet GOD BLESS YOU FOR YOUR INFORMATION
    JOANN AUD
    Arlington, Texas

  19. Thanks for the honest article! I’m sorry that those people wrote rude posts, but your reply was on point. My mother is taking it right now and even half a teaspoon is too much sometimes.

  20. Clearly no one is doubting your feelings of discomfort with the experience. Many people who use a significant amount of a drug for the first time can experience intensely uncomfortable sensations, but that doesn’t mean they’re anywhere near the point of organ damage or death. I’ve heard countless reports of people getting high on weed for the first time and claiming they were convinced they were going to die. None of these people were anywhere near death or injury, yet they were absolutely convinced they were.

    People have been focusing on the hydrocodone in this thread, yet I think the chlorpheniramine maleate is a far nastier and more dangerous drug. Taken in excess, the chlorpheniramine would cause horrific effects well before the hydrocodone would.

  21. Last year I was prescribed Tussionex for a cough and almost OD’d because the pharmacy made a mistake! The dr wrote the script for 1-2 tsp every 12 hours, but the pharmacy put 1-2 TBLS on the bottle. Not realizing, I took 1 tablespoonful like it was written. Wow, was that crazy! The mistake wasn’t caught until I called my dr. to get a refill since I ran out so quickly. They thought I was an addict til I showed them the bottle. The pharmacy admitted it’s mistake, refunded my script and refilled me for free. I was lucky. I’ve since changed pharmacies and just got prescribed Tussionex again today. Took 1 tsp and that’s it until bedtime!

  22. I did the same thing today but took 2 teas instead of three. I took them about three hours apart. Wow.. This medication knocked me out!! I agree with what u wrote. I also regret doing something stupid like this and am thankful I’m ok. My body, like yours, is not used to drugs and is really reacting strongly now. I’m so weak and fuzzy feeling I don’t even want to sit up. (just awoke from practically passing out). Sometimes we humans just don’t think!!

  23. Hillary – while you had a bad experience with this drug you should probably not throw it out. It is powerful and when taken as directed will save you a lot of coughing and give you the rest you need. I would suggest – if in fact you keep it – start with a smaller dose and see if it works for you. However, I would definitely give your body a chance to clean out the existing drug. Plenty of water will also help. This drug also has a tendancy to cause insomnia if taking too much and close to bed time. Give yourself 4 to 6 hours before going to bed – you will do just fine – all the best – Ladd

  24. I came across this article, after making a mistake last night with this medication. Im a 22 year old girl who has only taken hydrocodone previously for a bad root canal in pill form. I have been sick with a respitary infection, and my Doctor without any hesitation perscribed be tussionex. Last night, looking forward to a good nights rest I took a teaspoon, followed by another and another about a half hour in between. I laid awake all night, jittery, sweating and itching my skin feeling as if I had a fever. This morning i realized the tussionex is a extended release medication for 12 hours, which explains why I did not feel the doasge right away. It is mid-afternoon well over 12 hours since I overdosed and i still feel way out of place. I feel mentally as well as physically messd up, a “high” I would never like to feel again. After this one experiance and 60 dollars with insurance for a bottle I’m chucking it in the garbage and thanking God to still be here. I learned my lesson with liquid perscriptions and will stick to the nyquil for a safe sleep!

  25. As far as 3 teaspoons not being able to bring someone to the brink of death, I disagree 100%. I have asthma & typically get bronchitis 3-4 times a year. Nothing else has ever worked for me to soothe a cough. Delsym, any cough medicine containing DXM, or even benzonatate (Tessalon Perles.) After taking my “rescue” inhaler (Albuterol Sulfate) every 4 hours, I still hacked my head off. I’d cough so hard that I’d throw up & see stars. With all that being said… asthma is a condition that supresses your breathing. Bronchitis is an illness that makes it hard to breathe because of constant coughing. I accidentally took 2x the dose of the liquid gold- 2 tsp- and wound up at the ER because it had supressed my breathing to the point where I was truly having trouble. So… if you college frat party hotshots want to claim immunity to the effects of a very powerful narcotic, go ahead and drink yourselves silly (or dead.)

  26. What most of you are missing is that, the hydro in this medicine is a CNS Depressant and guess what, so are Anti-Histamines (excuse my spelling please). The Anti-Histamine in this med increases the CNS effects of the Hydro. One of the most dangerous parts of using too much of this med is that combined effect.

    Not only are you getting 30 mg’s across 12 hours but you are also getting an antihistamine at an exaggerated dosage at the same time which can be dangerous. Also you may have an unknown allergy to one or both active ingredients.

    You cannot just look at the hydro in this med when discussing overdose. Any amount of any med that causes sickness without it being some kind of allergic reaction, is an overdose, and it very scary for the person going through it.

    Sharing this experience is extremely helpful to people and if it even deters one person from taking more than what is prescribed by a Dr. then it is worth it.

    Thanks for sharing your experience hopefully it helps some people out.

    That being said it is much more difficult to die from a medicine overdose than you might think, and our bodies in many cases are great at protecting us through rejection (vomiting), and Fight or Flight (adrenaline rush) which may just give you enough time to make an emergency call or get other help before it’s too late. As well as keep the heart beating just long enough to get help.

    I for one do not want to test that theory.

    If you fear an overdose call 911. NOW!

  27. My doctor just prescribed this for me IF I start coughing or have trouble sleeping. I have a bad cold and didn’t sleep at all last night, so I Googled tussionex to determine if I should get the prescription filled. This blog is not what I expected to find. I think I’ll just keep tossing and turning. In fact, after reading this, I’m surprised my doctor gave me the prescription, since I”m hardly coughing at all. In the meantime, my father has pneumonia and coughs horribly at night. Sounds like HE’s the one who needs this!

    1. To the last comments…(and to others):

      Tussionex is generally prescribed in a liquid form. Seldom do physicians prescribe the tablet form as it has, in the past, hit the streets and been sold illicitly. Hydrocodone is a very effective anti-tussive. Don’t be afraid to take it unless, primarily, you are sensitive or allergic to codeine. Other drug interactions are very important, true, and certainly one should be very aware of other medications one is taking before taking Tussionex. Discuss those issues with the physician. But more importantly, taking the drug as typically prescribed, i.e., one teaspoon every twelve hours, AND, as needed is the rule. I have had this precribed for my wife because of its effectivness as she has dealt with a chronic cough for many, many years. And she takes it very seldom unless her cough is interfering with sleep.For cough associated with influenza, one of the more effective treatments out there is dextromethorphan, found in OTC medications such as Robitussin. Dextromethorphan is the most effective medication for pertussis outside of hydrocodone and is available w/o Rx.

  28. Love the insight on this medicine. I was actually trying to see if there was something that worked better, but I guess this is the best. I have pnumonia and am just miserable and was prescribed this medicine. I still woke up coughing and didn’t get much sleep, so I guess I should just wait and see if works better tonight. :)

    1. im 17 years old i have took 4 tables spoons of this stuff in 2 hours before and only felt high then again i been to rehab 4 times for addiction to vicodin

  29. My sister-in-law died from an accidental overdose of tussionex about 6 months before you wrote this. People need to listen to you.

  30. I have taken this and 1 teaspoon keeps me in bed all the next day,so whoever comnented on the low dosage obviously has not taken this stuff! Its very strong and quit sneaky you dont feel anything for a while then it just hits you.

    1. I think everyone has a slightly different reaction probably based on many factors. When I take it (which is unfortunately daily) – I can’t seem to sleep if I take it too late.

  31. Strangely enough, I dont think it was the opiate that overdosed you, but the antihistamine. That would only be 30mg hydro, not really that much, a fairly routine severe pain dose imo. And it was extended release, so yo werent getting it all at once. But that clorphenarimine is the same stuff in triple cs. The pills dumb ass kids who want to robotrip od on. A VERY good antihistamine- at the right dose level. Not to mention, drug synergy with antihistamines and opiates. Narcotics, strangely, are one of the safest drug types there are. When you add other sedators in the mix, thats when the ods happen. I am not a doctor, just fairly well read on this subject. I have VERY bad allergies and bronchits EVERY DAMN YEAR! and am QUITE familiar with the ol Tussin.

  32. Hello Raoul, I’ve been watching and reading the posts. I’m glad to see that most take this drug seriously. I posted my first comment on July 26, 2010. While I am still required to take this, I hate it but it does work, my resistance has been building up a bit – now I have to take it sometimes three times a day. That said – the reason for this post is to inform everyone that does have to take this drug, there is a new generic form that is identical to the original. Tussionex currently runs about $200 per 8oz or 240 ml. The new generic runs about $130. I know it is still expensive but when you have to take it for such an extended time $70 is a pretty good cost savings. To everyone that reads this blog I hope for you the most happy Christmas season or what ever you celebrate this time of year. Raoul – from sunny Southern California, (currently raining) all the best to you and your family for this Christmas season and New Year – Lad

  33. How unfortunate that you received negative/childish comments regarding your blog and warning regarding Tussionex. I am glad you lived to blog about it.

    I have asthma and I frequently get respiratory infections. I have a daughter who is now nearly 4, was premature, and frequently gets respiratory infections that take up residence in her lungs. I have used Tussionex once for my own illness, but due to the cost only used it the one time. For myself, I find 1/2 tablet of a 5/500 mg table of Vicodin is enough to calm my cough on the rare occasions that I have a bad cough. My daughter, however, has been intermittently prescribed Tussionex for her cough spasms when she gets a respiratory infection and it has been an an absolute godsend for her!

    Although not recommended for children under 6, it was literally our last resort. She had been prescribed Cherrtussin, a codeine-based cough syrup, and, in addition to not working, it made her vomit. She receives nebulizer treatments every 4-6 hours when she has a respiratory illness, has to take Prednisolone for inflammation, and she would LITERALLY cough nonstop throughout the night. . . Very often she would cough until she vomited mucous. At first there was reluctance to prescribe it to her because of it’s narcotic ingredient and her young age. We were told over and over and over to elevate the head of her bed, use a cold air vaporizer, put her in a steamy shower, put vapor-rubs on her, etc. etc. etc. . . . even open her window in the dead of winter to let the cold air in to calm her cough. All of these suggestions were things we were already doing. She began to look “sickly” because of the interrupted sleep and because of the lack of sleep her illnesses took longer and longer to recover from.

    I believe if the patient (and/or the patient’s parent) are well educated by the physician and pharmacist on an appropriate dosage and told of its potential side effects and exhibit some common sense that this medication is safe for adults and children. I am sure there are other parents out there with children who have asthma or other respiratory disease that are desperate to help their child feel better. We are very fortunate to live in a smaller community where you are a “name” to the doctor and not “a number” and our pharmacists know us by name.

    Regardless, thank you for warning those who have not used Tussionex before, it should be considered a very helpful blog.

    1. Thank you Stacey! I hope your daughter’s health improves! If you’d like to try something that will surely help but will take some effort, in terms of changing your diet and eating in a new way, try the raw vegan diet, which involves eating vegetables, fruits, nuts, seeds and sprouts, raw, dehydrated, or prepared at temperatures under 40 degrees Celsius (basically, not cooked). If you stick to it, it’s sure to get rid of your asthma and help prevent respiratory infections. Give it a try, but you’ll have to stick with it for at least a month to see the results.

  34. I just got prescribed this for coughing and pain. i took one teaspoon worth at the doctors office and the pain has not diminished at all. The whole reason i went to the doctor was for the pain because i HAD been coughing like crazy, so when i returned home, i took a second one about 30 mins ago, and still the pain remains the same dont worry im not gonna take another. The pain is still there but now i jsut feel dizzy. Im sure this isnt enough to OD on, but i dont take prescription drugs often at all. good to know you were ok with 3. Glad youre ok bud.

  35. I am greatly relieved that common sense finally prevailed in these postings. I too am a very occasional user of Tussionex, using it only when necessary for chronic cough. It has normal/strange side effects on me (depending upon who you listen to); I absolutely get a horrible nights’ sleep (if I can sleep at all) when I take it. However, in my sleeplessness, I experience some of the most lucid, clear, ‘problem solving’ thoughts that I ever get to experience.

    THAT SAID, this narcotic truly is nothing to trifle with. I have a friend that experienced a sinus infection-related chronic cough … for which he was prescribed standard dozing of Tussionex. Like others, he wasn’t able to secure a measuring spoon easily and chugged a bit of the ‘cough syrup.’ He ended up in the emergency room, and darned near had to be revived. The doctors there told him that his heart rate was so high – and his breath rate so slow – that if he’d waited much longer, a coffin would have been his next and final ‘prescription.’ He lives in a small town, and his GP (the writer of the prescription) got word of it and was outraged that my buddy hadn’t ‘listened’ to his “ONLY ONE teaspoon” admonition. Docs … if you’re bothering to read here, please don’t warn people without explaining just a bit more about the WHY of your warnings.

    Bottom line: your mileage not only “may vary” – but it’s darned likely that it will with this medication. So please follow directions and if you vary the dosage, err on the side of taking a bit *less* than the prescribed dosage if you absolutely feel the need to second guess your physician with regard to this medication/drug/narcotic/stuff. Don’t tempt fate by using this to get high or otherwise To do so needlessly invites you to become a recipient of a ‘Darwin Award’ for improving the collective gene pool of the human race by your untimely demise.

  36. Hi,

    I took this medicine last night for the first time. I’ve never used a rx cough medicine so i measured it precisely! After an hour I was going to take some more but figured I’d read up on it first. Glad I did! I waited another hour and it kicked in! Sort of a fun feeling but I know I wouldnt have liked it if I took more. Glad I found this site. Also, my doctor and pharmacist didnt warn me about this syrup at all. In fact, when I found out how much it costs I asked the pharmacist to call the dr. to find out if he would prescribe something cheaper. He said he would but really prefered me using this stuff! I figured he knows best and what the hell it’s my health we’re talkin about. In the end, my cough wasnt that bad (it is now gone) that I needed tussionex but I’m happy to know it’s out there if I ever really need it.

    Brian, NJ

  37. Hi,
    Thanks for the great information on Tussionex from someone who has taken it. My MD prescribed it for my cough associated with pnuemonia and I was a bit hesitant to take but after almost a week with only a couple hours a night of sleep and keeping my spouse awake. I took 5ml (1tsp) and voila it really did help. I will be very careful to make sure I wait the whole 12 hours for the next dose.
    I’m also glad you are okay!

    Kate, Salem MA.

  38. I don’t normally read blogs like this, but I really enjoyed everyone’s comments – good, bad, or otherwise they were educational. I’ve used Tussionex a few times – once during a really bad case of pneumonia. Used properly, it is safe and far more effective than other cough meds like dextromethorphan.

    One thing I did not see was a good analysis of why Raoul overdosed.
    One major difference of Tussionex versus other preparations containing hydrocodone is that Tussionex is a time-release formula. Raoul took a dose and didn’t notice an immediate effect. So he took another. Still no effect. Then a third dose. This medicine is designed to provide extended (overnight) cough relief. Most other preparations last 4-6 hours, not enough for a good night’s sleep. This drug contains a slightly different delivery mechanism, metering out the dose over 12 hours or so. But that also means that Tussionex has a slower onset of action. So you might be fooled into thinking it’s not effective after 30 mins or an hour. But at 10mg of hydrocodone, it’s fairly strong. Rauol’s mistake was some combination of not understanding the time-release nature of this medicine, his doctor or pharmacist not explaining it well enough, or both.
    There’s one other issue here that people have mentioned – the dose is 5mL, which is a relatively small amount. It needs to be measured precisely – using a kitchen spoon is terribly inaccurate. I don’t think Raoul mentioned how he measured his dose. Even a medicine dosing spoon – which is usually shaped like a test tube with a spoon-like opening, isn’t ideal. I had my doc give me a small 10mL graduated syringe (no needle – just the plastic tube and plunger with the rubber seal). Syringes are a great way to very accurately measure a liquid drug like this. They are available in a wide range of sizes and graduations, they are fairly inexpensive, and they are REALLY precise. The right syringe can be found for pennies (or free from your doc in most cases) and can measure your dose in fractions of a mL. I noticed many people posted that they actually needed to adjust their dose down to a smaller amount. Using a syringe allows you to know exactly how much you are taking and to make precise, fine adjustments to your dose if you find a smaller amount is in order.
    Last, Tussionex needs to be shaken very well. But the syrup is very thick and sticky. This makes is really hard to mix up well. It should be obvious, but the reason you shake a liquid is because its various components settle out in the bottle. I say not to be silly, but to illustrate these two scenarios:
    A) The hydrocodone “settles to the bottom”. Well – if you shook poorly when the bottle was full, you might have been taking doses that, even when measured accurately, had less hydrocodone in them. This meant that the last few doses were the most concentrated ones in the bottle.
    B) The hydrocodone “floats to the top” of the liquid. Maybe Raoul’s first doses had more hydrocodone in them, which means maybe those last 3 doses were in fact a little less potent, fooling him into taking three doses. Even with the reduced potency, maybe that put him over the edge.
    All in all, perhaps it was a perfect storm of the above factors – poor measurement, delayed onset of action due to the time-release nature of Tussionex, and insufficient mixing. In the final analysis, I want to say that I don’t think Tussionex is a dangerous drug. But I do think that because of the fact that it is a liquid and not a pill (where measuring mistakes are less likely), because it is time-released, and because it needs thorough mixing, Tussionex is a drug format that should be used carefully. One thing I find very troubling is when the FDA takes an otherwise useful, effective, and beneficial drug and limits it’s availability or bans it’s use because patients, doctors, pharmacists, and more importantly pharmaceutical companies can’t figure out how to solve what should otherwise be addressable problems.
    Raoul – I’m glad you came through OK, and I’m very sad by the lady who lost her husband and others who have had trouble. To the abusers of this drug – hey, I’m cool with you making your own choices, but it affects the rest of us when your bad decisions cause the rest of us not to be able to use drugs for their intended benefit. If you are intent on getting high, please at least be respectful of those of us who don’t by enjoying your high safely, especially to others – don’t drive a car, don’t be a burden on the rest of society, and please don’t get pregnant and harm your unborn child. If you truly believe it is your right to use drugs in this way, the best way to avoid the laws getting harsher (and hence protect your ability to use drugs recreationally) is to feed your habit responsibly. I’m not endorsing what you are doing, but I recognize that recreational drug use is probably always going to be here. If it’s going to happen, the least I can do is help encourage people to be somewhat responsible.

    1. All great points, Eric. Both my doctor and the pharmacist were very clear about the delayed onset of the drug. Both told me to take one teaspoon before bed, but if, after at least 3 or 4 hours I was still having problems, only then to take another. I only had to do this a couple times, hooray, and my pneumonia is all cleared up this week. A little hoarse but feeling alive! =)

  39. I have bronchitis and a sinus infection. The dr. prescribed me Tussinex 1 tsp every 12 hours, 400 mg Musinex every 4 hours and Augmentin 875 mg every 12 hours. I took the Tussinex about 5 a.m. and slept about 3 hours which is a record for me because I also suffer from insomnia. I am sitting here falling asleep at my pc. Tussinex is some bad-ass medicine but it is one you do not want to play around with.

  40. “do not comment and tell someone that they couldn’t have been effected by an amount as large as three teaspoons”

    The word you want is AFFECTED. :)

    (I majored in English.)

  41. I find it immensely amusing that someone said you were a wimp for not being able to handle 3 teaspoons full of Tussionex and that another immature kid actually boasted of drinking 4 ounces at once. Seriously, people? If that’s how you feel then you need rehab ASAP.

    First of all, I googled this to make sure it wouldn’t have an interaction with my Adderall and stumbled upon this page. I’ve had a bottle of it for over a year and I decided to take a 1/2 of tsp tonight because I can’t sleep no matter how hard I try. I took that half of a teaspoon full about 10-15 minutes ago and I am already buzzed and am very much ready to sleep now so please, do not comment and tell someone that they couldn’t have been effected by an amount as large as three teaspoons. I can 100% guarantee you that if I were to take that much I would not wake up ever again. Different people have varying degrees of tolerance so don’t knock someone for trying to educate people on the dangers of overdosing!

    FYI– Just to state how serious this drug is– I had to backspace by the end of this at least 10 times, consider and reconsider my grammar and punctuation and even spell-check a word. This wouldn’t be such a huge issue if it weren’t for the fact that my Minor degree was in English!

  42. You are so right about this drug. I never bothered to get an actual teaspoon to measure. I figured a swig would be sufficient but was I surprised to find that I was so high- literally out of my mind. I was trying to text people and it was coming out gibberish. I lay across the bed holding my phone for 8 hrs.
    This is not a drug to play with, for sure.
    Now— the hangover is another thing. I felt miserable the next day I got my toast from the toaster and by the time that I had spread butter on it, I was too dizzy and nauseated to bring it to my lips. I lay down with a cold compress ugh
    Today I still feel the after affects a bit, still on the queasy side but I have pink eye. So I went from one bacterial infection to another.

    Bottom Line
    Tussionex is nothing to play with. There was no way I could drive or hold a conversation. I was even afraid to use the restroom because I wasn’t sure if I really WAS in the restroom or just imagining that I was.

    Take heed.

  43. Dear Raoul,

    Thanks so much, and thank Heaven you are ok. I was just prescribed this (terrible bronchitis), and even though I am a total weanie with meds (I would take half of what was prescribed…) your experience is a real heads up for those who would attempt the same thing that you did. I know alot of people might have the same mind set, hey this isn’t working, I’ll just take more… And when your coughing your fool head off, like I am, you’re just impatient for result.

  44. Anybody else having problems urinating while taking it? Geez….I just got put on it, took a little more than the recommended dosage, and I’m having a terrible time peeing. I also can’t swallow very well….it reminds me of my father who has Parkinson’s. He doesn’t swallow well, either.

    It’s been 9 hours since my last dose. I will be more precise in dosing from now on.

    1. Yes – this product basically closes off the sphincter muscles in your body to include urinary and esophageal. This will minimize in time but hopefully you won’t be on it long enough to be a problem. You need to also stay hydrated as you may experience a strange sweating pattern. This product will dehydrate you if not careful. All the best – Ladd

      1. I’m actually really looking forward to that part, as I’ve been pissing myself a little bit every time I cough for the last week. It’s embarassing but true. I’ve been wearing pads all week and it’s still not helping – neither is doing Kegel exercises. Very frustrating indeed. I’m looking forward to getting a nice sleep tonight, but I’m very cautious about codeine and other drugs, as just one T3 makes me feel loopy for at least 4 hours. A nice short recreational buzz, but not something I want to screw around with. I’m glad everything worked out for you, Raoul.

  45. Well Raoul, I’m hoping this note finds you well. Good article by-the-way. I am in the unfortunate category of, nothing else seems to work. I’ll give you the short version – in 2003 I developed an uncontrollable cough. Doctors first thought it was bronchitis, treated me for that with antibiotics – cough didn’t stop. After about 4-months my primary doctor finally referred me to a pulmonologist. After a series of tests the good and bad news came back. The pulmonologist said – “all the things I thought it could be – it isn’t, the bad news is I don’t know why you’re still coughing.” He then put me on Tussionex. This killed 95% of the cough but I realized that it was just masking a bigger problem. So – in short – over a three-year period of time I saw two pulmonologists, two ENTs, two gastro intestinal specialists, had two MRIs one CT Scan, multiple x-rays of the upper chest and sinuses, one bronchoscopy, one endoscopy and tons of blood work while still taking Tussionex. Again – the good news was “all the things we thought it could be – it wasn’t. However, we still don’t know why you are coughing.” I was finally sent to USC Medical Center and spoke with the head of Gastroenterology. He stuck two tubes up my nose and down into the esophagus to monitor stomach gasses for 24-hours. It ends up that I have an unusual type of acid reflux condition but not quite GERD. Normally associated to acid reflux is bad heartburn. I don’t get heartburn of any type. What the test showed is that I have over 80 episodes a day of a small amount of gas that leaks into the esophagus causing an irritation and this gas also irritates the lungs which then try to protect themselves by secreting mucus. So this cycle just continues and the result is uncontrolled coughing. Tussionex works for me because I closes off or tightens the sphincter muscle between the stomach and the esophagus. I had stopped taking it for a while – actually went through a few withdraws but now I have had to start taking it again as I was coughing so hard that I actually fractured five chest ribs on the right side and three in my back at different times. Coughing with broken ribs is some of the worst pain I have ever been in. I’ve tried everything except the stomach bypass surgery the USC Gastro Doctor suggested. I think I’ve tried almost everything else to stop this cough. However, in closing, if you have an alternative to Tussionex that I have not tried, I would surly like to know about it – the cost of this stuff is astronomical and I’ve built up a kind of resistance too it I fear.

    1. Ladd, I’m really sorry for what you’re going through. From my experience, acid reflux is caused by one’s diet. Have you tried changing yours? It sounds like after all the pain and the efforts, you need to take some drastic steps in your life, because I doubt the surgery’s going to help much. Change your diet completely. My wife and I are on a mostly raw food diet — we do eat regular foods from time to time — but we can see the difference right away when we step off raw food. We don’t feel as good, we sometimes get a little stomach sick, etc. Just google “raw food” or “raw food recipes” and go from there. Give it a try, you’ve got nothing to lose.

      1. Thanks Raoul – I’ll give it a try. What’s the worst that could happen? I’ll still be coughing but I can check that one off the list :) – thanks again so much for this site. It is very informative and lets me know, while I might have a different set of circumstances – we all have a story that brings us together because of this one product. I guess in short that means – I’m not alone :) – Thanks

  46. Great post Raoul. I had been admitted to the hospital for 2-weeks last year for severe respiratory issues, and have been on Tussionex ever sense. It’s ability to severely influence mood, addictive qualities, and related aide effects have caused me to quitet twice, most recently for the last time. I will not use again. Can be an effective remedy within the right environment, and with the right controls/supervision. The abuse of prescriptions, especially various pain killers including but not limited to hyrdocodone, is skyrocketing right now … My best guess is that many (not all), of those who have posted comments here were/are much like myself, using the product for extended periods “even when not needed”, and as a coping mechanism to deal with other issues. I am no better than anyone here, however will rely on exercise, improved diet, faith, etc, to more effectively deal with my respiratory AND other “life issues”.

  47. I see only good in your article it can help many people and should not be taken as a joke. I was juts prescribed this and will be taking it tonight I am couging so much and have a severe tickle that I can’t take it anymore. Will take your advice

  48. Well, I finally got a 4-oz prescription for Tussionex. It didn’t look like very much for $100. And when I took it, it didn’t seem to help at all…so guess what–I took some more. I took over 2 oz in one night. Suffice it to say I am eating crow. I thought I was going to die. I have suffered from panic attack syndrome for years and I am medicated for it, but I never, ever felt more frightened or more sick in my life. I know this sounds ridiculous but while I was praying to the porcelain god, I was literally thinking about the Seven Deadly Sins and why GREED is among them. It took me nearly a week to just be able to walk again.

    Raoul, please consider this my abject apology to you for my earlier rant. No one should ever take this junk. No one should manufacture it because people like me and others here who thought they could take it like “normal” HC cough syrup find that they can’t. Tussionex is potentially deadly and now I’ve found that out through terrible experience. I am just grateful that I lived to talk about it. I understand, considering what I said before, that people who haven’t gone through this won’t believe me. All I can say to anybody is DON’T TRY IT. You won’t like it.

    1. I wouldn’t go that far. It’s a great drug when nothing else works. But yeah, everyone should be very careful when taking it. Glad you’re okay now!

      1. Yes, I’m probably overreacting, but doctors and pharmacists don’t warn people AT ALL that it takes awhile for this medicine to kick in. (They certainly didn’t in my case.) Anecdotal evidence, such as your blog, won’t convince everybody of this fact. It should be printed in great big letters on a pharmacy warning label. I’ve taken other kinds of HC cough syrup that took effect almost immediately after one dose. This stuff sneaked up on me. Never again.

      1. I have taken Tussionex for coughing several times in the past and the only reason I take it is that I immediately quit coughing and can sleep all night. It never gave me any kind of feeling but the other night I was coughing and took 1 tsp I had left in my bottle and after about 1/2 hr I developed a sharp pain in the mid chest area so as an idiot I got up and took 1/2 tab of Percocet not having any idea what I was doing because I never take any type pain medication. After about an hour the pain was still there so I took the other half of the Percocet and in about l0 min. I could no longer hold my body up. The pain eventually went away because I passed out but if i had know what I was doing I probably would have died since it would have scared me to death !!! I am a Christian and know now that The Lord allowed me to survive this idiotic happening and will never do such a thing again. They gave me the Percocet after my hiatal hernia surgery because hydrocodone w/apap does nothing for me but the Percocet did work well. However, I had never taken but one of these and had no idea how dangerous they could be – thanks for this info and I’m thanking My Lord and Saviour Jesus Christ !!!

  49. Dear Bethany,

    I was absolutely horrified to read your letter. One adult dose of Tussionex is one teaspoon every 12 hours. Three teaspoons = one tablespoon. Two tablespoons = one ounce. Four tablespoons = two ounces. If the measurements you put down are accurate, your husband gave you TWO shot-glasses of cough syrup! That’s POISON. There is no way he would have given you that much medicine by mistake.

    I am also surprised that your daughter’s pediatrician prescribed something that strong for your daughter unless she had pneumonia. Also, both you and your husband should be aware that taking medicine that is not prescribed for you is against the law. Next time you’re sick, talk to your own doctor and follow the prescription he gives you. And don’t let your husband “treat” you for illness again. Keep your eye on him from now on.

  50. I can relate! Last Sunday morning at 5:30 a.m. (3/28) I woke up coughing and coughing. I’ve been trying to get over a sinus infection. My husband got up and said he’d get me some cough medicine. We have a bottle of Tussinex that was prescribed for our 7 year old daughter. My husband read the dosage for her (1/2 teaspoon) so he figured he’d add a little more to the dosage and bring it to me to take. He filled up a dosage cup full – 4 tablestoons and brought it in to me to take.

    It didn’t take long for me to break out in hives. When it was time to get up – about 9 a.m. I could barely keep my eyes open and I was dizzy. I laid back down and tried to get up again around noon. Again I could hardly keep my eyes open and this time I felt flushed, my skin was clammy, I was shaking and my mouth was dry. Again I laid down and tried to get up again around 3:30 p.m. I drank some Ginger Ale and vomited that up. I thought I was having an allergic reaction to the Tussinex so I had my husband look up some information on-line. I was shocked when he told me I was having a reaction to an overdose.

    I was a mess for the rest of the day. Going back and forth from vomiting to sleeping a bit I started feeling a little better that night around 9:30 p.m. As I write this I was able to go to work today but I still do not feel well. My mouth is still dry and I have no appetite.

    My husband feels horrible for making me sick, I do not blame him, he was just trying to help me out. Do not mess with this stuff!

    1. Wow…very interesting that I came across this website. I’m a 31 year old male and was prescribed tussionex recently for a nagging cough. I honestly think that I didn’t even need it, as my cough wasn’t unbearable…more annoying than anything else. But like an idiot, I thought it was basically Robitussin with a kick. (my doctor or pharmacist only told me not to drive after taking it…no more information). So instead of measuring out a teaspoon, I just took a swig off the bottle. About hour & 1/2 later, not feeling the effects…took another swig. I probably had drank the equivalent of 1/4 of the bottle. So finally before 10pm, I started to feel real warm and fuzzy and really sleepy. After a good night sleep, I got out of bed to feel like I had just polished off a 12 pack. I felt wasted…dizzy as hell. I tried to relax and figured the dizziness would pass…2 hours later it didn’t…4 hours later it didn’t…by about the 5th hour, I felt like I was getting more dizzy. After checking my symptoms vs the internet, I decided it was time to go to the doctor. This now a full 13 to 14 hours after my last dose and I could not drive. I got a ride the doctor and by the time I got there, I felt like I was having a full blown panic attack (never had one before). I was experiencing shortness of breath, couldn’t swallow normally, extreme weakness and my heart felt like it was beating a mile a minute. Lucky enough for me, the Dr. told me that most of the medication should be leaving my system soon and prescribed me a sedative. Never picked up my sedative but went and laid down at my mother in laws for the next 5 hours(as I did not want to be alone in my condition), til I finally started to feel a bit more normal. What a helluva day. The OP is right…tussionex is no joke…nothing to play with. Gave me a good scare, that’s for sure!

      1. There you go, very similar symptoms to mine! Thanks for posting your experience, Joe! Glad you’re still around!

      2. I am going to jump in here at this point. I am not sure the Tussionex we are talking about here is the same tussionex I mentioned when I related above about my car trip with my daughter in law. I am sure she was getting !2 oz s every day, and I was drinking at least a 1/2 inch each time. Surely something is amiss here. My TS was rather thick, clear and tasted like cum, she told my daughter. I would not know that. I want to clear that up. But the taste was rather bland and slimy. It took effect immediately, or nearly. if I recall. Perhaps that was because I never came down for several days. I drove all the way with only a slight blurring, sort of as if I were slightly drunk. She nodded and tripped all the way. This was quite a few years ago. Did they have a different Tussionex then. Also the price. She said at the beginning that she would pay for the trip if we would let her score everyday. I do not know where she got the money. I had a card for the gasoline. I hope some of you can clear this up for me. I have a cough and that is why I discovered this Forum. I already take four vicodin every day for pain. I don’t suppose the doc will let me have a prescription hearing all this.

  51. I love this medicine and it works great but my mind is just clouded when I am on it. It makes me feel good but limits my ability to do work. I had to decrease it to half of teaspoon and take it every 8 hrs. I think the one I have is the extended release.

  52. This has been great info to have. I am a 63 yr old female that has just been diagnosed with left lung pneumonia and am on an antibiotic and Robitussin w/codeine. The Robitussin just does not work. Does not make me sleepy and certainly does not stop the coughing. My doctor suggested Tussionex initially but because I have no Rx coverage put me on Robitussin. I have just called and requested a script for Tussionex. Money is no object if you have not slept in 4 nights…..I am now better educated as to how this medicine works, how to take it, how long it takes to work etc. etc. etc. As they say “knowledge is power” and I now know how to use this drug respectfully so it can do what it was made to do. Thanks for great information !

    1. Hey PJ and Raul,

      I am a 32 yr old female who was just diagnosed on Saturday (3 days ago) with left lung pneumonia (I went in to the clinic with a wheezy cough and came out with pneumonia – wonderful.) I was prescribed an antibiotic (Cednifir) and a cough syrup with codeine (Promethazine VC). I haven’t slept for more than 20-30 min at a time for a few days now. I was getting really cranky and irritable and was thinking of going to the ER to be hospitalized. I was violently coughing every 5 min and just today started seeing stars when I coughed. Anyways, my cousin suggested the Tussionex and I knew hydrocodone was stronger than codeine from experience. I also have hydrocodone in pill form for cyst bursting pain so have a low tolerance for it and the one pill almost always knocks me out. The first cough syrup (promethazine vc) actually has phenylephrine (replaced pseudophedrine in OTC Sudafed; both drugs make me hyper) and didn’t work on my cough AT ALL. Besides the fact that the phenylephrine was probably also contributing to my insomnia (I have been taking it every 4 hours since Sat evening, sometimes 2 tsps at a time – never stopped the coughing. I’ve been abusing Halls drops and eating popsicles – both of which have helped more than the cough syrup.)

      Anyways, my primary care did phone in a script of the Tussionex to the 24 hour pharmacy tonight. I took one teaspoon initially and it didn’t seem to stop my coughing. About an hour later I took another half teaspoon (tiny swig from the bottle but knew it was less than the teaspoon I had taken earlier). Right now it’s been about 2.5 hours since I first started taking it and my coughing has decreased. It’s still not gone but I do think I will be able to sleep tonight though I’m surprisingly not sleepy at 2am ET, having not slept in days. The antihistamine in the Tussionex is not supposed to cause sleeplessness so maybe the other cough syrup is still in my system. Usually 10mg of hydrocodone knocks me out so I’m not going to take anymore tonight just to be safe.

      Raul, I think any dosage which is more than what is recommended is an overdose and am glad you did not die of it or experience more dire symptoms. I think if you have no tolerance at all for hydrocodone or other opiates, it was very dangerous to do what you did but I’m sure many people, including myself, think it’s okay to take a little more if it’s not working (a teaspoon sounds so small!) My hydrocodone pill bottle says I can take one every 4-6 hours for pain. However, whenever I’ve taken a second pill after 4 hours, it messes me up pretty badly (only done it twice cause for some reason the first pill doesn’t always work on the pain but 2 is too much in 5 elapsed hours.) Anyways, I really appreciate your blog for your initial review of Tussionex and for the informative comments (some of these other crazy comments are amusing.) Also, your site was the 3rd unique result when I googled Tussionex. :D

      Sorry for the long review but wanted to post the experience I had with the other prescribed cough syrup as others may or may not have the same experience. Codeine doesn’t seem to affect me at all but that may be because I’ve had the stronger hydrocodone before. The codeine certainly wasn’t enough to counteract the effects of the phenylephrine in the syrup, in my opinion.

      Thanks again for sharing your experience and here’s to hoping I can sleep!

      A new fan of Tussionex,
      Kelly

  53. I’ve had a bad cough and trouble breathing for a very long time (more than a year). For the last few weeks I haven’t been able to sleep because I can’t breathe without sitting up. My husband recently had bronchitis and received a prescription for two rounds of Tussionex. He was kind enough to share some of this medicine with me when I was gasping for air. When I went to my doctor for treatment, he refused to give me cough syrup despite the fact he said I was congested and my cough sounded serious. I understand why doctors are reluctant to prescribe this stuff, but I’m not looking to get high–I just want to stop coughing! Why did they create Tussionex and other such products if all it’s going to do is gather dust in the pharmacy? Addicts are going to find a way to get it in any case, while I, ironically, cannot. Frankly, I don’t care what happens to them. Let them die if they’re stupid enough to abuse narcotics. Very frustrating.

    1. Tussinex should not be given to people who have chronic breathing problems because it can cause respiratory failure. Also, it thickens the mucus in your lungs – not good for someone who is congested.

  54. Raoul,
    meant to put 240 ml. not a 40 ml. 240 ml is the biggest I think they issue …and is 8 oz.
    Tom

  55. Raoul, Interesting reading. I am a 50 year old white male. I have had severe gas reflux for years and all the proton pump inhibitors were just not making much of a dent in the problem. I have taken Tussionex for years when my chronic GERD related cough was so persistent that I could not work well or go more than 30 seconds without coughing. I was going through a 40 ml.(8oz) about one a month … definitely built a strong tolerance …. due to my love/hate relationship with this drug I opted for surgery three months ago and had a complete Nissen Fundoplication where they basically repair and beef up your LES (Lower Esophogeal Sphincter) valve by wrapping your stomach around the valve and sewing it to itself. This shuts the GERD down a 100% … it becomes a one way valve in the strictest sense. I cannot (and was told before the operation) even throw up if I get the flu or have nausea … it works that well. The Tussi works great as designed … and is time release for long lasting relief. But, I opted for the surgery just to try and get the stuff out of my life … still coughing three months post op …but, surgeon says the scarring of the esophogus is healing and I just have to be a patient patient. A teaspoon full will hold me for 2-3 days … but, I did try some recreational escapes with it a few years back and could easily take 2 – 3 oz. of the stuff with a couple of rum and cokes and fly like superman … not proud of it … but, as you say I was playing russian roulette with it …. I gave up alcohol all together and cannot quite believe I used to do that … sure I kept my guardian angel up at nights working overtime ….Good blog and as you say … your mileage may vary, but I look forward to throwing this stuff out of my life as soon as the cough abates …. Cheers,
    Tom

  56. The main ingredient in Tussionex is not Codeine or a derivative of it. It is Hydrocodone. Hydrocodone and codeine are not the same although they, in some ways, ACT the same. Codeine is a Prodrug which needs to be metabolized in the body into an opiod pain killer by specific enzymes. Whereas Hydrocondone is not a Prodrug. It is already active as a narcotic without being metabolized. Hydrocodone is far more powerful than Codeine.

  57. thank you for your comments I just got this a few days ago and when I took my first teaspoon I thought well this didnt make me dizzy or anything , I dont see what the big deal is about not driving , until a couple of hours later boy did it hit me , so I can only imagine what taking extra does would do and my pharmicist specfically said do not !! take more than 2 teaspoons a day 1 in the morning and one at bed, I sure do hope more people take heed to this medicine and believe it can be deadly . take care and I am glad you are ok .

  58. Im going to be honest, I am a naive 20 year old and I had just recieved tussionex from a doctor because of a bad cough. I have a abused substances such as hydrocodone,perks,codein before and have been ok and I was planning on abusing tuss as well to get a high. Your story made me think about what I am doing to my body and the real threat I am taking by putting in more than the recommended dosage. Tonight you just stopped me from possibly overdosing and killing myself. Good Lookin Raoul I really appreciate it. I am extremely glad I happened to stumble upon your blog.

  59. I stumbled across your website accidentally and read about your tussinex “overdose”. your dosage was NOWHERE lethal, even for someone with low tolerance. If you were taking regular hydrocodone cough medicine you would have to take 8 teaspoons at once to overdose, and thats if you have no tolerance. Tussinex is a timed release, so your not getting all the medication at once. Standard hydrocodone cough medicine has 5mg of hydrocodone per teaspoon ful, tussinex has 10. So yes your getting twice as much but its released MUCH slower. You were more than likely sick because of a hangover, which happens if you get really messed up on pain medication and not because you were going to die. The hangover feels a little like a hangover from drinking but much worse of a headache and fuzzy/funny/generally-not-so-good-feelin espically in your head. After being around people that constantly completly abused opiates you were way, way far off from dyin lol.

    1. It’s funny how perfect strangers know better than me how that Tussionex overdose made me feel, and are eager to volunteer their expertise on the matter so easily. It reminds me of all the idiot pundits on TV, always eager to shoot their mouth off about the latest “crisis” for the sake of a couple of minutes of air time. Got any other expert opinions to provide? I await them with bated breath, I assure you…

      1. Raoul, as stated you did not overdose, you merely experienced the effects and side effects of the narcotics in the medicine. It might have been intensified from the other medications you took prior. Had you overdosed, it would have been much more severe than what you experienced. Your right, everyone reacts differently to drugs. You have a low tolerance or none at all, but even still if you had overdosed you would have known it. Symptoms of an overdose can be present, such as nausea and pale skin, but that does not mean that you actually overdosed. Side effects and the effects themselves can be similar to those of an overdose.

        Some people can become nauseated from 1mg of opiates, that does not mean they overdosed on the drug, it is simply how their body reacts to the narcotic.

        Hope that cleared up your confusion.

  60. Tussionex is a wonder for severe cough, but I treat it like I treat a hand grenade, with care!

    I only have a capful because it lasts a lot longer than other drugs. Its a happy drug so I don’t suggest getting to acquainted with it, otherwise you may not want to stop surfing that cosmic wave. The good thing is that it doesn’t have acetominophen, which is bad for the liver.

  61. This is overly dramatic. Opiate-naive or not, three doses of this do not qualify as a “brush with death.” Also, those of you who are talking about those who are addicted to or abuse substances as though they are all mindless, unintelligent peons, you are making a subjective GENERALIZATION. I might remind you to look around, do some research, and you will learn that many people (yes, intelligent ones, too) fall victim to substance addiction and abuse. A problem such as this is not indicative of or correlated with IQ, even though a significant demographic of drug users may be an unintelligent bunch. This does not mean that all of them are. Making assumptions such as this prove YOU to be the uneducated one, as does the widespread lack of practical knowledge in general being displayed in this thread.

    1. Eric, did you get up on the wrong side of your bed this morning? You sure sound cranky… People are simply expressing their points of view, much like you have just done. If you keep going around trying to correct everyone, you might just get addicted to painkillers because of all the headaches you’ll have. :-)

    2. There is much contention over whether this was truly an overdose. No one seems to be taking into account that the poster had already taken multiple doses of other cough meds first. The interaction between Tuss and other meds could easily lead to an overdose reaction.

      Plus, while some people build up a tolerance to opiates, any dose over the prescribed amount is an “over dose”. Taking Tuss seems like it starts off innocent and legal, but as people start increasing use I see how fine the line between tuss taker and crack head really is.

      1. This is an old thread, so I don’t know if anyone is here. I also noticed that he had already taken several medicines.

        Big mistake. Take one and wait a few hours (as per the bottle).

  62. I can’t believe this is the first article I’v read about this. I googled this to see how much harm I had done to myself. I have some Tussionex and in the middle of the night I woke up coughing so I went in to take a dose. Couldn’t find the little cup I was using so I just took a swig from the bottle. THIS IS A BAD IDEA!!! Not only did I get the “warm fuzzy”, I also got incredibly horny (which the wife appreciated), then itchy and I mean Meth Head itchy. I went to sleep and woke up about 5am couldn’t sleep cause I felt like I was sleeping in fiberglass Insulation. Went to my study and Passed out. I do not mean got sleepy and lie down pass out but Black Out pass out. Came too three hours later. Next time I’ll find that damn little cup!

  63. Hi Raoul, I have been prescribed Tussionex probably over 5 times or more in my life, and im only 20. To be honest I havent ever noticed it work very much if at all either. Anyways, I have been prescribed a teaspoon every 4 hours…and if im not mistaken possibly more, i’ve experienced nausea only 1 time from it, and that’s when i took the dose then looked on the back to notice it’s 8 months old… You could very well be sick from it being out of date not ‘overdose’ as to idk how you could over dose on the little amount of codeine thats in tussionex compared to other medicines.Meaning I know people who are stupid and chugged half or more of these bottles to get “high” and they never had any problems (besides lack of intelligence)

  64. Im just going to say that Tuss. was my drug of choice, Herion actually was, but back in 1979,80,81 I was hooked up with a pharmisist, and used to get sealed CASES of Tuss from Penwalt the manafacture back then, and there were 12 bottles of the golden liquid, and 16oz per bottle. I live about 60 miles north of Los Angles, so this is where my rippin & runnin went on, Im 52yrs old now and I remember the first time I tried Tuss, I drank 4 oz cause I remember having to go to a thrifty drug store and buy a baby bottle so I could measure out 4oz,s and going to the car wash and shaking up the bottle real good and pouring out my dose, I have to pre-face that I had an active tolerence to opiates at that time in my life, so the warm fuzzy, nose itching, warm stomach, voice lowering, great feeling, new habit just started the moment it hit me, the old Tuss had 5mg hydrocodone,and phenolatoximine? spelling, but it was a suspension liquid I forgot the techicnal term but I think its different now, but back then, there were more than a hand full of overdoses. I made it though. They also had Tuss tabs, there were 100 in a bottle, and we would get 4 boxes in a brick that had 4 bottles of 100, but for me 1oz of liquid was equle to 6 pills, ( they had 5mg hydrocodone) ea, and the anti-histimine type stuff. So I would chew 24 pills at once and I was good for 12 hrs of bliss, to me anyway, also being a good addict I would also add barbituates to the mix, Seconal, Carbital, Tunial my fav. and Doridin, so usally drulling spit down the side of my face was the norm back then, and I was an aircraft mech at that time, with a big company and slid right thru, it was a blur back then, to much $ to many drugs and you have an addict. But back to the Tuss, it was my favorite opiate and, I had them all at one time or another,,Lots and lots of scary stories but that makes me who I am, and Im ok with me today! Peace Greg

    1. WOW Greg. You are so lucky to have a pharmacist as a friend. I would love to have a connection like that. I tried Tuss syrop only once and I LOVE it. I have been taking Hydrocodone for about 3 years now (120-200mg a day) i always got it legaly from my pain doc.. I made my self quit many times but then after a few month being clean I would go back to the old ( i just love that, warm, fuzzy, calm, loving life feeling.) I know people would judge me and call me an addict and crack head, but i dont give a s*** about them. Its my life and I live only once, so why not to enjoy my life to the fullest. Opiates Rock!

  65. This stuff is a Godsend. After nearly a month of the worst cold of my life (including four nosebleeds and pink eye), my uncontrollable, spasmodic coughing was damn near killing me. Although it’s certainly not cheap, it has done the trick. But, I am careful to use the measuring tube…and you know, while I don’t have a lot of the side effects, I do get a funky, euphoric feeling. Hydrocodone is not to be messed with.

    Oh, and for anyone looking to save $$ on a prescription, look at Costco (you don’t have to be a member for RX), or the Walgreen’s prescription card. That saved me $28. My insurance plan doesn’t cover name brand.

  66. I got prescribed Tussionex for a cough this week. I have had opiate-based cough syrups before in my life so I thought I knew what to expect. However I was surprised when I sat down for the mandatory pharmacist counseling at the pharmacy and the pharmacist seemed to take great pains to make sure that you take the Tussionex as prescribed – one MEASURED teaspoon at bedtime ONLY. Why? Because the Tussionex Pennkinetic product that gets prescribed these days, is a TIME-RELEASE formula. It works gradually over up to 12 hours time. Raoul discovered the time release aspect of this formula, it seems… where he thought it wasn’t working. When I first took this, I thought it wasn’t working either, but because the pharmacist had been so adamant about “ONE teaspoon at BEDTIME only,” I figured I should wait… which I did. Lo and behold, the drug really didn’t take effect until 2 hours later and then it lasted a very long time. Even if you take one teaspoon 12 hours apart, you can really get spaced out by this stuff.

    So even if you think you are familiar with codeine based cough syrups, please read up on this product. It’s much stronger than the stuff you had when you were younger. In fact, young children have died from it.. which is probably why pharmacists are instructed to really read you the riot act over it.

    1. Donna, you have answered my question. The time released info is the key. The old stuff hit right away and, apparently did not last as long, although I could not vouch for that. My Son’s wife consumed all but a healthy “Spider” as she called it. She nodded off for the rest of each day and I drove with no problem, and I must admit I felt extremely mellow all that day and in the morning when I imbibed my issue of Spider. After we left her in Texas I was concerned that I might get sick, but nothing much happened. I could easily kept it up until I was addicted as she was. With a Chest exray,and all that medicine every day I was sure she would not live long, but, except for a few months in prison since then, she is alive and I understand healthy. She had some sort of hustle going in ORE, that kept herself and her brother supplied with crack cocaine until he died a year ago. But he died of cancer. My opinion is that a terrific resistance is built up if one is lucky enough to survive long enough. My son really died from too much Tylenol from all the pills he ingested. Not the drugs,

  67. It is unbelievable how naive some of the people on this board are. Like a few others have said, this cough syrup contains hydrocodone. The exact same ingredient in Lortab and Vicodin (which are identical drugs made by different companies). It is HIGHLY addictive and is known as one of the most popular choices of “drug seeking” individuals in the U.S. It amazes me that even some Dr.’s prescribe this to patients sight unseen (although, said patient must pick up the script from the Dr’s office as it can no longer be called in to a pharmacy via phone/fax due to its change from the lower scheduled rating). Yes, people have different tolerances to different meds Raoul, but Tussionex only comes in one strength at this point in time and dosages are Rx’d by patient age and or weight. I would love to address Mr. Crew’s SuperHuman feat of downing “half of an 8 oz bottle” of Tussionex “without dying”. I can assure you 100% that u did not down half of an 8 oz bottle. First and foremost, it is illegal to dispense the syrup in amounts greater than 4 oz’s total. Now if you were simply mistaken about the size of your bottle and did in fact drink half of it, then that would have given you approximatly 30 adult sized doses. You are in fact correct that this amount would probably not kill you…..but BOY would I have loved to have had tickets to THAT show!!!! Your 120 massive man body pounds would have reacted to that much narcotic like a child on speed. Im not even sure where I am going with this anymore except to say that I know horse manure when I smell it. This is a cough syrup people….use it for a cold, and leave the abuse to the idiots!

  68. About 2 years ago I had a cough and nothing over the counter worked. I have COPD and my lung Dr. gave me a subscription for Tussionex. I got such a small amount that I knew it had to be potent. I could take one tsp. twice a day. However when I took one at night I slept real good and didn’t even start coughing intil the next evening. I found if i took 1/2 tsp at night it worked. Every time I got the cough I would get another subscription and stretch it out until I got better. Now my Medicare and sublimental insurance won’t pay for tussionex. The last subscription which amounted to about 15 days cost me $150. It’s too bad some people are abusing this product and indangering their health and life. Now the insurance companies are refusing to pay for people that really need it. I wish I knew how to afford it if I need it in the future.

  69. Raoul -

    Thanks for this blog on Tussionex. I’ve taken it once before but went thru 4 bottles of Robitussin over the last month and a half before calling my Dr and asking for this again. We just switched insurance and an 8 oz bottle cost $75. I love the euphoria it gives you and I’m amazed at how my coughing eventually goes away throughout the “time released” day, however, I have to work every day and it is impossible for me to even take the full 1 tsp. at a time in order to be able to drive or fully function. I am calling my Pharmacist tomorrow to see if taking 1/2 tsp. every 6 hours instead of 1 tsp. every 12 hours will still help me with the unending cough. This stuff works great, but it is very POTENT! Be careful people!

  70. As I previously posted, my 56 year old husband died 2 1/2 years ago in his sleep after taking too much Tussionex. He too claimed he had a high tolerance and could handle it. He was also taking xanax, so his death was most likely due to multiple drug toxicity. Please be careful.

  71. Let me just add:

    I’m not condoning or suggesting that *anyone* try to take more than the prescribed dose. I do have a very high tolerance and it would not be safe for most people to try taking more than two teaspoons. However, I felt like suggesting that taking three teaspoons was a death-defying act seemed to put undue anxiety on the notion of taking the medicine. Tussionex has been one of my saving graces during the long, horrible nights of coughing. People shouldn’t fear the medicine. And if someone I knew took three teaspoons and complained of dizziness and nausea… I’d give them some toast and milk, not tell them to fear for their lives.

  72. I know all about tolerance, and I’m well aware that through out my many years of taking Tussionex, I’ve built up a very large tolerance for hydrocodone. Still, I feel it may be a bit of an exaggeration to say that you’re lucky to still be alive after only taking three teaspoons. I’m 4’11″, 110lbs, and I have taken eight to ten TABLESPOONS full. Granted, I do have a tolerance, as I am prescribed the drug five or six times a year for my bronchitis. Still, tolerance or no tolerance, I don’t think three teaspoons would put you anywhere near death–not when a girl literally half your size can take three times the amount safely.

  73. It’s amazing how ignorant most adults are of prescription medications and their potential for abuse. And fyi hydrocodone is a codeine derivative, that produces a cleaner and more euphoric ‘sense of well being’ than codeine itself, otherwise known as being HIGH. And also, an overdose is not simply taking more than the recommended dose. An actual O.D on tussionex would be similar to one on say, heroin, and would include a potentially fatal respiratory depression and intense vomiting. Your ‘overdose,’ is what many would call a high. Any opiates can be used to relieve coughs, because they slow down your respiratory system and make it harder for your body to produce a cough. People should really educate themselves about any substance they put in their body, prescribed or not. The internet is a great resource, and it’s scary that I can’t even vote and I’m still so much more informed on the potential benefits and drawbacks about prescription medications.

  74. How long does it take to kick in? I took it 2 hours ago and I am still coughing up a lung and I am wide awake. Hopefully I’ll fall a sleep some time around 3am from just being exhausted.

  75. One thing, not related to the Tussionex… going out in the cold without bundling up does not cause you to catch a cold. I find myself arguing with old people about this all the time. Viruses cause colds – and the viruses don’t care how many layers of clothing you have on. You could play naked in a blizzard, and if there are no viruses, you will not catch a cold. You could also wrap up in thirty layers of clothing, and if you breathe in a virus, you will get a cold.

  76. I just happened onto this website. Interesting….I have basically been taking any narcotic i can find, not paying for it or street drugs at all. But my mom gets them and I snatch them occasionally. So sue me. I feel that with my chronic back pain and lack of health insurance, its the only thing that helps me with getting anything done. I have two kids, and both small, and keeping up with them is hell and torturous. The small amount I take helps enough. I have no other recourse. I would be happy taking this amount everyday forever, but I doubt if I can find anything this regular. I have never tried Tussionex, but my point was about tolerances. I have taken no more than 1 10mg hydrocodone at once, but there is definitely a tolerance you get and it doesnt really go away. Even if it does, it goes back after a day or two. I never get nauseous with narcs, but some people do.

  77. Yeah, just wanted to say that Tussionex does not contain just any derivative of codeine, it contains hydrocodone, which is the narcotic commonly known as Vicodin and is much stronger than codeine. It is literally liquid vicodin in an extended release suspension. That funny feeling of well being, lightheadedness, nausea, or euphoria is how you experience being high on narcotics.

  78. I have been taking Tussionex for years and it has been my life saver. See the thing is every time I come back from overseas trip through my work, mostly to Asia I come back with uncontrollabe cough. None of the over the counter or perscrption strength cough syrup do a thing. But the Tussionex on the other hand works like a magic. You go from non stop cough to absolutley none for another 8 to 10 hours with 1 tea spoon which by the way rarely exceed. And yes the most awsome side effect of it is that you feel happy and elated. Not that I need it necessarily since I am fairly happy and otherwise healthy person. I think if there’s some side affect from taking some medicine why not it be a plesant one than a painful one. Another side affect (again a plus one for me) is that you sleep like a baby.
    For me it also rejouvinates my taste buds making everthing taste better. So I always get a 8 oz bottle from doctor when I am coughing badly. By the way this stuff is $90 for 8 oz bottle and strictly dispensed only with hard prescrption copy. So my suggetion don’t overdose and abuse this wonderful medication.

  79. Wow! This is some great info! Glad you are OK, Raoul!

    I am currently taking Tussionex for flu & upper respiratory infection-related symptoms, ie.. cough, etc… I can honestly say I have no clue how anyone that takes more than two TEASPOONS in a 24 hour period are able to walk & talk, much less type a response in this blog!

    To Blake, the hotshot college student, you are playing with fire! You may be able to tolerate and “accidental” overdose of 4 ozs. now, but that doesn’t mean you will always be able to tolerate it. What you are doing is called “prescription medication abuse”. I would be very cautious if I were you, and follow your Doctor & pharmacist’s instructions.

    I took my first teaspoon dose on an empty stomach, and although this wasn’t my intention, I was high as a kite. I have been prescribed this medication in the past, and it is the only medication that works for my cough, but I also know how potent it can be, and take it as prescribed. I didn’t even drink the occasional beer whilst taking it, for fear it would counteract & cause me problems.

    Thank you , Raoul, for posting about your scary experience. Perhaps you have helped others from a similar or worse experience!

    Best of health to everyone!

      1. Dear Raoul,

        Thank you for all this wonderful information! I agree, Tussionex is not something to mess around with. I have taken Tussionex in the past and must admit I abused it. I am fighting the flu now and the coughing is horrendous. I can’t sleep and I feel like I’m going nuts. I was prescribed Tussionex yesterday and decided to do extensive research on it. I’m so glad I came across this and your experience as well as others experiences. Now I know that one teaspoon is ALL that I need! Even though and I am feeling weird, at least the cough is FINALLY gone, hopefully now I can get some sleep, safely now that I know how dangerous Tussionex can be.
        Thank you.

  80. I went to the doctor yesterday and got a bottle of Tussinex. I’ve had it before so I knew what i was in for. The guy who said he drank 4 ozs. and was ok I highly recommend against doing that again. The stuff works great if you take it as prescribed but there’s a couple things to keep in mind. First of all it’s time released so it takes a really long time to kick in… as in about an hour. It helps with the cough right away but as far as making you tired and able to sleep you have to give it time. If you keep taking it because you don’t think it’s working they you can really get yourself in trouble. Also, if you take too much you’ll really feel horrible. You’ll get the sweats and feel like your going to throw up. That brings me to my second point. If you get to that stage then you’re in for several hours of hell because it is time released so it lasts forever. Anyway, just a couple things to think about. More importantly, I am not a doctor so my thoughts are just my thoughts. You should in know way take my advice. If I were you I would listen to your doctor and take as prescribed. Tussionex is like any other medication. It works great until people start to abuse it. Good luck.

  81. I have the h1n1 flu right now and I was perscribed tussionex because my cough is killing me…I’ve been taking 4-6 teaspoons daily…however I also have a history of opiate abuse…mostly oxy and dilaudid so as stupid as that may be of me is that possibly the reason its not affecting me the same as it affected you? Because even after 6 teaspoons I feel no different at all.

    1. I think you answered your own question, Kayla. Your previous opiate use increased your tolerance for Tussionex, so that’s why you don’t feel it. Perhaps you should talk to your doctor about this, to see if there’s something else he or she can prescribe.

    2. If one of my patients complained of tolerance to codeine or hydrocodone for cough I would recommend their doctor switch them to benzonatate (Tessalon Perles), if it were safe to do so. It works by a completely different mechanism and so cross tolerance is unlikely. While opiates act on the cough center in the CNS, benzonatate works locally on the stretch receptors in the throat. If you ever have a problematic cough again, ask your doctor about it.

  82. So appreciate CVS service. We use them and they have caught things just like this. I was on another med for shoulder surgery pain and then got the nasty bug going round here. Got the trusty tussionex as nobody in the house was sleeping due to my cough – not to mention every time I coughed my shoulder would jar and another sort of hell washed over me and apparently I was crying in my sort of sleep state.

    CVS caught the combo and told me to stay away from the other med if I was going to take the syrup. I followed their directions to the letter and slept finally. And I think part of the med in the syrup was enough to help with the shoulder pain that I never needed that pain drug I was on again. two birds, one stone and safely. Glad CVS caught it otherwise I might have taken both not thinking or not reading the info included as I’ve used tussionex on several occasions. it really is the only cough med that works for my husband and me

    1. My CVS is incompetent, so I go to Target.

      I’m glad you caught the contraindication. I had shoulder surgery, so I’m willing to bet you had hydrocodone which is the heart and soul of Tussionex.

      In fact, the dosage I had for my cough made me feel like 2 pills.

  83. I’m a retail Pharmacy Technician at CVS. While I can’t speak for hospital pharmacies, I can assure most people that, if you’re getting your prescriptions at your local pharmacy, your Pharmacist is very aware of any and all interactions between your medications, but for your sake keep a couple of things in mind: 1) get your medications ALL from one place; the more places you frequent, the more likely it is that one pharmacy will not be aware of other medications which can have potential interactions (luckily, most primary insurance providers track your prescriptions, and if you fill at another pharmacy on the same insurance, the pharmacist there is usually warned, assuming you’re not paying out-of-pocket); and 2) if you’re someone who gets lots of medication, or is frequently prescribed medication and/or prone to becoming ill, go to a pharmacy that has a full-time pharmacist on STAFF that you TRUST; I cannot stress how important that last part is. I have seen pharmacists who don’t give a damn and are only there for the money (usually they’re lazy, which is the reason they’re “floaters” and don’t have their own stores), and who won’t think twice about ignoring the big red flag on-screen that says “DRUG-DRUG INTERACTION.” More often than not, however, you’ll find a pharmacist who is at least professional enough to take care of you properly, or in my case, my Pharmacist-In-Charge is the most personable, friendly, helpful person I have ever met, and his patients love him, and consequently us technicians as well.

    I’m sorry for straying from the subject of your blog, but because my perspective on the health care industry is totally different from an in-house perspective, I just wanted to inform people that, if you’re doing retail, your pharmacist is there to catch your doctor’s mistakes–and believe me, doctors can make some serious mistakes.

  84. I’m surprised no one has mentioned the fact that Tussionex contains hydrocodone — the same synthetic opiate used in Vicodin and its many generic counterparts.

    In fact, a teaspoon contains 10mg of hydrocodone, which is the same as taking two lower-dose pills or one higher-dose pill. That’s why you get that “exaggerated sense of well-being.” You’re not almost high, or kind of high — you ARE high.

    So if you make it a habit to take Tussionex regularly for every night of coughing, or use it a sleep aid, you’re unknowingly developing an opiate habit. You might not realize it, but after using a cough syrup like this for anywhere from one to three weeks, if you suddenly stop using it you’re going to go into withdrawal. Most people will think they’ve come down with a bad cold or the flu, but in truth it’s withdrawal — the runny nose, the nausea, the restless leg (or back) syndrome, diarrhea, cold sweats, and even slight depression are all symptoms of withdrawal that could be mistaken for a bad cold, a virus or the flu.

    I’m not saying this cough medicine shouldn’t be prescribed — on the contrary, I think many doctors are downright paranoid these days and are reluctant to prescribe medicine to patients who are genuinely suffering. That’s a shame. However, I do agree with the blog author’s point that many doctors are largely ignorant of drug interactions, and patients themselves aren’t particularly well-informed regarding what they’re taking, how it affects their bodies, and how it may interact with other medications. In fact, I think doctors and the pharmaceutical companies are almost single-handedly responsible for the epidemic of liver disease in this country, with all the APAP they stuff in every medication, but that’s a long discussion for another time.

  85. There is no way you overdosed on 3 teaspoons. I am a 19 year old male, I weigh about 120 lbs. and im about 5′ 5″ and I can handle half of an 8 oz. bottle at once. I’m not stupid enough to do that but I have done it on accident before… And I didn’t die.

    1. Blake, as you go on with your college education and perhaps take a course in Physiology or Anatomy, you’ll understand that different people have varying thresholds of tolerance when it comes to drugs. I’m sure that you’ve already seen this in action with alcohol at your college. Some can hold their booze better than others. If you’re more resistant to Tussionex, one of two things can be happening: you’re not getting the same dosage I got (less active ingredients per same volume), or your tolerance for it is higher, which means you’ve either been born with it, or you’ve built it up through repeated use.

      1. agreed Raoul. Wow these young kids have a lot to learn. I thought i knew everything at 19 and 20………….huh! Yeah i’m 30 and i still don’t know it all:) I am so glad you are ok.

        1. Its so annoying when people thing that just aging a bit equals greater intelligence. Some people do get very nervous and are not comfortable with the effects of drugs that alter CNS function. The feeling can be very unnerving. In reality though, the dose taken here is certainly enough to cause a “high” feeling. It is definitely not enough to be worried about death, but if one weren’t familiar with the effects I understand the potential to think you are dying. I’ve seen a friend throw up the first time he took 5mg of vicoden for a broken arm, but that doesn’t mean he had a brush with death. Regardless of the subjective effects one feels, the threshold of death isn’t reached until the LD50 is approached. For hydrocodone, the drug in question, the ld50 is around 375mg. The author was always very safe but probably afraid.

    2. Ummm how do you “accidentally” take half an 8 oz bottle of a narcotic cough suspension….

      1. Sounds like Blake was lucky – it is not simply the hydrocodone that causes the problem – it is the addition of chlorpheniramine that can basically stop you from breathing – some of the side effects include:
        •weak or shallow breathing;
        •chest tightness;
        •painful urination;
        •urinating less than usual or not at all; or
        •confusion, hallucinations, or unusual behavior
        As for Matt – if he learns how to spell correctly he will learn that people who are older have more life experience – it intrinsically (look it up if you don’t know what it means) makes them smarter through that life experience. Basically it is like this – are you smarter than a 4-year old? All things are relative. One of my favorite quotes from Mark Twain – “teenagers, they know everything – except how to earn a living.”
        To Blake and Matt – be careful with this stuff – unless of course you like the idea of being an organ donor.. Be safe

  86. I have taken Tussionex mostly becoause of bad coughing when I get a cold, sinusitis or allergy symptoms with wheezing. I am a nurse and I know for sure to look up all medications that are prescribed for myself and my family. However my PMD is very reluctant to prescribe this cough syrup and it is so far the only cough syrup that works for me. My husband is sooooooooo irritated when I cough all night long. I am sooooooo sick when I cough all night long. Headaches, throat pain, bloody sputum, laryngitis, you name it. Hopefully this is not too gross for some of you. Tussionex works but patients need to be aware that they should take it only as directed.

  87. I’m currently on Tussionex, and I’ve had it many times before (it seems that I’m very susceptible to respiratory issues, and coughing is intense for me). It works fantastically, and yes–it does give that feeling of ‘well-being’, which I now jokingly refer to as being ‘high’. However, it works almost too well for me, and I find myself taking less than the prescribed dose (usually 1/2 teaspoon, twice a day).

    That said, a year ago I had a terrible cough and was prescribed Tussionex. I didn’t think it worked well enough on my cough initially, so I almost always took a higher dosage than prescribed. Later, my doctors used it to treat my insomnia, since it also was the one thing that would make me sleep. I trust my physicians, and my own father is one of them…but looking back at the amount of Tussionex I would take for my coughing, I was probably putting myself in a dangerous situation. It was good to read this and see the risks! I’m going to be very careful with this med…

    Good to hear you’re alright!

    -Jen

  88. Hey man. Taking more than the medication than perscribed does not necessarily mean an overdose. I have taken like 7X the dose cause I was being a dumbass and trying to get high. I mean it was the best high I ever had but then again it was dangerous as hell.

    1. Wow, really? I think that’s the most immature, irresponsible decision i’ve ever read. Not to mention a very stupid comment about the greatest high. Sounds like you need help.

      1. Not really. As others have said, Hydrocodone, the active ingredient of Tussionex, is an opiate, meaning that with persistent abuse or even medicinal use, you can become tolerant to its effects. At 10mg Hydrocodone per tsp., the author probably took no more than 30mg, which is near the upper limit of safe dosage for people without tolerance. 7x the dose, or around 70mg, is high for someone with no tolerance, but not at all if he did. The author really doesn’t know what he’s talking about. Opiates are dangerous, yes, but they’re also one of the oldest and most well-researched medicines, so saying we “don’t know” how it works to relieve cough is wrong. Hydrocodone relieves cough by the same mechanism it can kill with: depressing the respiratory system.

      2. i guess everyone on here has never heard of “LEAN”. mix about 3-4oz of tussionex or actavis (promethazine-codeine) with 20oz sprite & add a few jolly ranchers for flavor, and you have yourself some DRANK, Texas Tea, Dirty Sprite, Sizzerp, Lean… you literally lean off of it. people are actually drinking ounces of these syrups, so i don’t see how a few teaspoons affected you so much. read more up on this

        1. Ssisurp or “lean” is promethazine with codeine. Its purple drank because it is purple in color. Tussionex is yellow or liquid gold. Its not the same thing and most ppl who sip lean have never even heard of tuss. Tussionex is way stronger! I overdosed on it and found myself on the floor of my restroom unable to get up. On the real I almost died but I had been drinking massavie amounts, smoking it on dipped blunys and drinking alcohol. I literally had three 8 oz. bottles in my arsanal a week. “Nothing exceeds like excess” Needless to say I graduated to oxys and now im battling my demons as I go to med school. Irony is a bitch haha. Here’s the point, tussionex and opioids in general should only be used when absolutely necessary! I’ve never tried H and I promised myself I never would but I’ve had many of friend’s fall yo the devil and it’s both sad and upsetting. Do what you will but please be guided by common sense and moderation!

    2. If that’s the best high you’ve ever got then you have problems,you need to go down the street to your local weed dealer and pick up some good old fashioned marijuana,don’t keep messing with over the counter syrups or pills,they will hurt you and you have the possibility of dieing.

      1. Tussionex is not over the counter. It contains hydrocodone which is a schedule 3 controlled substance. I’m wondering if the author took exact 5ml doses or just pulled a spoon out of the drawer, which would have been the first mistake he made before taking it 4 times in 1 night.

      2. Obviously you have no idea how opiates work man. Haven’t you ever heard that the best feeling you could ever have is from using Heroin? Yeah, it is the worst drug you can put in your body, but it delivers a high and euphoria that nothing else can. I’ve never tried H but I have had my fair share of PK experience, and it is a great feeling. I love cannabis more than anything, but it doesn’t compare to the high you get from opiates. But yes, the huge problem with them is that they are very easily addictive and overdosing is a big risk as well. Not saying everyone should go out and get faded but you can’t say it isn’t the best high because it is, unfortunately.

        1. Opiate addiction is AWFUL! I had a chronic condition and was hospitalized several times for it, it also came with a tremendous amount of pain, so I was given iv dilaudid. Wow, great stuff until you have withdrawals from it!! I unknowingly became addicted to dilaudid and when I came home from the hospital I went through withdrawals for TWO weeks and wished for death! All in all the high is NOT worth the withdrawals!
          I have just been prescribed Tussionex, since I have a high tolerance to pain meds. I am afraid that the normal dose won’t work but I am not willing to risk another addiction and more withdrawals!
          I think this author did exactly as he set out to do, warn people that cough medicines aren’t as harmless as one might think!

  89. I am so glad you are okay. Two years ago my husband of 33 years did the same as you, but he did not wake up.
    I did wake up, next to a corpse.

    1. Jen, I’m so sorry to hear that. Please accept my condolences. I’ll consider myself blessed to still be alive.

    2. Jen I’m so sorry about your husband. Prayers and thoughts to you family. (I know the post was from awhile ago but wanted to let you know someone out in the world was thinking of you)

    3. Dear Jen,

      I am so sorry for your loss. If only you and he had known how dangerous this med can be.
      How old was your husband and how much of the Tussionex did he take? It seems like it has different effects on patients depending upon age and a person’s tolerance to narcotics.

  90. Thanks Julie! It’s not fun to feel your senses and motor movements spin out of control, I’m with you there. And it’s kind of scary to think there’s only a short distance between those sensations and a coma, or worse, death.

    1. Raoul, Thank you for the detailed thoughtful warning. Most people don’t realize how dangerous some meds can be. Several years ago I was taking Tussonex for bronchitis. It said take one teaspoon. I had been doing that. I asked my hubby to bring me the med at bedtime. He brought a tablespoon. I didn’t think it could hurt anything. I just didn’t fill it up. Next thing I know I can’t breathe. Everytime I almost went to sleep I stopped breathing. Finally I had to spend the night sitting up in a chair.I learned my lesson. Bless you for letting people know that things like this can happen very easily. you don’t have to be a drug addict to overdose.

  91. Glad you’re okay, Raoul. I had that stuff when I was in college. The doctor prescribed a combination of that and Dimetapp, which I think was only available by prescription at the time.

    I got high. It was the only time I’ve ever been high, and it taught me to be very careful whenever I try a new med.

    1. I am prescribed this medication all the time for bronchitis/and pneumonia. It is the only thing that works for both me and my husband. We only take a teaspoon every twelve hours and would never take more than prescribed. We take this every year for the past 15 years to overcome our bronchitis or pneumonia. You just have to watch what you are doing. A teaspoon means a teaspoon, twice a day…every 12 hours.

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