Hydrocodone

Hydrocodone Brand Names- Hysingla ER | VANTRELA ER | Zohydro

What is Hydrocodone

Hydrocodone is an oral semisynthetic opioid agonist derived from the opioid alkaloid, thebaine and is similar to other phenanthrene derivatives such as codeine.

Extended release hydrocodone products are used to manage pain severe enough to require daily, around-the-clock, long-term opioid treatment and for which alternative treatment options are inadequate.

The extended-release products are not approved for as-needed pain relief. Due to the risks of addiction, abuse, and misuse with opioids, even at recommended doses, and because of the greater risks of overdose and death with extended-release opioid formulations, hydrocodone extended-release products should be reserved for use in patients for whom alternative treatment options are ineffective, not tolerated, or would be otherwise inadequate to provide sufficient management of pain.

The extended-release formulations have abuse deterrent properties that are expected to reduce abuse of the drug.

The first hydrocodone extended-release product was FDA-approved in October 2013.

Indications

  • severe pain

Side Effects

  1. abdominal pain
  2. adrenocortical insufficiency
  3. agitation
  4. amenorrhea
  5. anaphylactoid reactions
  6. anxiety
  7. apnea
  8. arthralgia
  9. back pain
  10. chest pain (unspecified)
  11. chills
  12. confusion
  13. constipation
  14. cough
  15. dehydration
  16. depression
  17. diarrhea
  18. dizziness
  19. drowsiness
  20. dyspepsia
  21. dysphagia
  22. dyspnea
  23. edema
  24. erythema
  25. fatigue
  26. fever
  27. flushing
  28. gastroesophageal reflux
  29. GI obstruction
  30. gonadal suppression
  31. headache
  32. hypercholesterolemia
  33. hyperhidrosis
  34. hypertension
  35. hypokalemia
  36. hyponatremia
  37. hypotension
  38. hypoxia
  39. impotence (erectile dysfunction)
  40. infection
  41. infertility
  42. influenza
  43. insomnia
  44. irritability
  45. lethargy
  46. libido decrease
  47. malaise
  48. migraine
  49. muscle cramps
  50. musculoskeletal pain
  51. myalgia
  52. nasal congestion
  53. nausea
  54. neonatal opioid withdrawal syndrome
  55. night sweats
  56. orthostatic hypotension
  57. palpitations
  58. pancreatitis
  59. paresthesias
  60. peripheral edema
  61. pharyngitis
  62. physiological dependence
  63. pruritus
  64. psychological dependence
  65. QT prolongation
  66. rash
  67. respiratory arrest
  68. respiratory depression
  69. seizures
  70. serotonin syndrome
  71. SIADH
  72. sinusitis
  73. syncope
  74. tinnitus
  75. tolerance
  76. tremor
  77. urinary retention
  78. vomiting
  79. withdrawal
  80. xerostomia

Monitoring Parameters

  • laboratory monitoring not necessary

Contraindications

  • abrupt discontinuation
  • accidental exposure
  • acute abdomen
  • adrenal insufficiency
  • alcoholism
  • angina
  • asthma
  • AV block
  • biliary tract disease
  • bradycardia
  • breast-feeding
  • cardiac arrhythmias
  • cardiac disease
  • chronic obstructive pulmonary disease (COPD)
  • CNS depression
  • coadministration with other CNS depressants
  • coma
  • constipation
  • cor pulmonale
  • dehydration
  • depression
  • driving or operating machinery
  • dysphagia
  • electrolyte imbalance
  • emphysema
  • esophageal stricture
  • ethanol ingestion
  • ethanol intoxication
  • geriatric
  • GI disease
  • GI obstruction
  • head trauma
  • heart failure
  • hypotension
  • hypothyroidism
  • hypovolemia
  • hypoxemia
  • ileus
  • increased intracranial pressure
  • infertility
  • inflammatory bowel disease
  • intracranial mass
  • labor
  • long QT syndrome
  • myxedema
  • neonatal opioid withdrawal syndrome
  • obesity
  • obstetric delivery
  • opiate agonist hypersensitivity
  • opioid-naive patients
  • orthostatic hypotension
  • pancreatitis
  • parenteral administration
  • potential for overdose or poisoning
  • pregnancy
  • psychosis
  • pulmonary disease
  • QT prolongation
  • reproductive risk
  • requires an experienced clinician
  • respiratory depression
  • respiratory insufficiency
  • scoliosis
  • seizure disorder
  • seizures
  • shock
  • sick sinus syndrome
  • sleep apnea
  • status asthmaticus
  • substance abuse
  • ulcerative colitis

Interactions

  • Abiraterone
  • Acetaminophen; Butalbital
  • Acetaminophen; Butalbital; Caffeine
  • Acetaminophen; Butalbital; Caffeine; Codeine
  • Acetaminophen; Caffeine; Dihydrocodeine
  • Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine
  • Acetaminophen; Chlorpheniramine; Dextromethorphan; Pseudoephedrine
  • Acetaminophen; Chlorpheniramine; Phenylephrine; Phenyltoloxamine
  • Acetaminophen; Codeine
  • Acetaminophen; Dextromethorphan; Doxylamine
  • Acetaminophen; Dichloralphenazone; Isometheptene
  • Acetaminophen; Diphenhydramine
  • Acetaminophen; Oxycodone
  • Acetaminophen; Pentazocine
  • Acetaminophen; Propoxyphene
  • Acetaminophen; Tramadol
  • Acrivastine; Pseudoephedrine
  • Aldesleukin, IL-2
  • Alfentanil
  • Aliskiren; Amlodipine
  • Aliskiren; Amlodipine; Hydrochlorothiazide, HCTZ
  • Aliskiren; Hydrochlorothiazide, HCTZ
  • Almotriptan
  • Alosetron
  • Alprazolam
  • Aluminum Hydroxide; Magnesium Hydroxide
  • Aluminum Hydroxide; Magnesium Hydroxide; Simethicone
  • Alvimopan
  • Amide local anesthetics
  • Amifampridine
  • Amiloride
  • Amiloride; Hydrochlorothiazide, HCTZ
  • Amiodarone
  • Amitriptyline; Chlordiazepoxide
  • Amlodipine
  • Amlodipine; Atorvastatin
  • Amlodipine; Benazepril
  • Amlodipine; Celecoxib
  • Amlodipine; Hydrochlorothiazide, HCTZ; Olmesartan
  • Amlodipine; Hydrochlorothiazide, HCTZ; Valsartan
  • Amlodipine; Olmesartan
  • Amlodipine; Telmisartan
  • Amlodipine; Valsartan
  • Amobarbital
  • Amoxapine
  • Amoxicillin; Clarithromycin; Lansoprazole
  • Amoxicillin; Clarithromycin; Omeprazole
  • Amphetamine
  • Amphetamine; Dextroamphetamine
  • Amphetamines
  • Anticholinergics
  • Apalutamide
  • Apomorphine
  • Apraclonidine
  • Aprepitant, Fosaprepitant
  • Aripiprazole
  • Armodafinil
  • Artemether; Lumefantrine
  • Articaine; Epinephrine
  • Asenapine
  • Aspirin, ASA; Butalbital; Caffeine
  • Aspirin, ASA; Butalbital; Caffeine; Codeine
  • Aspirin, ASA; Caffeine; Dihydrocodeine
  • Aspirin, ASA; Caffeine; Orphenadrine
  • Aspirin, ASA; Carisoprodol
  • Aspirin, ASA; Carisoprodol; Codeine
  • Aspirin, ASA; Oxycodone
  • Atazanavir
  • Atazanavir; Cobicistat
  • Atenolol; Chlorthalidone
  • Atropine
  • Atropine; Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
  • Atropine; Difenoxin
  • Atropine; Diphenoxylate
  • Atropine; Edrophonium
  • Atropine; Hyoscyamine; Phenobarbital; Scopolamine
  • Azelastine
  • Azelastine; Fluticasone
  • Azilsartan; Chlorthalidone
  • Baclofen
  • Barbiturates
  • Belladonna Alkaloids; Ergotamine; Phenobarbital
  • Belladonna; Opium
  • Benazepril; Hydrochlorothiazide, HCTZ
  • Bendroflumethiazide; Nadolol
  • Benzhydrocodone; Acetaminophen
  • Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
  • Benzonatate
  • Benzphetamine
  • Benztropine
  • Bethanechol
  • Bexarotene
  • Bicalutamide
  • Bisacodyl
  • Bismuth Subcitrate Potassium; Metronidazole; Tetracycline
  • Bismuth Subsalicylate
  • Bismuth Subsalicylate; Metronidazole; Tetracycline
  • Bisoprolol; Hydrochlorothiazide, HCTZ
  • Boceprevir
  • Bosentan
  • Brexpiprazole
  • Brigatinib
  • Brimonidine
  • Brimonidine; Brinzolamide
  • Brimonidine; Timolol
  • Brompheniramine
  • Brompheniramine; Carbetapentane; Phenylephrine
  • Brompheniramine; Dextromethorphan; Guaifenesin
  • Brompheniramine; Dextromethorphan; Phenylephrine
  • Brompheniramine; Guaifenesin; Hydrocodone
  • Brompheniramine; Hydrocodone; Pseudoephedrine
  • Brompheniramine; Pseudoephedrine
  • Bumetanide
  • Bupivacaine
  • Bupivacaine Liposomal
  • Bupivacaine; Lidocaine
  • Buprenorphine
  • Buprenorphine; Naloxone
  • Bupropion
  • Bupropion; Naltrexone
  • Buspirone
  • Butabarbital
  • Butorphanol
  • Calcium Carbonate; Magnesium Hydroxide
  • Candesartan; Hydrochlorothiazide, HCTZ
  • Cannabidiol
  • Capsaicin; Metaxalone
  • Captopril; Hydrochlorothiazide, HCTZ
  • Carbamazepine
  • Carbetapentane; Chlorpheniramine
  • Carbetapentane; Chlorpheniramine; Phenylephrine
  • Carbetapentane; Diphenhydramine; Phenylephrine
  • Carbetapentane; Guaifenesin
  • Carbetapentane; Guaifenesin; Phenylephrine
  • Carbetapentane; Phenylephrine
  • Carbetapentane; Phenylephrine; Pyrilamine
  • Carbetapentane; Pseudoephedrine
  • Carbetapentane; Pyrilamine
  • Carbinoxamine
  • Carbinoxamine; Dextromethorphan; Pseudoephedrine
  • Carbinoxamine; Hydrocodone; Phenylephrine
  • Carbinoxamine; Hydrocodone; Pseudoephedrine
  • Carbinoxamine; Phenylephrine
  • Carbinoxamine; Pseudoephedrine
  • Cariprazine
  • Carisoprodol
  • Castor Oil
  • Celecoxib
  • Cenobamate
  • Ceritinib
  • Cetirizine
  • Cetirizine; Pseudoephedrine
  • Chlophedianol; Dexbrompheniramine
  • Chlophedianol; Dexchlorpheniramine; Pseudoephedrine
  • Chloral Hydrate
  • Chloramphenicol
  • Chlorcyclizine
  • Chlordiazepoxide
  • Chlordiazepoxide; Clidinium
  • Chloroprocaine
  • Chlorothiazide
  • Chlorpheniramine
  • Chlorpheniramine; Codeine
  • Chlorpheniramine; Dextromethorphan
  • Chlorpheniramine; Dextromethorphan; Phenylephrine
  • Chlorpheniramine; Dihydrocodeine; Phenylephrine
  • Chlorpheniramine; Dihydrocodeine; Pseudoephedrine
  • Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine
  • Chlorpheniramine; Hydrocodone
  • Chlorpheniramine; Hydrocodone; Phenylephrine
  • Chlorpheniramine; Hydrocodone; Pseudoephedrine
  • Chlorpheniramine; Phenylephrine
  • Chlorpheniramine; Pseudoephedrine
  • Chlorpromazine
  • Chlorthalidone
  • Chlorthalidone; Clonidine
  • Chlorzoxazone
  • Cimetidine
  • Cinacalcet
  • Ciprofloxacin
  • Citalopram
  • Clarithromycin
  • Clemastine
  • Clobazam
  • Clonazepam
  • Clonidine
  • Clopidogrel
  • Clorazepate
  • Clozapine
  • Cobicistat
  • Codeine
  • Codeine; Guaifenesin
  • Codeine; Phenylephrine; Promethazine
  • Codeine; Promethazine
  • COMT inhibitors
  • Conivaptan
  • Crizotinib
  • Crofelemer
  • Cyclizine
  • Cyclobenzaprine
  • Cyclosporine
  • Cyproheptadine
  • Dabrafenib
  • Dacomitinib
  • Dalfopristin; Quinupristin
  • Danazol
  • Dantrolene
  • Darifenacin
  • Darunavir
  • Darunavir; Cobicistat
  • Darunavir; Cobicistat; Emtricitabine; Tenofovir alafenamide
  • Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir
  • Deferasirox
  • Delavirdine
  • Desflurane
  • Desmopressin
  • Desvenlafaxine
  • Deutetrabenazine
  • Dexamethasone
  • Dexchlorpheniramine
  • Dexchlorpheniramine; Dextromethorphan; Pseudoephedrine
  • Dexmedetomidine
  • Dexpanthenol
  • Dextroamphetamine
  • Dextromethorphan; Diphenhydramine; Phenylephrine
  • Dextromethorphan; Promethazine
  • Dextromethorphan; Quinidine
  • Diazepam
  • Dicyclomine
  • Dihydrocodeine; Guaifenesin; Pseudoephedrine
  • Diltiazem
  • Dimenhydrinate
  • Diphenhydramine
  • Diphenhydramine; Hydrocodone; Phenylephrine
  • Diphenhydramine; Ibuprofen
  • Diphenhydramine; Naproxen
  • Diphenhydramine; Phenylephrine
  • Dolasetron
  • Doxylamine
  • Doxylamine; Pyridoxine
  • Dronabinol
  • Dronedarone
  • Droperidol
  • Duloxetine
  • Duvelisib
  • Efavirenz
  • Efavirenz; Emtricitabine; Tenofovir
  • Efavirenz; Lamivudine; Tenofovir Disoproxil Fumarate
  • Elagolix
  • Elagolix; Estradiol; Norethindrone acetate
  • Elbasvir; Grazoprevir
  • Eletriptan
  • Elexacaftor; tezacaftor; ivacaftor
  • Eliglustat
  • Eltrombopag
  • Eluxadoline
  • Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Alafenamide
  • Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate
  • Enalapril; Hydrochlorothiazide, HCTZ
  • Enflurane
  • Enzalutamide
  • Eprosartan; Hydrochlorothiazide, HCTZ
  • Erythromycin
  • Erythromycin; Sulfisoxazole
  • Escitalopram
  • Esketamine
  • Eslicarbazepine
  • Estazolam
  • Eszopiclone
  • Ethacrynic Acid
  • Ethanol
  • Etomidate
  • Etravirine
  • Everolimus
  • Fedratinib
  • Fenfluramine
  • Fentanyl
  • Fesoterodine
  • Flavoxate
  • Flibanserin
  • Fluconazole
  • Fluoxetine
  • Fluoxetine; Olanzapine
  • Fluphenazine
  • Flurazepam
  • Flutamide
  • Fluvoxamine
  • Fosamprenavir
  • Fosinopril; Hydrochlorothiazide, HCTZ
  • Fosphenytoin
  • Fospropofol
  • Fostamatinib
  • Frovatriptan
  • Furosemide
  • Gabapentin
  • General anesthetics
  • Glycopyrrolate
  • Glycopyrrolate; Formoterol
  • Granisetron
  • grapefruit juice
  • Guanabenz
  • Guanfacine
  • Haloperidol
  • Halothane
  • Homatropine; Hydrocodone
  • Hydralazine; Hydrochlorothiazide, HCTZ
  • Hydrochlorothiazide, HCTZ
  • Hydrochlorothiazide, HCTZ; Irbesartan
  • Hydrochlorothiazide, HCTZ; Lisinopril
  • Hydrochlorothiazide, HCTZ; Losartan
  • Hydrochlorothiazide, HCTZ; Methyldopa
  • Hydrochlorothiazide, HCTZ; Metoprolol
  • Hydrochlorothiazide, HCTZ; Moexipril
  • Hydrochlorothiazide, HCTZ; Olmesartan
  • Hydrochlorothiazide, HCTZ; Propranolol
  • Hydrochlorothiazide, HCTZ; Quinapril
  • Hydrochlorothiazide, HCTZ; Spironolactone
  • Hydrochlorothiazide, HCTZ; Telmisartan
  • Hydrochlorothiazide, HCTZ; Triamterene
  • Hydrochlorothiazide, HCTZ; Valsartan
  • Hydromorphone
  • Hydroxyzine
  • Hyoscyamine
  • Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate; Sodium Biphosphate
  • Ibuprofen; Oxycodone
  • Idelalisib
  • Iloperidone
  • Imatinib
  • Indacaterol; Glycopyrrolate
  • Indapamide
  • Indinavir
  • Isavuconazonium
  • Isocarboxazid
  • Isoflurane
  • Isoniazid, INH
  • Isoniazid, INH; Pyrazinamide, PZA; Rifampin
  • Isoniazid, INH; Rifampin
  • Istradefylline
  • Itraconazole
  • Ivacaftor
  • Ketamine
  • Ketoconazole
  • Lactulose
  • Lapatinib
  • Larotrectinib
  • Lasmiditan
  • Lefamulin
  • Lemborexant
  • Lesinurad
  • Lesinurad; Allopurinol
  • Letermovir
  • Levobupivacaine
  • Levocetirizine
  • Levomilnacipran
  • Levorphanol
  • Lidocaine
  • Lidocaine; Prilocaine
  • Lincosamides
  • Linezolid
  • Lisdexamfetamine
  • Lithium
  • Lofexidine
  • Loop diuretics
  • Loperamide
  • Loperamide; Simethicone
  • Lopinavir; Ritonavir
  • Lorazepam
  • Lorcaserin
  • Lorlatinib
  • Loxapine
  • Lumacaftor; Ivacaftor
  • Lumacaftor; Ivacaftor
  • Lumateperone
  • Lurasidone
  • Magnesium Citrate
  • Magnesium Hydroxide
  • Magnesium Salts
  • Magnesium Sulfate; Potassium Sulfate; Sodium Sulfate
  • Maprotiline
  • Melatonin
  • Mepenzolate
  • Meperidine
  • Meperidine; Promethazine
  • Mephobarbital
  • Mepivacaine
  • Mepivacaine; Levonordefrin
  • Meprobamate
  • Metaxalone
  • Methadone
  • Methamphetamine
  • Methenamine; Sodium Acid Phosphate; Methylene Blue; Hyoscyamine
  • Methocarbamol
  • Methohexital
  • Methscopolamine
  • Methyclothiazide
  • Methyldopa
  • Methylene Blue
  • Methylphenidate
  • Metoclopramide
  • Metolazone
  • Metyrapone
  • Metyrosine
  • Midazolam
  • Mifepristone
  • Milnacipran
  • Mineral Oil
  • Minocycline
  • Mirabegron
  • Mirtazapine
  • Mitotane
  • Modafinil
  • Molindone
  • Monoamine oxidase inhibitors
  • Morphine
  • Morphine; Naltrexone
  • Nabilone
  • Nafcillin
  • Nalbuphine
  • Naloxone
  • Naltrexone
  • Naproxen; Sumatriptan
  • Naratriptan
  • Nefazodone
  • Nelfinavir
  • Nesiritide, BNP
  • Netupitant, Fosnetupitant; Palonosetron
  • Nevirapine
  • Nicardipine
  • Nilotinib
  • Nitroglycerin
  • Olanzapine
  • Ombitasvir; Paritaprevir; Ritonavir
  • Omeprazole; Amoxicillin; Rifabutin
  • Ondansetron
  • Oritavancin
  • Orphenadrine
  • Osilodrostat
  • Oxazepam
  • Oxcarbazepine
  • Oxybutynin
  • Oxycodone
  • Oxymorphone
  • Ozanimod
  • Palbociclib
  • Paliperidone
  • Palonosetron
  • Panobinostat
  • Papaverine
  • Paroxetine
  • Pazopanib
  • Peginterferon Alfa-2b
  • Pegvisomant
  • Pentazocine
  • Pentazocine; Naloxone
  • Pentobarbital
  • Perampanel
  • Perindopril; Amlodipine
  • Perphenazine
  • Perphenazine; Amitriptyline
  • Phenelzine
  • Phenobarbital
  • Phentermine; Topiramate
  • Phenylephrine; Promethazine
  • Phenytoin
  • Pimozide
  • Polyethylene Glycol
  • Polyethylene Glycol; Electrolytes
  • Polyethylene Glycol; Electrolytes; Ascorbic Acid
  • Polyethylene Glycol; Electrolytes; Bisacodyl
  • Posaconazole
  • Pramipexole
  • Pramlintide
  • Prasugrel
  • Pregabalin
  • Prilocaine
  • Prilocaine; Epinephrine
  • Primidone
  • Procaine
  • Prochlorperazine
  • Promethazine
  • Propafenone
  • Propantheline
  • Propofol
  • Propoxyphene
  • Quazepam
  • Quetiapine
  • Quinidine
  • Quinine
  • Ramelteon
  • Ranolazine
  • Rasagiline
  • Remifentanil
  • Ribociclib
  • Ribociclib; Letrozole
  • Rifabutin
  • Rifampin
  • Rifapentine
  • Rifaximin
  • Risperidone
  • Ritonavir
  • Rizatriptan
  • Rolapitant
  • Ropinirole
  • Ropivacaine
  • Rotigotine
  • Rucaparib
  • Safinamide
  • Saquinavir
  • Scopolamine
  • Secobarbital
  • Selegiline
  • Selpercatinib
  • Serotonin-Receptor Agonists
  • Serotonin-Receptor Antagonists
  • Sertraline
  • Sevoflurane
  • Sibutramine
  • Sildenafil
  • Simeprevir
  • Skeletal Muscle Relaxants
  • Sodium Oxybate
  • Solifenacin
  • Sorbitol
  • Spironolactone
  • St. John’s Wort, Hypericum perforatum
  • Streptogramins
  • Sufentanil
  • Sumatriptan
  • Suvorexant
  • Tapentadol
  • Tasimelteon
  • Tazemetostat
  • Tedizolid
  • Telaprevir
  • Telithromycin
  • Telotristat Ethyl
  • Temazepam
  • Terbinafine
  • Tetrabenazine
  • Tetracaine
  • Tezacaftor; Ivacaftor
  • Thalidomide
  • Thiazide diuretics
  • Thiopental
  • Thioridazine
  • Thiothixene
  • Ticagrelor
  • Tipranavir
  • Tizanidine
  • Tolterodine
  • Topiramate
  • Torsemide
  • Tramadol
  • Trandolapril; Verapamil
  • Tranylcypromine
  • Trazodone
  • Triamterene
  • Triazolam
  • Tricyclic antidepressants
  • Trifluoperazine
  • Trihexyphenidyl
  • Trimethobenzamide
  • Triprolidine
  • Trospium
  • Tucatinib
  • Valerian, Valeriana officinalis
  • Valproic Acid, Divalproex Sodium
  • Vemurafenib
  • Venlafaxine
  • Verapamil
  • Vigabatrin
  • Vilazodone
  • Voriconazole
  • Vortioxetine
  • Voxelotor
  • Zafirlukast
  • Zaleplon
  • Ziconotide
  • Ziprasidone
  • Zolmitriptan
  • Zolpidem
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