Drug information of Hydrocodone

Hydrocodone

Drug group:

Translations: فارسی
Translator: dr ashrafi

Hydrocodone is a synthetic opioid derivative of codeine.¹⁴ It is commonly used in combination with acetaminophen to control moderate to severe pain. Historically, hydrocodone has been used as a cough suppressant although this has largely been replaced by dextromethorphan in current cough and cold formulations. Hydrocodone's more potent metabolite, hydromorphone has also found wide use as an analgesic and is frequently used in cases of severe pain.

Mechanism of effect

Hydrocodone binds to the mu opioid receptor (MOR) with the highest affinity followed by the delta opioid receptors (DOR).¹³ Hydrocodone's agonist effect at the MOR is considered to contribute the most to its analgesic effect

Pharmacodynamic

Hydrocodone inhibits pain signaling in both the spinal cord and brain ¹². Its actions in the brain also produce euphoria, respiratory depression, and sedation

Pharmacokinetics

The liquid formulations of hydrocodone have a Tmax of 0.83-1.33 h.
Hydrocodone is 36% bound to plasma proteins
Hydrocodone undergoes oxidative O-demethylation to form hydromorphone, a more potent active metabolite
The half-life of elimination reported for hydrocodone is 7-9 h.

Drug indications

Antitussive

Hydrocodone is indicated for the management of acute pain, sometimes in combination with acetaminophen or ibuprofen, as well as the symptomatic treatment of the common cold and allergic rhinitis in combination with decongestants, antihistamines, and expectorants

Dosage

The following dosing recommendations can only be considered suggested approaches to what is actually a series of clinical decisions over time; each patient should be managed individually.

Drug contraindications

Contraindications. Contraindications to hydrocodone/acetaminophen include patients who have severe respiratory depression, acute or significant bronchial asthma, gastrointestinal obstruction, and anaphylactic reactions due to components of the formula

Side effects

stomach pain
dry mouth
tiredness
headache
back pain
muscle tightening
difficult, frequent, or painful urination
ringing in the ears
difficulty falling asleep or staying asleep
foot, leg, or ankle swelling
uncontrollable shaking of a part of the body

Some side effects can be serious. If you experience any of these symptoms or those listed in the IMPORTANT WARNING or SPECIAL PRECAUTIONS sections, call your doctor immediately or get emergency medical treatment:

chest pain
agitation, hallucinations (seeing things or hearing voices that do not exist), fever, sweating, confusion, fast heartbeat, shivering, severe muscle stiffness or twitching, loss of coordination, nausea, vomiting, or diarrhea
nausea, vomiting, loss of appetite, weakness, or dizziness
inability to get or keep an erection
irregular menstruation
decreased sexual desire
swelling of your eyes, face, lips, tongue, or throat
hoarseness
changes in heartbeat
hives
itching
difficulty swallowing or breathing

Interactions

Cefalexin , Succinylcholine , Methocarbamol , Midazolam , Chlorpheniramine , fentanyl , Rifabutin , Rifapentine , Darunavir , Sodium Oxybate , Tapentadol , rasagiline , codeine , ritonavir , Pindolol , Alprazolam , Diazepam , Diphenhydramin , Zolpidem , Cetirizine , Zaleplon , Promazine , Triazolam , Methohexital , Chloral hydrate , Chlorzoxazone , Orphenadrine , Mibefradil , Doxylamine , Molindone , cobicistat , Delavirdine , Letermovir , Alvimopan , Paliperidone , Paraldehyde , Butorphanol , Butabarbital , Acetaminophen and benzhydrocodone , Pimavanserin , Tasimelteon , Ramelteon , Secobarbital , Apalutamide , Tolcapone , Estazolam , Oxymorphone , Ethchlorvynol , Aminoglutethimide (Oral) , nalbuphine , voxelotor , dexmedetomidine

Alerts

You should not use hydrocodone if you are allergic to it, or if you have:

severe asthma or breathing problems; or
a blockage in your stomach or intestines.

To make sure hydrocodone is safe for you, tell your doctor if you have ever had:

breathing problems, sleep apnea;
a head injury, brain tumor, or seizures;
drug or alcohol addiction, or mental illness;
urination problems;
liver or kidney disease;
problems with your gallbladder, pancreas, or thyroid; or
a heart rhythm disorder called long QT syndrome.

Pregnancy level

If you use opioid medicine while you are pregnant, your baby could become dependent on the drug. This can cause life-threatening withdrawal symptoms in the baby after it is born. Babies born dependent on opioids may need medical treatment for several weeks.

Breast feeding warning

Do not breastfeed while taking this medicine. Hydrocodone can pass into breast milk and cause drowsiness, breathing problems, or death in a nursing baby.

GENERIC DRUG INFO

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