Hydrocodone

Table of contents

  • Brand Names
  • Drug Combinations
  • Chemistry
  • Pharmacologic Category
  • Mechanism of Action
  • Therapeutic Use
  • Pregnancy and Lactation Implications
  • Contraindications
  • Warnings and Precautions
  • Adverse Reactions
  • Genes that may be involved
  • Substrate of
  • Inhibits
  • Drug Interactions
  • Dosage
  • Pharmacokinetics and Pharmacodynamics

Brand Names

Europe

Germany: Dicodid.

North America

Canada: Hycodan, Hydrocodan.

Drug combinations

Hydrocodone and Acetaminophen

Hydrocodone and Chlorpheniramine

Hydrocodone and Guaifenesin

Hydrocodone and Homatropine

Hydrocodone and Ibuprofen

Hydrocodone and Pseudoephedrine

Hydrocodone, Carbinoxamine, and Pseudoephedrine

Hydrocodone, Chlorpheniramine, and Pseudoephedrine

Hydrocodone, Guaifenesin, and Phenylephrine

Hydrocodone, Guaifenesin, and Pseudoephedrine

Chemistry

Hydrocodone Bitartrate: C~18~H~21~NO~3~ C~4~H~6~O~6~ 2½H~2~O. Mw: 494.49. (1) Morphinan-6-one, 4,5-epoxy-3-methoxy-17-methyl-, (5α)-, [R-(R*,R*)]-2,3-dihydroxybutanedioate (1:1), hydrate (2:5); (2) 4,5α-Epoxy-3-methoxy-17-methylmorphinan-6-one tartrate (1:1) hydrate (2:5). CAS-34195-34-1; CAS-143-71-5 (anhydrous); CAS-125-29-1 (hydrocodone)(1963).

Pharmacologic Category

Analgesics and Antipyretics; Opiate Agonists. Antitussives. (ATC-Code: R05DA03).

Mechanism of action

Phenanthrene-derivative opiate agonist, used as analgesic and antitussive agent. Acts at several sites within CNS involving several systems of neurotransmitters in order to produce analgesia (precise mechanism of action not fully elucidated). Suppresses cough reflex by direct effect on cough center in medulla of brain. Exerts drying effect on respiratory tract mucosa and increases viscosity of bronchial secretions.

Therapeutic use

Symptomatic relief of moderate to moderately severe pain. Symptomatic relief of nonproductive cough, alone or in combination with other antitussives or expectorants.

Pregnancy and lactiation implications

Use caution during pregnancy or lactation (unknown whether hydrocodone is distributed into milk).

Unlabeled use

Contraindications

Known hypersensitivity to hydrocodone or any ingredient in the formulation. Possible cross-sensitivity to hydrocodone if hypersensitive to other opioids.

Warnings and precautions

May cause CNS depression. Concurrent use of other CNS depressants may potentiate CNS depression. Possible tolerance, psychological dependence, and physical dependence following prolonged administration. Some formulations contain sulfites, or the dye tartrazine (FD&C yellow No. 5). Potential for increased respiratory-depressant effects and elevation of CSF pressure in increased intracranial pressure, head trauma, or other intracranial lesions. Administration may complicate assessment of acute abdominal conditions. Use may result in obstructive bowel disease, especially in underlying intestinal motility disorder. Possible dose-related respiratory depression. Potential for increased viscosity of bronchial secretions and suppression of cough reflex, with subsequent respiratory insufficiency, in asthma or pulmonary emphysema. Suppression of cough reflex following thoracotomy or laparotomy may lead to postoperative retention of secretions. Use with caution in debilitated patients and in those with hypothyroidism, Addison’s disease, and prostatic hypertrophy or urethral stricture. Risk of overdosage and toxicity (including death) in children <2 years of age receiving preparations containing antihistamines, cough suppressants, expectorants, and nasal decongestants alone or in combination for relief of symptoms of upper respiratory tract infection. Use with caution in geriatric patients. Use with caution in severe hepatic or renal impairment.

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