hydrocodone; dihydrocodeinone (Zohydro ER, Hysingla ER)
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Introduction
Prior to 2014, DEA-controlled substance: class 3.
All hydrocodone combinations to became class 2 Oct 6, 2014.[4][5][7]
Indications
- treatment of pain (acute pain & chronic pain)
- cough
Dosage
- 5 mg PO every 4-6 hours
Pharmacokinetics
- well absorbed orally
- onset of action 15-60 minutes
- duration 4-8 hours
- metabolized in the liver by cytochrome CYP2D6 into hydromorphone & by CYP3A4 into norhydrocodone
- excreted by kidney
elimination via liver
1/2life = 4 hours
Adverse effects
- common (> 10%)
- less common (1-10%)
- shortness of breath, troubled breathing, confusion, diminished urination, nausea/vomiting, bradycardia, tachycardia
- uncommon (< 1%)
- hallucinations, hypertension, double vision, dry mouth, anorexia, miosis, biliary spasm, urinary spasm, histamine release, hot & dry skin, impaired GI motility, mydriasis, blurred vision
- other
- rash
- blood dyscrasias
- nephrotoxicity with chronic use
- hepatotoxicity
- respiratory depression is dose & tolerance-related
- tolerance & dependence
- constipation
Drug interactions
- any pharmaceutical agent that inhibits cyt P450 2D6 may increase levels of hydrocodone
- see opiate
Laboratory
Mechanism of action
- alters perception of pain at the level of the spinal cord & higher levels of the CNS
- alters emotional response to pain
- cough suppressant effects are due to direct action on the cough centers of the medulla
More general terms
Additional terms
Component of
- hydrocodone/pseudoephedrine/triprolidine
- hydrocodone/pheniramine/phenylephrine/phenylpropanolamine/pyrilamine
- guaiacolsulfonate/hydrocodone/pseudoephedrine
- chlorpheniramine/hydrocodone/phenylephrine/pyrilamine
- carbinoxamine/hydrocodone/pseudoephedrine
- carbinoxamine/hydrocodone/phenylephrine
- brompheniramine/hydrocodone/phenylephrine
- brompheniramine/guaifenesin/hydrocodone
- acetaminophen/caffeine/chlorpheniramine/hydrocodone/phenylephrine
- guaiacolsulfonate/hydrocodone
- dexbrompheniramine/hydrocodone/phenylephrine
- hydrocodone/pseudoephedrine
- hydrocodone/phenylephrine/pyrilamine
- guaifenesin/hydrocodone/pseudoephedrine
- guaifenesin/hydrocodone
- guaifenesin/hydrocodone/phenylephrine
- diphenhydramine/hydrocodone/phenylephrine
- diphenhydramine/huntingtin/hydrocodone/phenylephrine
- dexchlorpheniramine/hydrocodone/phenylephrine
- hydrocodone/phenylephrine
- chlorpheniramine/hydrocodone/pseudoephedrine
- chlorpheniramine/guaifenesin/hydrocodone/pseudoephedrine
- chlorpheniramine/hydrocodone/phenylephrine
- brompheniramine/hydrocodone/pseudoephedrine
- aspirin/hydrocodone
- homatropine/hydrocodone (Hycodan)
- hydrocodone/phenylpropanolamine (Hycomine, Codamine)
- acetaminophen/hydrocodone (Anexsia, Lorcet, Lortab, Vicodin, Norco)
- hydrocodone/ibuprofen (Vicoprofen)
- chlorpheniramine/hydrocodone (Tussionex)
References
- ↑ The Pharmacological Basis of Therapeutics, 9th ed. Gilman et al, eds. Permagon Press/McGraw Hill, 1996
- ↑ Drug Information & Medication Formulary, Veterans Affairs, Central California Health Care System, 1st ed., Ravnan et al eds, 1998 - not on National VA formulary
- ↑ FDA New Release: Oct. 25, 2013 FDA approves extended-release, single-entity hydrocodone product. http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm372287.htm
- ↑ 4.0 4.1 Food and Drug Administration (FDA). Oct 24, 2013 Statement on Proposed Hydrocodone Reclassification from Janet Woodcock, M.D., Director, Center for Drug Evaluation and Research. http://www.fda.gov/drugs/drugsafety/ucm372089.htm
- ↑ 5.0 5.1 Prescriber's Letter 21(9): 2014 PDF: DEA Update on Rescheduling of Hydrocodone Combination Products (August 21, 2014) CHART: Equianalgesic Dosing of Opioids for Pain Management LETTER: A Note from Your Pharmacist: Hydrocodone Combinations are Moving from Schedule III to Schedule II PATIENT EDUCATION HANDOUT: Changes for Hydrocodone Combinations Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=300943&pb=PRL (subscription needed) http://www.prescribersletter.com
- ↑ 6.0 6.1 FDA News Release. November 20, 2014 FDA approves extended-release, single-entity hydrocodone product with abuse-deterrent properties http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm423977.htm
- ↑ 7.0 7.1 Habbouche J, Lee J, Steiger R et al Association of Hydrocodone Schedule Change With Opioid Prescriptions Following Surgery. JAMA Surg. Published online August 22, 2018 PMID: https://www.ncbi.nlm.nih.gov/pubmed/30140896 https://jamanetwork.com/journals/jamasurgery/article-abstract/2696622
- ↑ Barakat NH, Atayee RS, Best BM, Ma JD Urinary Hydrocodone and Metabolite Distributions in Pain Patients Journal of Analytical Toxicology. 2014 38(7):404-409 September PMID: https://www.ncbi.nlm.nih.gov/pubmed/2483689 https://academic.oup.com/jat/article/38/7/404/2797996
Database
- PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=62918
- PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=26917
- PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=22258
- PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=411697
- PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=5284569