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hydrocodone

R05DA03

Forms & Strengths

Oral Solution: 2.5 mg/5 mL, 5 mg/5 mL
Tablets: 5 mg, 7.5 mg, 10 mg (often combined with acetaminophen or ibuprofen)

Adult Dosing

Cough Suppression: 5 mg orally every 4 to 6 hours as needed; max 30 mg/24 hours
Pain Management (Combination products): 5 mg to 10 mg orally every 4 to 6 hours as needed

Pediatric Dosing

Children < 6 years: Contraindicated for cough and pain
Children 6-12 years: 2.5 mg orally every 4 to 6 hours as needed (cough); safety/efficacy not established for pain

Indications

Symptomatic relief of nonproductive cough associated with colds and upper respiratory infections
Management of acute severe pain requiring opioid analgesia

Mechanism of Action

Binds to mu-opioid receptors in the central nervous system
Inhibits ascending pain pathways and alters perception of and response to pain
Suppresses cough reflex by direct central action on the cough center in the medulla

Contraindications

Significant respiratory depression
Acute or severe bronchial asthma in an unmonitored setting or lack of resuscitative equipment
Known or suspected gastrointestinal obstruction, including paralytic ileus
Hypersensitivity to hydrocodone

Adverse Reactions

Respiratory depression
Somnolence, dizziness, sedation
Constipation, nausea, vomiting
Hypotension, bradycardia
Physical dependence and opioid use disorder

Drug Interactions

Concomitant use with CNS depressants (alcohol, benzodiazepines, other sedatives) increases risk of profound sedation, respiratory depression, coma, and death
Strong CYP3A4 inhibitors may increase hydrocodone plasma concentrations, leading to enhanced toxicity
Strong CYP3A4 inducers may decrease hydrocodone efficacy
Concurrent use with MAO inhibitors may cause severe adverse reactions including central nervous system excitation or depression

Curated Content: Needs Vetting Before Put to Clinical Use