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Hydrocodone is a semi-synthetic opioid medication that is classified as a schedule II drug. This medication is approved by the U.S. Food and Drug Administration (FDA) and used for pain management. It is primarily used to treat severe chronic pain that requires opioid analgesia and is not effectively treated by nonopioid alternatives. It is used in combination formulations to treat nonproductive cough in adults and has antitussive properties. It functions as an opioid receptor agonist and activates mu-opioid receptors to produce analgesic effects. In addition, it also activates delta- and kappa-opioid receptors as the plasma drug concentration increases beyond the starting doses.
Hydrocodone is available in oral forms, 12 hours of ER capsules of 10, 15, 20, 30, 40, and 50 mg, and 24 hours of ER abuse-deterrent tablets of 20, 30, 40, 60, 80, 100, and 120 mg strength. Notably, it should not be crushed, chewed, or dissolved as tablets and capsules to prevent uncontrolled and rapid medication delivery, which could result in an overdose.
The FDA approves this medication for pain management. Hydrocodone is primarily used to treat severe chronic pain that requires opioid analgesia and is not effectively treated by non-opioid alternatives.
Hydrocodone is combined with other medications, such as decongestants and antihistamines, to address coughs and symptoms associated with allergies or the common cold.
Signs and Symptoms of Overdose
The signs and symptoms of hydrocodone toxicity include apnea, breathing difficulties, bradycardia, miosis, clammy skin, cyanosis, hypotension, decreased level of consciousness, and loss of consciousness. Overdose-related pulmonary complications include noncardiogenic pulmonary edema and aspiration pneumonitis. Central respiratory depression leading to CO2 retention often results in respiratory acidosis.
Management of Overdose
The antidote for overdose is an opioid antagonist medication. Clinicians should administer IV naloxone for hydrocodone overdose.
Side Effects
Possible side effects include nausea, vomiting, constipation, lightheadedness, dizziness, and drowsiness. Many of these effects may lessen as your body adjusts to the medication. If any symptoms persist or worsen, please notify your doctor or pharmacist promptly.
To help ward off constipation, maintain a high‑fiber diet, stay well‑hydrated, and stay active. You might also consider using a laxative—ask your pharmacist which kind would be most suitable for you.
To minimize dizziness or lightheadedness, stand up slowly when moving from sitting or lying down.
Remember, your doctor prescribed this medication because they believe the benefits outweigh the risks. Most people taking it do not experience serious side effects.
However, contact your doctor immediately if you notice any of the following serious symptoms:
Interrupted breathing during sleep (sleep apnea),
Changes in mental state or mood, such as agitation, confusion, or hallucinations,
Stomach or abdominal pain,
Trouble urinating,
Signs of poor adrenal function, such as loss of appetite, unusual fatigue, or weight loss.
Seek emergency medical attention if you experience very serious symptoms like fainting, seizures, slow or shallow breathing, or severe drowsiness from which it’s hard to awaken.
Although rare, a serious allergic reaction can occur. Get help right away if you notice signs such as a rash, itching or swelling (especially of the face, tongue, or throat), severe dizziness, or difficulty breathing.
This list does not cover all possible side effects. If you experience anything not mentioned here, please contact your doctor or pharmacist.
Precautions
Before taking this medication, inform your doctor or pharmacist if you have known allergies to this drug, any other opioids (such as benzhydrocodone, hydromorphone, morphine, or codeine), or any other allergens. Be aware that this medication may include inactive ingredients that could trigger allergic reactions or other issues. Consult your pharmacist for more information about these ingredients.
Prior to using this medication, share your full medical history with your doctor or pharmacist—especially if you’ve experienced:
Neurological conditions: head injuries, brain tumors, or seizures,
Respiratory issues: asthma, sleep apnea, or chronic obstructive pulmonary disease (COPD),
Kidney or liver disease,
Mental health concerns: confusion, depression, or suicidal thoughts,
Personal or family history of substance abuse,
Gastrointestinal problems: bowel blockages, constipation, infection-driven diarrhea, or paralytic ileus,
Difficulty urinating, potentially due to an enlarged prostate,
Gallbladder disease or pancreatitis.
This medication may cause dizziness or drowsiness. Combining it with alcohol or cannabis (marijuana) can increase these effects. Avoid driving, operating machinery, or performing tasks that require full alertness until you're confident you can do them safely. Refrain from consuming alcohol and consult your doctor if you're using cannabis.
Note for liquid forms of this medication: they may contain sugar and alcohol. Use caution if you have diabetes, alcohol dependence, liver disease, or any condition that limits your intake of these substances. Speak with your doctor or pharmacist for guidance on safe use.
Also, before undergoing surgery, inform your doctor or dentist of all medications and supplements you're taking—this includes prescription, over-the-counter, and herbal products.
Special considerations:
Children may be more susceptible to side effects like slowed or shallow breathing.
Older adults may be more prone to confusion, dizziness, drowsiness, or respiratory suppression.
If you're pregnant, use this medication only if absolutely necessary, as it may pose risks to the fetus. Discuss the potential benefits and concerns with your doctor.
If you're breastfeeding, know that the medication can pass into breast milk and may negatively affect your baby. Watch for signs of unusual sleepiness, feeding difficulties, or breathing problems in your infant, and contact your doctor immediately if they occur. Consult your healthcare provider before using this medication while nursing.
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