Table of ContentsView AllTable of ContentsUnderstanding OpioidsWhat Is Hydrocodone?Dosing GuidelinesSafe Using GuidelinesHow Quickly Will Hydrocodone Work?Side EffectsAlternative Treatment OptionsFrequently Asked Questions
Table of ContentsView All
View All
Table of Contents
Understanding Opioids
What Is Hydrocodone?
Dosing Guidelines
Safe Using Guidelines
How Quickly Will Hydrocodone Work?
Side Effects
Alternative Treatment Options
Frequently Asked Questions
Hydrocodoneis an orally administered, generic prescriptionopioidthat is categorized as aSchedule II medicationaccording to the Controlled Substance Act.
The Food and Drug Administration (FDA) has approved hydrocodone for the management ofchronic painthat otheranalgesics (painkillers)cannot effectively manage. It is available via prescription only in extended-release (ER, long-acting) tablets and capsule forms.
Hydrocodone can be combined with other active ingredients for pain management, such asacetaminophen(the active ingredient in Tylenol).
Generally, however, hydrocodone is dosed at 10-20 milligrams (mg) to be taken every 12 or 24 hours, based on the administrative form being used.
This article will provide an in-depth review of hydrocodone, emphasizing safe dosing procedures.
Getty Images / Smith Collection/Gado
Opioids, also known as narcotics, are a type of drug made from the opium plant, and others are synthetic (artificial).
They are also used to reduce pain after a significant injury or surgery, severe pain from health conditions like cancer, and chronic pain.
How They Work
They block pain messages from the body through the spinal cord to the brain.
Although opioids can effectively relieve pain, they carry some risks and can be highly addictive. The risk of addiction is exceptionally high when opioids are used to manage chronic pain over a long period.
Commonly Administered Opioids
Some commonly used opioids includefentanyl,OxyContin (oxycodone), codeine, andmorphine, among others.
Hydrocodone is the most commonly used drug for acute and chronic pain in the United States, which consumes nearly 99% of the global supply of hydrocodone.
With its easy availability and abuse patterns, hydrocodone is a primary driver of opioid-related abuse and misuse.
Hydrocodone is a semi-synthetic opioid drug classified as a Schedule II drug. It is in a class of medications called opiate (narcotic) analgesics.
Similarly, the safety and effectiveness of hydrocodone in children and adolescents have not been established.
Forms of Administration
Hydrocodone is available in ER dosage forms, including capsules and tablets.
Hydrocodone ER capsules or ER tablets should not be used to treat pain that other medications can control.
Common brand name forms of hydrocodone include Hysingla.
Use In Other Products
Hydrocodone is also available in combination with other ingredients prescribed for different uses. Hydrocodone combination products are used to relieve moderate-to-severe pain.
Some others are also used to relieve cough.
Some combinational products include:
How Does Hydrocodone Work?
Hydrocodone is an opioid receptor agonist which works on the mu-opioid receptors in the body.
Boxed Warning
Boxed warnings are safety-related warnings related to a medication causing severe adverse effects or even death.
It is the strongest warning the Food and Drug Administration assigned to bring attention to the significant risks of the drug.
Hydrocodone also comes with black-box warnings.
These include:
Hydrocodone is recommended for use in adults only.
Always follow the guidelines of your healthcare provider. Your healthcare provider may prescribe a specific dose depending on your needs.
Furthermore, a healthcare provider will gradually increase the dose if required until the therapeutic effect is achieved.
Hydrocodone ER tablets are generally safe and well tolerated at 15–90 milligrams (mg) doses administered every 12 hours.
Standard dosing guidelines include the following:
The following provides guidelines for the safe consumption of hydrocodone:
Potential for Interaction
Hydrocodone may cause drug-drug interactions when used with a few other medications.
This may not be a complete list of drugs that interact with hydrocodone.
Always talk to your healthcare provider before taking any drug when using hydrocodone.
After a single oral intake, hydrocodone reaches maximum serum concentrations within one hour.
The ER formulations of hydrocodone reach peak blood concentration within 14-16 hours.
How Long Does Hydrocodone Stay in Your System?
The average half-life (time taken to eliminate half of the drug from the body) was similar for all hydrocodone ER dosage forms, ranging from approximately 7 to 9 hours across the range of doses.
Finally, hydrocodone may be present in your urine for two to four days, in saliva for 12-36 hours, and in your hair for 90 days.
Side Effects and Precautions
Hydrocodone is a Schedule II drug that must be taken as prescribed and has the potential for habit forming with prolonged use.
When taken as prescribed, hydrocodone is safe and effective.
However, it may cause some side effects and must be taken only as prescribed.
Common Side Effects
Common side effects associated with the use of hydrocodone include:
Severe Side Effects
Seek emergency medical help or call 911 right away if you have any of these severe side effects after using hydrocodone:
Long-Term Side Effects
Taking hydrocodone for a more extended period, such as months or years, is likely to develop tolerance.
As a result, people may require higher doses to get the desired effect, and the drug may stay in their system longer.
Precautions and Warnings
Before taking hydrocodone, tell your healthcare provider if you have a history of:
Prolonged use of hydrocodone during pregnancy can cause life-threatening withdrawal symptoms in the infant if not treated.
Do not drive or operate heavy machinery until you know how hydrocodone affects you. It can make you sleepy, dizzy, or lightheaded.
There are options for pain management beyond the use of prescription opioids.
Some options include:
Summary
Primary care physicians in the United States write 10s of millions of opioid prescriptions annually for pain management.
Hydrocodone is also an opioid drug used for pain management, available on prescription in ER dosage forms. It is an effective pain reliever, but it also has the risk of tolerance, dependence, and addiction.
Hydrocodone is traditionally dosed at 10-20 milligrams (mg) every 12 or 24 hours, based on the administrative form used.
Your healthcare provider will determine the dose you require, depending on your needs, and should closely monitor it.
When stopping hydrocodone, your healthcare provider will gradually decrease the dose. This helps to avoid withdrawal symptoms. Don’t suddenly stop taking hydrocodone, even if you feel well.
Store hydrocodone at room temperature (68-77 degrees F) and away from heat and moisture (not in the bathroom).
Store the tablets or capsules securely, out of sight, and out of reach of children.
Studies support that hydrocodone ER tablets are generally safe and well tolerated. It was associated with a significant improvement in pain.The results, combined with the established efficacy of hydrocodone as an analgesic, generally support the effectiveness of the hydrocodone ER formulation for treating chronic pain.
Studies support that hydrocodone ER tablets are generally safe and well tolerated. It was associated with a significant improvement in pain.
The results, combined with the established efficacy of hydrocodone as an analgesic, generally support the effectiveness of the hydrocodone ER formulation for treating chronic pain.
16 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.DailyMed.Label: hydrocodone bitartrate tablet extended release.DailyMed.Label: hydrocodone bitartrate capsule extended-release.DailyMed.Label: Hycet- hydrocodone bitartrate and acetaminophen solutionDailyMed.Label: Hysingla ER- hydrocodone bitartrate tablet, extended-releaseNational Institute on Drug Abuse.Opioids.MedlinePlus.Opioids and opioids use disorders.Ghelardini C, Di Cesare Mannelli L, Bianchi E.The pharmacological basis of opioids.Clin Cases Miner Bone Metab.2015;12(3):219-221. doi:10.11138/ccmbm/2015.12.3.219American Society of Anesthesiologists.What are opioids?Manchikanti L, Atluri S, Kaye AM, Kaye AD.Hydrocodone bitartrate for chronic pain.Drugs Today (Barc). 2015;51(7):415-427. doi:10.1358/dot.2015.51.7.2361328.MedlinePlus.Hydrocodone.MedlinePlus.Hydrocodone combination products.Hale ME, Laudadio C, Yang R, Narayana A, Malamut R.Efficacy and tolerability of a hydrocodone extended-release tablet formulated with abuse-deterrence technology for the treatment of moderate-to-severe chronic pain in patients with osteoarthritis or low back pain.J Pain Res. 2015;8:623-636. doi:10.2147/JPR.S83930American Addiction Centers.How long do opioids stay in your system?Martyn JAJ, Mao J, Bittner EA.Opioid tolerance in critical illness.N Engl J Med. 2019;380(4):365-378. doi:10.1056/NEJMra1800222Centers for Disease Control and Prevention:Nonopioid therapies for pain management.Dowell D, Haegerich TM, Chou R.CDC guideline for prescribing opioids for chronic pain–United States, 2016.JAMA. 2016;315(15):1624-1645. doi:10.1001/jama.2016.1464
16 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.DailyMed.Label: hydrocodone bitartrate tablet extended release.DailyMed.Label: hydrocodone bitartrate capsule extended-release.DailyMed.Label: Hycet- hydrocodone bitartrate and acetaminophen solutionDailyMed.Label: Hysingla ER- hydrocodone bitartrate tablet, extended-releaseNational Institute on Drug Abuse.Opioids.MedlinePlus.Opioids and opioids use disorders.Ghelardini C, Di Cesare Mannelli L, Bianchi E.The pharmacological basis of opioids.Clin Cases Miner Bone Metab.2015;12(3):219-221. doi:10.11138/ccmbm/2015.12.3.219American Society of Anesthesiologists.What are opioids?Manchikanti L, Atluri S, Kaye AM, Kaye AD.Hydrocodone bitartrate for chronic pain.Drugs Today (Barc). 2015;51(7):415-427. doi:10.1358/dot.2015.51.7.2361328.MedlinePlus.Hydrocodone.MedlinePlus.Hydrocodone combination products.Hale ME, Laudadio C, Yang R, Narayana A, Malamut R.Efficacy and tolerability of a hydrocodone extended-release tablet formulated with abuse-deterrence technology for the treatment of moderate-to-severe chronic pain in patients with osteoarthritis or low back pain.J Pain Res. 2015;8:623-636. doi:10.2147/JPR.S83930American Addiction Centers.How long do opioids stay in your system?Martyn JAJ, Mao J, Bittner EA.Opioid tolerance in critical illness.N Engl J Med. 2019;380(4):365-378. doi:10.1056/NEJMra1800222Centers for Disease Control and Prevention:Nonopioid therapies for pain management.Dowell D, Haegerich TM, Chou R.CDC guideline for prescribing opioids for chronic pain–United States, 2016.JAMA. 2016;315(15):1624-1645. doi:10.1001/jama.2016.1464
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
DailyMed.Label: hydrocodone bitartrate tablet extended release.DailyMed.Label: hydrocodone bitartrate capsule extended-release.DailyMed.Label: Hycet- hydrocodone bitartrate and acetaminophen solutionDailyMed.Label: Hysingla ER- hydrocodone bitartrate tablet, extended-releaseNational Institute on Drug Abuse.Opioids.MedlinePlus.Opioids and opioids use disorders.Ghelardini C, Di Cesare Mannelli L, Bianchi E.The pharmacological basis of opioids.Clin Cases Miner Bone Metab.2015;12(3):219-221. doi:10.11138/ccmbm/2015.12.3.219American Society of Anesthesiologists.What are opioids?Manchikanti L, Atluri S, Kaye AM, Kaye AD.Hydrocodone bitartrate for chronic pain.Drugs Today (Barc). 2015;51(7):415-427. doi:10.1358/dot.2015.51.7.2361328.MedlinePlus.Hydrocodone.MedlinePlus.Hydrocodone combination products.Hale ME, Laudadio C, Yang R, Narayana A, Malamut R.Efficacy and tolerability of a hydrocodone extended-release tablet formulated with abuse-deterrence technology for the treatment of moderate-to-severe chronic pain in patients with osteoarthritis or low back pain.J Pain Res. 2015;8:623-636. doi:10.2147/JPR.S83930American Addiction Centers.How long do opioids stay in your system?Martyn JAJ, Mao J, Bittner EA.Opioid tolerance in critical illness.N Engl J Med. 2019;380(4):365-378. doi:10.1056/NEJMra1800222Centers for Disease Control and Prevention:Nonopioid therapies for pain management.Dowell D, Haegerich TM, Chou R.CDC guideline for prescribing opioids for chronic pain–United States, 2016.JAMA. 2016;315(15):1624-1645. doi:10.1001/jama.2016.1464
DailyMed.Label: hydrocodone bitartrate tablet extended release.
DailyMed.Label: hydrocodone bitartrate capsule extended-release.
DailyMed.Label: Hycet- hydrocodone bitartrate and acetaminophen solution
DailyMed.Label: Hysingla ER- hydrocodone bitartrate tablet, extended-release
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MedlinePlus.Hydrocodone.
MedlinePlus.Hydrocodone combination products.
Hale ME, Laudadio C, Yang R, Narayana A, Malamut R.Efficacy and tolerability of a hydrocodone extended-release tablet formulated with abuse-deterrence technology for the treatment of moderate-to-severe chronic pain in patients with osteoarthritis or low back pain.J Pain Res. 2015;8:623-636. doi:10.2147/JPR.S83930
American Addiction Centers.How long do opioids stay in your system?
Martyn JAJ, Mao J, Bittner EA.Opioid tolerance in critical illness.N Engl J Med. 2019;380(4):365-378. doi:10.1056/NEJMra1800222
Centers for Disease Control and Prevention:Nonopioid therapies for pain management.
Dowell D, Haegerich TM, Chou R.CDC guideline for prescribing opioids for chronic pain–United States, 2016.JAMA. 2016;315(15):1624-1645. doi:10.1001/jama.2016.1464
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