hydrocodone (Zohydro ER)
Omudhome Ogbru, PharmD
Omudhome Ogbru, PharmD
Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.
Medical and Pharmacy Editor:
GENERIC NAME: hydrocodone
BRAND NAMES: Zohydro ER
DRUG CLASS AND MECHANISM: Hydrocodone is an opioid narcotic pain-reliever similar to oxycodone, morphine, methadone, fentanyl, and other opioids. Hydrocodone, like other opioids, stimulates receptors on nerves in the brain to increase the threshold to pain (the amount of stimulation it takes to feel pain) and reduce the perception of pain (the perceived importance of the pain). Unlike other hydrocodone products such as Vicodin which contain acetaminophen, Zohydro ER contains only hydrocodone. The FDA approved Zohydro in October 2013.
GENERIC AVAILABLE: No
PREPARATIONS: Capsules (Extended Release): 10, 15, 20, 30, 40, and 50 mg
STORAGE: Hydrocodone should be stored at room temperature, between 15 C to 30 C (59 F to 86 F).
PRESCRIBED FOR: Hydrocodone is prescribed for the treatment of pain severe enough to require daily, around-the-clock, long-term opioid treatment and for which alternative treatment options are inadequate.
DOSING: The initial dose for adults is 10 mg orally every 12 hours. The dose may be increased every 3 to 7 days by 10 mg every 12 hours as needed to control pain. Capsules must be swallowed whole and not chewed.
DRUG INTERACTIONS: Combining alcohol and other sedatives with hydrocodone can lead to increased sedation and even cause confusion. Hydrocodone should not be taken with any of the monoamine oxidase inhibitor (MAOI) class of antidepressants, for example, isocarboxazid (Marplan), phenelzine (Nardil), tranylcypromine (Parnate), selegiline (Eldepryl), and procarbazine (Matulane) or other drugs that inhibit monoamine oxidase, for example, linezolid (Zyvox). Such combinations may lead to confusion, high blood pressure, tremor, hyperactivity, coma, and death.
Hydrocodone should not be administered within 14 days of stopping an MAOI.
PREGNANCY: There are no adequate studies of hydrocodone in pregnant women.
NURSING MOTHERS: Hydrocodone is excreted in breast milk, and, therefore should be used cautiously by nursing mothers.
SIDE EFFECTS: The most frequent adverse reactions include lightheadedness, dizziness, sedation, nausea, and vomiting. Other side effects include drowsiness, constipation, and spasm of the ureter, which can lead to difficulty in urinating. Hydrocodone can impair thinking and the physical abilities required for driving or operating machinery. Hydrocodone can depress breathing, and should be used with caution in elderly, debilitated patients, and in patients with serious lung disease. Hydrocodone is habit forming. Mental and physical dependence can occur when used long-term.
REFERENCE: FDA Prescribing Information.
Last Editorial Review: 4/17/2014
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