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Hydrocodone Dosage

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Usual Adult Dose for:

Additional dosage information:

Usual Adult Dose for Pain

Hydrocodone ER should be prescribed only by healthcare professionals who are knowledgeable in the use of potent opioids for the management of chronic pain.

Initial dose: 10 mg orally every 12 hours

Titration: The dose should be increased in increments of 10 mg orally every 12 hours every 3 to 7 days as needed to achieve adequate analgesia. Hydrocodone ER should be titrated to a dose that provides adequate analgesia and minimizes adverse reactions. Patients should be monitored routinely to assess the maintenance of pain control and incidence of adverse reactions, as well as monitoring for the development of addiction, abuse, or misuse. Patients who experience breakthrough pain may require a dose increase, or may need a rescue medication with an appropriate dose of an immediate-release analgesic.
-If unacceptable adverse reactions are observed, the dose may be reduced. The dose should be adjusted to obtain an appropriate balance between management of pain and adverse reactions.

Maximum dose: A single dose of hydrocodone ER greater than 40 or 50 mg, or a total daily dose greater than 80 mg are only for patients in whom tolerance to an opioid of comparable potency is established.

Approved indication: For the management of pain severe enough to require daily, around-the-clock, long-term opioid treatment and for which alternative treatment options are inadequate

Renal Dose Adjustments

Patients with renal impairment may have higher plasma concentrations than those with normal function. Therapy should be initiated with a low initial dose in patients with renal impairment.

Liver Dose Adjustments

Mild to moderate impairment: No dose adjustment recommended
Severe impairment: Start with lowest dose (10 mg)

Dose Adjustments

The dosing regimen should be initiated for each patient individually, according to prior analgesic treatment experience and risk factors for addiction, abuse, and misuse.

Precautions

Consult WARNINGS section for dosing related precautions.

Dialysis

Data not available

Other Comments

Administration advice:
-Hydrocodone ER capsules must be swallowed whole and not chewed, crushed, or dissolved.
-Hydrocodone ER is not to be used on an as needed basis.
-All other around-the-clock opioid drugs should be discontinued when hydrocodone ER therapy is initiated.
-To convert to hydrocodone ER from another opioid, consult the manufacturer product information.

Monitoring:
-Patients should be monitored for respiratory depression, especially within the first 24 to 72 hours.
-Hydrocodone ER should be titrated to a dose that provides adequate analgesia and minimizes adverse reactions. Patients should be monitored routinely to assess the maintenance of pain control and incidence of adverse reactions, as well as monitoring for the development of addiction, abuse, or misuse. Patients who experience breakthrough pain may require a dose increase, or may need a rescue medication with an appropriate dose of an immediate-release analgesic.
-If unacceptable adverse reactions are observed, the dose may be reduced. The dose should be adjusted to obtain an appropriate balance between management of pain and adverse reactions.

Patient advice:
-Hydrocodone ER should be swallowed whole with enough water to ensure complete swallowing.
-Crushing, chewing, or dissolving capsules will result in uncontrolled delivery of hydrocodone and can lead to overdose or death.
-Patients must not consume alcoholic beverages, or prescription or nonprescription products containing alcohol, while on therapy.

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