Generic Name: hydrocodone (oral) (HYE droe KOE done)
Brand Name: Zohydro ER
What is hydrocodone?
Hydrocodone is an opioid pain medication. An opioid is sometimes called a narcotic.
Zohydro ER is an extended-release form of hydrocodone that is used for around-the-clock treatment of severe pain. This form of hydrocodone is not for use on an as-needed basis for pain.
Hydrocodone may also be used for purposes not listed in this medication guide.
What is the most important information I should know about hydrocodone?
Hydrocodone can slow or stop your breathing. Never use this medicine in larger amounts, or for longer than prescribed. Do not crush, break, or open an extended-release pill. Swallow it whole to avoid exposure to a potentially fatal dose. Hydrocodone may be habit-forming, even at regular doses. Never share this medicine with another person, especially someone with a history of drug abuse or addiction. Keep the medication in a place where others cannot get to it.
MISUSE OF NARCOTIC MEDICATION CAN CAUSE ADDICTION, OVERDOSE, OR DEATH, especially in a child or other person using the medicine without a prescription.
You should not use this medicine if you have severe asthma or breathing problems, or a blockage in your stomach or intestines.
Tell your doctor if you are pregnant. Hydrocodone may cause life-threatening addiction and withdrawal symptoms in a newborn.
Do not drink alcohol. Dangerous side effects or death can occur when alcohol is combined with hydrocodone.
What should I discuss with my healthcare provider before taking hydrocodone?
You should not use hydrocodone if you are allergic to it, or if you have:
severe asthma or breathing problems; or
a bowel obstruction called paralytic ileus.
Hydrocodone may be habit forming. Never share hydrocodone with another person, especially someone with a history of drug abuse or addiction. Keep the medication in a place where others cannot get to it. Selling or giving away hydrocodone is against the law.
To make sure hydrocodone is safe for you, tell your doctor if you have:
any type of breathing problem or lung disease;
a history of head injury, brain tumor, or seizures;
a history of drug abuse, alcohol addiction, or mental illness;
liver or kidney disease;
a blockage in your stomach or intestines; or
problems with your gallbladder, pancreas, or thyroid.
Hydrocodone is more likely to cause breathing problems in older adults and people who are severely ill, malnourished, or otherwise debilitated.
FDA pregnancy category C. It is not known whether hydrocodone will harm an unborn baby. Hydrocodone may cause breathing problems, behavior changes, or life-threatening addiction and withdrawal symptoms in your newborn if you use the medication during pregnancy. Tell your doctor if you are pregnant.
Hydrocodone can pass into breast milk and may harm a nursing baby. You should not breast-feed while you are using hydrocodone.
How should I take hydrocodone?
Hydrocodone may be habit-forming, even at regular doses. Never share this medicine with another person, especially someone with a history of drug abuse or addiction. MISUSE OF NARCOTIC MEDICATION CAN CAUSE ADDICTION, OVERDOSE, OR DEATH, especially in a child or other person using the medicine without a prescription. Selling or giving away hydrocodone is against the law.
Follow all directions on your prescription label. Hydrocodone can slow or stop your breathing, especially when you start using this medicine or whenever your dose is changed. Never use hydrocodone in larger amounts, or for longer than prescribed. Tell your doctor if the medicine seems to stop working as well in relieving your pain.
Your dose needs may be different if you have recently used a similar opioid (narcotic) pain medicine and your body is tolerant to it. Talk with your doctor if you are not sure you are opioid-tolerant.
Do not crush, break, or open an extended-release pill. Swallow it whole to avoid exposure to a potentially fatal dose.
Do not stop using hydrocodone suddenly after long-term use, or you could have unpleasant withdrawal symptoms. Ask your doctor how to avoid withdrawal symptoms when you stop using hydrocodone.
Never crush or break a hydrocodone pill to inhale the powder or mix it into a liquid to inject the drug into your vein. This practice has resulted in death with the misuse of hydrocodone and similar prescription drugs.
Store at room temperature, away from heat, moisture, and light. Keep the medication in a place where others cannot get to it.
Keep track of the amount of medicine used from each new bottle. Hydrocodone is a drug of abuse and you should be aware if anyone is using your medicine improperly or without a prescription.
After you have stopped using this medication, flush any unused pills down the toilet. Disposal of medicines by flushing is recommended to reduce the danger of accidental overdose causing death. This advice applies to a very small number of medicines only. The FDA, working with the manufacturer, has determined this method to be the most appropriate route of disposal and presents the least risk to human safety.
What happens if I miss a dose?
Since hydrocodone is used for pain, you are not likely to miss a dose. Skip any missed dose if it is almost time for your next scheduled dose. Do not use extra medicine to make up the missed dose.
What happens if I overdose?
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. A hydrocodone overdose can be fatal, especially in a child or other person using the medicine without a prescription. Overdose symptoms may include slow breathing and heart rate, severe drowsiness, muscle weakness, cold and clammy skin, pinpoint pupils, and fainting.
What should I avoid while taking hydrocodone?
Do not drink alcohol. Dangerous side effects or death can occur when alcohol is combined with hydrocodone. Check your food and medicine labels to be sure these products do not contain alcohol.
This medication may impair your thinking or reactions. Avoid driving or operating machinery until you know how hydrocodone will affect you. Dizziness or severe drowsiness can cause falls or other accidents.
Hydrocodone side effects
Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.
Stop using hydrocodone and call your doctor at once if you have:
weak or shallow breathing;
pain or burning when you urinate;
confusion, tremors, severe drowsiness; or
a light-headed feeling, like you might pass out.
Common side effects may include:
constipation, stomach pain, nausea, vomiting;
swelling in your hands or feet;
muscle pain, back pain,
cold symptoms such as stuffy nose, sneezing, sore throat;
mild drowsiness, tired feeling; or
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
See also: hydrocodone side effects (in more detail)
Hydrocodone Dosing 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
What other drugs will affect hydrocodone?
Taking this medicine with other drugs that make you sleepy or slow your breathing can cause dangerous or life-threatening side effects. Ask your doctor before taking hydrocodone with a sleeping pill, muscle relaxer, other pain medicine, or medicine for anxiety, depression, or seizures.
Other drugs may interact with hydrocodone, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell each of your health care providers about all medicines you use now and any medicine you start or stop using.
Where can I get more information?
- Your pharmacist can provide more information about hydrocodone.
- Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
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