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Hydrocodone Patient Tips

Medically reviewed on Feb 08, 2017 by C. Fookes, BPharm

How it works

Hydrocodone works on opioid receptors in the brain and spinal cord and is used to relieve moderate-to-severe pain unresponsive to less potent pain-relief medicines.


  • Relieves moderate-to-severe acute and chronic pain not controlled by other pain relief medicines.
  • Hydrocodone (by itself) is only available in abuse-deterrent, branded, extended-release forms, under the brand names: Hysingla ER, Vantrela ER, and Zohydro ER.
  • Hydrocodone is available in combination with other medications, for example, hydrocodone and acetaminophen, and hydrocodone and ibuprofen. Generic formulations of these combination medications are available.
  • Less potential for constipation, nausea and vomiting than morphine.


If you are between the ages of 18 and 60, take no other medication or have no other medical conditions, side effects you are more likely to experience include:

  • Constipation, nausea, vomiting (although less likely than other narcotics to cause these effects).
  • May impair reaction skills and affect a person's ability to drive or operate machinery. Avoid alcohol.
  • Known to cause addiction and dependence and may be misused or sought after by drug addicts; risk is higher in people with psychiatric disorders.

Notes: In general, seniors or children, people with certain medical conditions (such as liver or kidney problems, heart disease, diabetes, seizures) or people who take other medications are more at risk of developing a wider range of side effects. For a complete list of all side effects, click here.

Bottom Line

Hydrocodone is a potent pain-relieving medicine; however, use is limited by its potential for addiction.


  • Monitor for breathing difficulties, particularly in the first few days of treatment or with any dosage increase.
  • Available in abuse-deterrent formulations.
  • Absorption or effect not influenced by food.
  • One formulation in particular (Hysingla ER) has been associated with choking and getting stuck in the throat. Do not wet or suck tablet before taking and swallow whole with a large glass of water.
  • Withdrawal symptoms (symptoms may include muscle and bone pain, diarrhea, insomnia, vomiting) may occur if long-term hydrocodone is stopped abruptly; discontinue slowly on a doctor's advice.
  • Avoid alcohol while taking this medicine.
  • Do not chew or crush, presoak or attempt to dissolve; swallow whole with a glass of water.
  • Keep well out of reach of children; even one accidental dose can be fatal.
  • Constipation caused by hydrocodone may be treated with laxatives; nausea and vomiting may be treated with antiemetics.
  • May lower blood pressure on standing; take your time when going from a lying down to a standing up position.
  • Need for continued treatment should be assessed at regular intervals.

Response and Effectiveness

  • Time to peak after oral administration of Hysingla ER is 6 to 30 hours, Vantrela ER: 8 hours, and Zohydro R: 5 hours.
  • Once absorbed, hydrocodone is metabolized by hepatic enzymes CYP2D6 to hydromorphone which is the major metabolite of hydrocodone and has an approximately 10 to 33 fold higher binding affinity (in some cases as much as a 100-fold higher binding affinity) for the mu receptor than hydrocodone. Other hepatic enzymes are involved in the elimination of metabolized hydrocodone.
  • Because CYP2D6 exhibits genetic polymorphism, there is potentially a wide interindividual variation in the way individuals respond to hydrocodone.
  • One dose of Hysingla ER lasts for 24 hours, whereas one dose of either Vantrela ER or Zohydro ER lasts for 12 hours.


Hydrocodone [A to Z Facts]. Accessed 02/2016. Zohydro ER capsules (hydrocodone) [package insert] Revised 01/2016. Pernix Therapeutics. Accessed 02/2016

  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use hydrocodone only for the indication prescribed.

  • Disclaimer: Every effort has been made to ensure that this information is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. This drug information does not endorse drugs, diagnose patients or recommend therapy. It is an informational resource designed as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. does not assume any responsibility for any aspect of healthcare administered with the aid of this information. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2017 Revision Date: 2017-08-11 03:33:20