Generic Name: hydrocodone (oral) (HYE droe KOE done)
Brand Names: Zohydro ER
Medically reviewed: July 25, 2017
What is Zohydro ER?
Zohydro ER (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. Extended-release hydrocodone is not for use on an as-needed basis for pain.
Zohydro ER may also be used for purposes not listed in this medication guide.
Zohydro ER 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 capsule. Swallow the capsule whole to avoid exposure to a potentially fatal dose. Hydrocodone may be habit-forming, even at regular doses. Never share Zohydro ER 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 Zohydro ER 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 withdrawal symptoms in a newborn if the mother has taken this medicine during pregnancy.
Fatal side effects can occur if you use this medicine with alcohol, or with other drugs that cause drowsiness or slow your breathing.
Before taking this medicine
You should not use Zohydro ER if you are allergic to hydrocodone, or if you have:
severe asthma or breathing problems; or
a blockage in your stomach or intestines.
Zohydro ER may be habit forming. 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. Selling or giving away Zohydro ER is against the law.
Some medicines can interact with hydrocodone and cause a serious condition called serotonin syndrome. Be sure your doctor knows if you also take stimulant medicine, herbal products, or medicine for depression, mental illness, Parkinson's disease, migraine headaches, serious infections, or prevention of nausea and vomiting. Ask your doctor before making any changes in how or when you take your medications.
To make sure Zohydro ER is safe for you, tell your doctor if you have ever had:
any type of breathing problem or lung disease;
a head injury, brain tumor, or seizures;
drug or alcohol addiction, or mental illness;
liver or kidney disease;
a heart rhythm disorder called long QT syndrome;
problems with your gallbladder, pancreas, or thyroid; or
if you use a sedative like Valium (diazepam, alprazolam, lorazepam, Ativan, Klonopin, Restoril, Tranxene, Versed, Xanax, and others).
If you use Zohydro ER while you are pregnant, your baby could become dependent on hydrocodone. This can cause life-threatening withdrawal symptoms in the baby after it is born. Babies born dependent on habit-forming medicine may need medical treatment for several weeks. Tell your doctor if you are pregnant or plan to become pregnant.
Do not breast-feed while you are using Zohydro ER. Hydrocodone can pass into breast milk and cause drowsiness, breathing problems, or death in a nursing baby.
How should I take Zohydro ER?
Take Zohydro ER exactly as prescribed by your doctor. 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 Zohydro ER 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 Zohydro ER 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 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 capsule. Swallow it whole to avoid exposure to a potentially fatal dose.
Do not stop using Zohydro ER suddenly after long-term use, or you could have unpleasant withdrawal symptoms. Ask your doctor how to avoid withdrawal symptoms when you stop using this medicine.
Never crush or break a Zohydro ER capsule 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.
Do not keep leftover Zohydro ER capsules. Ask your pharmacist where to locate a drug take-back disposal program. If there is no take-back program, flush any unused capsules 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.
Zohydro ER Dosing Information
Usual Adult Dose for Pain:
Zohydro 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. Zohydro 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 Zohydro 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
See also: Dosage Information (in more detail)
What happens if I miss a dose?
Since Zohydro ER 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 Zohydro ER?
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.
See also: Zohydro ER and alcohol (in more detail)
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.
Zohydro ER side effects
Get emergency medical help if you have any signs of an allergic reaction to Zohydro ER: hives; difficult breathing; swelling of your face, lips, tongue, or throat.
Like other opioid medicines, hydrocodone can slow your breathing. Death may occur if breathing becomes too weak. A person caring for you should seek emergency medical attention if you have slow breathing with long pauses, blue colored lips, or if you are hard to wake up.
Stop using Zohydro ER and call your doctor at once if you have:
weak or shallow breathing;
pain or burning when you urinate;
confusion, tremors, severe drowsiness;
a light-headed feeling, like you might pass out;
infertility, missed menstrual periods;
impotence, sexual problems, loss of interest in sex; or
low cortisol levels - nausea, vomiting, loss of appetite, dizziness, worsening tiredness or weakness.
Seek medical attention right away if you have symptoms of serotonin syndrome, such as: agitation, hallucinations, fever, sweating, shivering, fast heart rate, muscle stiffness, twitching, loss of coordination, nausea, vomiting, or diarrhea.
Hydrocodone is more likely to cause breathing problems in older adults and people who are severely ill, malnourished, or otherwise debilitated.
Long-term use of opioid medication may affect fertility (ability to have children) in men or women. It is not known whether opioid effects on fertility are permanent.
Common Zohydro ER side effects may include:
constipation, stomach pain, nausea, vomiting;
dizziness, drowsiness, feeling tired;
tremors, muscle spasms, back pain;
cold symptoms such as stuffy nose, sneezing, sore throat;
swelling in your hands or feet.
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: Side effects (in more detail)
What other drugs will affect Zohydro ER?
Narcotic (opioid) medication can interact with many other drugs and cause dangerous side effects or death. Be sure your doctor knows if you also use:
other narcotic medications - opioid pain medicine or prescription cough medicine;
drugs that make you sleepy or slow your breathing - a sleeping pill, muscle relaxer, sedative, tranquilizer, or antipsychotic medicine; or
drugs that affect serotonin levels in your body - medicine for depression, Parkinson's disease, migraine headaches, serious infections, or prevention of nausea and vomiting.
This list is not complete. Other drugs may interact with hydrocodone, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.
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.
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
Copyright 1996-2018 Cerner Multum, Inc. Version: 3.01.
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- Drug class: narcotic analgesics