II. Indications
- Moderate pain not relieved with NSAIDs or Acetaminophen
III. Classification
- Hydrocodone was reclassified as FDA Schedule II Opioid in United States as of Spring 2013
IV. Preparations
- Hydrocodone (5, 7.5 or 10 mg) with Acetaminophen 300 mg (Vicodin)
- Vicodin reformulated as of January 2014 in United States to lower Acetaminophen doses per pill (maximum 300 mg)
- Hydrocodone (7.5 mg/15 ml) with Acetaminophen (500 mg/15 ml) Suspension (Lortab Elixir)
- Hydrocodone Alone (Zohydro ER)
- Benhydrocodone (4.08 mg, 6.12 mg or 8.16 mg) with Acetaminophen 325 mg (Apadaz)
- Benhydrocodone 4.08 mg, 6.12 mg and 8.16 mg is roughly equivalent to Hydrocodone 5, 7.5 and 10 mg
- Benhydrocodone is a prodrug enzymatically converted to Hydrocodone in Gastrointestinal Tract
- Submitted and declined by FDA as an Opioid Abuse Deterrent Agent
- Offers no benefit over other Opioids including Hydrocodone and not recommended
- (2020) Presc Lett 27(1):4
V. Dosing: Hydrocodone with Acetaminophen (Vicodin Tablets)
- Hydrocodone 5 with Acetaminophen 300 (Vicodin 5/300)
- Vicodin 5/300 take 1-2 every 4-6 hours as needed for moderate pain (up to 8 tabs/day)
- Hydrocodone 7.5 with Acetaminophen 300 (Vicodin ES 7.5/300)
- Vicodin ES 7.5/300 take 1-2 every 4-6 hours as needed for moderate pain (up to 5 tabs/day)
- Hydrocodone 10 with Acetaminophen 300 (Vicodin HP 10/300)
- Vicodin HP 10/300 take 1 every 4-6 hours as needed for moderate pain (up to 6 tabs/day)
VI. Dosing: Hydrocodone with Acetaminophen Suspension (Lortab Elixir)
- Components per 15 ml
- Hydrocodone 7.5 mg
- Acetaminophen 500 mg
- Dosing
- Age 2-3 years (12-15 kg or 27-34 lbs)
- Dose: 3.75 ml (0.75 tsp)
- Age 4-6 years (16-22 kg or 35-50 lbs)
- Dose: 5 ml (1 tsp)
- Age 7-9 years (23-31 kg or 51-69 lbs)
- Dose: 7.5 ml (1.5 tsp)
- Age 10-13 years (35-45 kg or 70-100 lbs)
- Dose: 10 ml (2.0 tsp)
- Age 2-3 years (12-15 kg or 27-34 lbs)
VII. Dosing: Hydrocodone alone
- Hydrocodone extended release (Zohydro ER)
- CII agent due out in United States in March 2014
- Available in 10-50 mg capsules and taken twice daily for severe Chronic Pain
- Increased abuse risk at a high financial cost without unique benefit
- Not in tamper resistant packaging and risk of crushing of immediate high (and further potentiated by Alcohol)
- Twice the cost of Oxycontin and 7 times the cost of generic Morphine ER
- FDA approved despite FDA expert panel voting to not approve (11 to 2 decision)
- In Zohydro Overdose, consider Activated Charcoal and Whole Bowel Irrigation, in addition to Naloxone infusion
- See Opioid Overdose
- References
- Swadron and Nordt in Herbert (2014) EM:Rap 14(10):3
- (2014) Presc Lett 21(4): 21
VIII. Resources
- Hydrocodone and Acetaminophen Tablet (DailyMed)
IX. References
- (2013) Presc Lett 20(12): 67
Images: Related links to external sites (from Bing)
Related Studies
| hydrocodone (on 10/19/2022 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
| HYDROCODONE-ACETAMINOPHEN 10-300 MG TABLET | Generic | $0.28 each |
| HYDROCODONE-ACETAMINOPHEN 10-325 MG TABLET | Generic | $0.13 each |
| HYDROCODONE-ACETAMINOPHEN 5-300 MG TABLET | Generic | $0.22 each |
| HYDROCODONE-ACETAMINOPHEN 5-325 MG TABLET | Generic | $0.10 each |
| HYDROCODONE-ACETAMINOPHEN 7.5-300 MG TABLET | Generic | $0.24 each |
| HYDROCODONE-ACETAMINOPHEN 7.5-325 MG TABLET | Generic | $0.11 each |
| HYDROCODONE-ACETAMINOPHEN 7.5-325 MG/15 ML SOLUTION | Generic | $0.20 per ml |
| HYDROCODONE-CHLORPHEN ER SUSP | Generic | $0.45 per ml |
| HYDROCODONE-HOMATROPINE 5-1.5 MG TABLET | Generic | $1.05 each |
| HYDROCODONE-HOMATROPINE SOLN | Generic | $0.09 per ml |
| HYDROCODONE-IBUPROFEN 10-200 | Generic | $3.22 each |
| HYDROCODONE-IBUPROFEN 7.5-200 | Generic | $0.26 each |