At times, over-the-counter painkillers do nothing to reduce the pain of people who have chronic aches. They are given more potent and dangerous drugs, such as hydrocodone instead. Nevertheless, it also has its risks and benefits.
So, hydrocodone is very effective at relieving pain and blocking all those pain signals to your brain, but with it comes a whole lot of not-so-good stuff for your body. We are talking about constipation, trouble breathing, hormonal imbalance, and more. It is these effects that have made hydrocodone a Schedule II drug. Its addiction or overdose can potentially take you to the ER or the grave. So, it is not something to be taken lightly, and in no circumstances without a doctor’s prescription.
You’ll find out all about this drug in this truly detailed article. We’ve added all the details to give you the full lowdown on the painkiller.
What is Hydrocodone?
Is hydrocodone an opioid? Yes, it is! It is a therapeutic opioid that is less harmful than morphine and codeine but has a lot of similar effects. It is basically a semi-synthetic prescription opioid that is made from codeine and is used most frequently in the treatment of pain after surgery, severe arthritis, and cancer pain.
So, this drug was made all the way back in the 1920s by a German pharmaceutical firm named Knoll. They created hydrocodone by adding some hydrogen atoms to codeine molecules. And just in case you’re curious, “Does hydrocodone have codeine in it?” the answer is no. These two opioids are distinct chemicals.
Hydrocodone Classification
It is also worth noting that hydrocodones intoxicate and produce euphoric effects and can make certain individuals high, just like other drugs. As a result of many reports of drug abuse and accounts of people becoming dependent on the drug, hydrocodone is currently rated as a Schedule II drug under the CSA. The medical opioid was previously rated as a Schedule III drug. But its part in the opioid crisis has reversed that status, making it a drug doctors try not to prescribe to patients.
Brand Names of Hydrocodone
Hydrocodone is the name of a drug—not the medicine containing this drug that you usually see at pharmacies. The hydrocodone medications you usually interact with have hydrocodone and another drug with it, depending on the use case of a medication.
- Hydrocodone-only drugs: Zohydro ER, Hysingla ER
- Hydrocodone and Acetaminophen: Vicodin (one of the most popular), Norco, Lortab, Hycet, Zamicet, Xodol
- Hydrocodone and Ibuprofen: Vicoprofen
- Hydrocodone and Homatropine: Hycodan (medicine for severe cough)
Hydrocodone Dosage and Forms
They are commonly 2.5 mg, 5 mg, 7.5 mg, and 10 mg, depending on the drug. Drugs like the super popular hydrocodone drug “Norco” contain a hydrocodone 7.5/325 mg ratio of potencies.
Just like different formulations of hydrocodone, there are also different forms of this drug for intake. You will find tablets, capsules, and oral suspensions (like hydrocodone-based cough syrup). Oblong, hard, and almost impossible-to-chew tablets are some of their popular forms.
Within these forms of the drug, you will see types like IR (immediate-release) and ER (extended-release). Evident from the names, IR medications give fast pain relief and ER takes some time to relieve pain. Examples of these two are Vicodin and Zohydro ER, respectively.
Uses of Hydrocodone: FDA-Approved and Off-Label
The consensus is that a drug, whether hydrocodone or other medication, should only be administered based on the FDA-approved indication. FDA-approved indications for hydrocodone include pain and cough. Like most medications, hydrocodone has uses outside of the label indications and is therefore referred to as “off-label uses.” But the use of an FDA-approved prescription by a practitioner for reasons other than the approved use is a rather common practice.
Off-label uses are very contextual and may vary from case to case. In hydrocodone’s case, such uses may include its application to treat shortness of breath in palliative care. Fibromyalgia, neuropathic pain, and insomnia patients in a few cases. Opioids, including hydrocodone and codeine, are occasionally utilized to treat patients who have terminal illnesses in order to ease the process of breathing. Some other new applications of hydrocodone exist but at the discretion of a patient’s condition and a physician’s judgment. Again, these are unsafe drugs with a high potential to cause damage if used without the oversight of a physician.
Hydrocodone’s Mechanism of Action
In simple words, the opioids in the central nervous system help the body release chemicals that suppress activities resulting in pain. In a more detailed view, hydrocodone relieves pain as an opioid receptor agonist and activates the mu-opioid receptors. After the drug concentration in the body increases, the drug also activates kappa- and delta-opioid receptors. Opioid receptors are spread through the body but are dominant in the brain and spinal cord (and other regions of the body). Their agonist stimulation results in inhibition of cAMP, resulting in suppression of nociceptive neurotransmitter release, postsynaptic neuronal hyperpolarization, and reduced neuronal excitability.
Hydrocodone Side Effects
Many risks and side effects are associated with this painkiller. Opioid receptors are spread throughout the body. Therefore, the usage of hydrocodone-based medication can result in a variety of side effects in a patient. Doctors who prescribe this drug actively monitor the effects of this drug to avoid any unfortunate scenarios.
One of the common side effects of hydrocodone is dizziness. Therefore, after taking the drug, operating machinery or driving a car should be avoided. Patients with chronic pain should prioritize rest or sleep under the effects of this medicine. Sleepiness is one of the standout qualities of opioid-based products, whether synthetic or natural. We hope this answers one of the most frequently asked questions, “Does hydrocodone make you sleepy?” As for other risks, a wrong hydrocodone dose can have effects ranging from damaging to being fatal. Consult the following table to learn about the common side effects, serious risks, and long-term effects:
| Common Side Effects | Serious Risks | Long-Term Effects |
| Drowsiness | Respiratory depression | Cognitive decline |
| Constipation | Hypotension | Hormonal changes |
| Nausea | Allergic reactions | High tolerance for opioids |
| Dizziness | Addiction | Dependence (physical and mental) |
| Temporary loss of taste |
Is Hydrocodone Addictive?
Let’s start with a common question: why is hydrocodone highly addictive? A simple answer is that it is super effective—just like other opioids. One of the major reasons why it is habit-forming is because of the euphoric effects that a user gets from using opioids. The dopamine release, euphoria, and emotional relief make it a highly addictive drug.
Physical and Psychological Dependency
The dependence on hydrocodone can be divided into physical and psychological. It can be either or both for a patient. For example, someone taking hydrocodone-based medication for a long time can feel depressed for longer periods, as opioids cause dopamine release. For another patient with chronic pain, performing daily functions without hydrocodone can be much more difficult. This is how both the body and the brain can become dependent on this drug.
After continuous use (or abuse) of an opioid-based medication, the tolerance for the drug increases. That’s when the same dosage of the medicine as before will not result in pain relief. Increasing the dosage ultimately increases the risk of addiction and long-term dependence.
Risk Factors for Addiction
Some people are at a higher risk of developing an addiction. The following factors can increase the likelihood of addiction among patients:
- Addiction in family or friends
- Poor mental health
- History of alcohol or drug abuse
- Long-term pain
- Certain life incidents
These things can happen to anyone. To avoid risks, doctors monitor the dosage and its effects on patients using this hydrocodone.
Overdose Signs and Symptoms
The signs and symptoms of an opioid overdose are much worse than the usual side effects. Pinpoint pupils are a clear symptom of opioid overdose. Other indicators may include slow breathing and low blood pressure.
More critical signs include bluishness of skin (caused due to lack of oxygen), severe drowsiness, and lack of consciousness. A patient’s family or friends should contact a doctor and explain the condition. Contact emergency because such conditions can be life-threatening. It is highly advisable to take the patient to the hospital right away to avoid permanent damage or death.
Naloxone for Emergency Situations
Naloxone is the drug that one can have in stores at home just in case, especially for those patients who have a history of drug abuse or addiction. If one has a friend or a relative staying over with him who is an opioid addict, getting Naloxone should be on his top list. It might help you save their lives one day. Naloxone is a very safe drug that will reverse the effects of the opioid, making it a potentially life-saving medicine.
A good thing about it is the fact that it is over-the-counter in many places. You will find this medicine in forms like injectors and nasal sprays.
Treatment for Overuse and Addiction
The National Institute on Drug Abuse reports that opioid abuse disorder is a chronic but complex, treatable medical condition. Treatment may entail recovery through medicines, counseling, and rehabilitation, along with managing the withdrawal symptoms to provide effective results. If it sounds like the treatment for heroin addicts, then you are not wrong because again this drug belongs to the same family.
The first step is to safely remove the drug from the patient’s system with a detox developed with medications, home remedies, or a mix of both. But in case of a mix of both, the doctors should be kept informed. A major challenge with the treatment of opioid addiction is withdrawal management and easy falling back to opioid use.
Patients may be suggested inpatient and outpatient care depending on the severity of addiction. Inpatient care involves getting admitted to the hospital/rehab and receiving round-the-clock care. Patients with outpatients may be partially hospitalized or have a treatment structured in a way that patients can go home after the scheduled treatment hours during rehab. There are early stage, later stage, and psychological symptoms. Rehabilitation centers are effective in dealing with withdrawal symptoms and helping with detox. Medications like methadone, buprenorphine, and naltrexone are often prescribed for opioid abuse treatment. They mostly help with the withdrawal symptoms and the body’s dependence on the opioid.
In addition to medication, therapy, and support from family play an important role in recovery and avoiding relapse.
Precautions and Drug Interactions
Now that you are aware of the benefits and the worst-case situation with this medicine, there are different precautions highly advisable for patients using this drug.
Age
Hydrocodone is a highly toxic drug and should be kept away from the reach of children under any circumstances. You should even count tabs to ensure no tablets are missing from the container.
Medical Conditions
People with conditions or illnesses should always share their medical history with their doctor when prescribed hydrocodone. People with mental health issues, kidney problems, and other problems like respiratory issues should use the drug with carefulness. Report any symptoms or changes to your doctor as soon as possible.
Pregnancy
Hydrocodone is an extremely strong drug that should never be ingested during pregnancy unless there are extreme conditions. Because there have been reports of this drug impacting the respiration of newborns. So, during pregnancy, this drug not only puts you but also your newborn at risk.
Drug Interactions
Hydrocodone is not to be taken when other medications are present in the body, such as alcohol, benzodiazepines, and other strong pain medications. The effects of the medication can become severe for a patient with hydrocodone and alcohol in their system. A significantly high state of sleepiness, confusion, and respiratory depression becomes prominent. If you are on any medication, please inform your physician when hydrocodone has been prescribed to you.
Alternatives to Hydrocodone
It is probably best to avoid hydrocodone for most patients. Instead of debating and comparing which opioids are safer, talking about codeine vs hydrocodone, there are, in general, safer medications: the non-opioid analgesic class of drugs.
Medications that may be of benefit include analgesics such as paracetamol and NSAIDs, including ibuprofen, and gabapentinoids. The combination of such medication with pain management therapies, both psychological and physical, can result in continued improvement and improved health.
Sometimes taking weaker opioids and extended-release medicines can be great alternatives to hydrocodone opioids. Examples of such opioids include tramadol, tapentadol, and buprenorphine. Their side effects are mild, and they can help with pain management like stronger members of the opioid family.
FAQs
How Long Does Hydrocodone Take to Work?
So, on average, it begins to work about 10 to 30 minutes after consuming it, and you’ll feel it the most at about 30 to 60 minutes after that. But it also kind of depends on whether you’re taking the ER or IR form of hydrocodone. For immediate-release, you’ll feel something in about 10 to 20 minutes.
The extended-release preparations are known to have a more delayed onset of action with peaks of effects at approximately 14-16 hours post-dosing.
How Long Does Hydrocodone Last?
The relief of pain provided by the immediate-release hydrocodone is for approximately 4 to 6 hours, and the extended-release formulations extend it for 12 hours.
Can You Take Hydrocodone and Ibuprofen Together?
You can take a combination of both in the form of Vicoprofen medicine. But you will need a prescription to get them.
Conclusion
Hydrocodone is a very potent drug; if used accordingly, it can cure chronic pains due to injury, surgery, cancer treatment, etc. Their use can, however, present many potential hazards, as is the case with other opioids. Its side effects and risks of addiction make it a perilous drug that should be handled with care. Following your doctor’s prescribed dosage and being transparent about its effects with your doctor can help you lower the risks and help manage pain.
In case of side effects or high dosage, do not delay taking the necessary steps and contact a rehab center near you. Do know that proper medication and therapy can help with addiction and withdrawal symptoms.
With a full picture of what this drug is, how it works, and the risks associated, patients should make informed decisions.
