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Overview: Hydrocodone is a medicine taken to help treat pain. Hydrocodone is an opioid that binds to specific receptors in your body to give you pain relief. Common side effects may include constipation, dizziness, drowsiness, headache, and stomach pain. Do not drive or do other activities that require alertness or coordination until you know how hydrocodone affects you. Call your health care provider right away if your pain increases, you feel more sensitive to pain, or if you develop pain in other areas of the body while taking hydrocodone.

Uses

What is hydrocodone used for?

Hydrocodone is commonly taken for severe pain.

Hydrocodone may also be used for other conditions as determined by your health care provider.

How does hydrocodone work (mechanism of action)?

Hydrocodone binds to and activates specific receptors in the body, causing pain relief.

How is hydrocodone supplied (dosage forms)?

Brands and other names

  • Hysingla ER
  • Zohydro ER

Dosage forms and strengths

  • 10 mg, 15 mg, 20 mg, 30 mg, 40 mg, 50 mg extended-release oral capsules
  • 20 mg, 30 mg, 40 mg, 60 mg, 80 mg, 100 mg, 120 mg extended-release oral tablets

How should I store hydrocodone?

Hydrocodone should be stored at room temperature, between 68 F and 77 F (20 C and 25 C). It can be exposed to temperatures between 59 F and 86 F (15 C and 30 C) for shorter periods of time, such as when transporting it. Store in a cool, dry place.

Side Effects

What are the most common side effects of hydrocodone?

The most common side effects of hydrocodone are listed below. Side effects can vary based on the specific hydrocodone product you are using. Tell your health care provider if you have any of these side effects that bother you.

  • Constipation (see below)
  • Nausea, vomiting, or stomach pain
  • Tiredness
  • Infection in the nose or throat, sore throat, or common cold symptoms
  • Dizziness
  • Headache 
  • Dry mouth
  • Itching
  • Fluid retention
  • Muscle spasms
  • Urinary tract infection
  • Back pain
  • Uncontrolled shaking

There may be other side effects of hydrocodone that are not listed here. Contact your health care provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088. In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of hydrocodone?

While less common, the most serious side effects of hydrocodone are described below, along with what to do if they happen.

Severe Allergic Reactions. Hydrocodone may cause allergic reactions, which can be serious. Stop taking hydrocodone and get help right away if you have any of the following symptoms of a serious allergic reaction.

  • Breathing problems or wheezing
  • Racing heart
  • Fever or general ill feeling
  • Swollen lymph nodes
  • Swelling of the face, lips, mouth, tongue, or throat
  • Trouble swallowing or throat tightness
  • Itching, skin rash, or pale red bumps on the skin called hives
  • Nausea or vomiting
  • Dizziness, feeling lightheaded, or fainting
  • Stomach cramps
  • Joint pain

Risk of Misuse and Addiction. Misusing hydrocodone can lead to serious side effects like coma or death. Misuse means taking a medicine in a way other than how it was prescribed. Take hydrocodone exactly as prescribed. Tell your health care provider if you feel that hydrocodone is not working. Call your health care provider right away or go to the nearest emergency room if you have any of the following serious symptoms.

  • Sudden confusion or feeling disoriented
  • Feeling paranoid
  • Suicidal thoughts or actions
  • Seizures
  • Trouble breathing

Breathing Problems. Hydrocodone may cause slow or shallow breathing, especially if you have breathing problems from another condition or take other medicines that can slow your breathing. Tell your health care provider if you develop severe sleepiness or trouble breathing, especially when you start hydrocodone or when your dose is increased. Get emergency help if you have any of the following symptoms.

  • Changes in the color of your skin, including bluish color to your lips and fingernails
  • Confusion
  • Shortness of breath
  • Feeling dizzy, lightheaded, or fainting
  • Changes in your heart rate or rhythm, such as a fast, slow, pounding or skipping heartbeat
  • Slow or shallow breathing
  • Excessive sleepiness or trouble staying awake

Increase in Pain Sensitivity (Hyperalgesia). Hydrocodone can cause an increased sensitivity to pain. It can cause things that normally cause pain to feel more painful than usual. Hydrocodone can also cause allodynia. This happens when things that normally do not cause pain, such as wearing glasses or brushing your hair, become painful. If your pain increases, do not take extra doses of hydrocodone. This could cause you to overdose or develop other serious side effects. Call your health care provider right away if your pain increases, you feel more sensitive to pain, or if you develop pain in other areas of the body.

Reduced Adrenal Function. Long-term use of hydrocodone can cause your body’s adrenal glands to stop making as much cortisol (the stress hormone). This is known as adrenal insufficiency. Adrenal insufficiency can get worse if your body is under stress because of fever, surgery, or trauma. Tell your health care provider if you have any of the following symptoms of adrenal insufficiency.

  • Nausea and vomiting
  • Weakness, tiredness, or lack of energy
  • Low blood pressure
  • Loss of appetite
  • Dizziness

Low Blood Pressure (Hypotension). Hydrocodone may cause low blood pressure. If you feel faint or dizzy, lie down. Tell your health care provider right away if you have any of the following symptoms of low blood pressure.

  • Dizziness, feeling lightheaded, or fainting
  • Confusion
  • Feeling weak or tired

Sphincter of Oddi Spasm. The sphincter of Oddi is a muscular valve in your body that controls the flow of bile and digestive juices from the pancreas into the small intestine. When this valve spasms, it may feel like getting a tight muscle cramp, causing pain and blocking the flow of these juices, which can lead to discomfort and digestive problems. This is more likely to happen if you do not have a gallbladder. Stop taking hydrocodone and get emergency help if you have new or worse stomach pain or pain in the upper right side of your stomach area that travels to your back or shoulder, with or without nausea and vomiting. 

Constipation. Some people taking hydrocodone may develop severe constipation or a blockage of the gut (bowel obstruction). Stop taking hydrocodone and call your health care provider right away if you have any of the following symptoms of a blockage in your intestines.

  • Nausea or vomiting
  • Stomach pain or bloating
  • Loss of appetite 
  • Unable to pass gas

Heart Rhythm Changes. Hydrocodone may cause a rare, dangerous heart rhythm problem called QT prolongation. Some people have a higher risk of this, including people who are older, have other people in their family who have had these conditions, have low potassium or magnesium levels, or who take medicines that can prolong the QT interval. Tell your health care provider right away if you faint or have changes in your heart rate or rhythm, such as a fast or skipping heartbeat.

Warnings & Precautions

Who should not use hydrocodone?

Allergies to Ingredients. People who are allergic to any of the following should not take hydrocodone.

  • Hydrocodone
  • Hysingla ER
  • Zohydro ER
  • Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in the specific hydrocodone products they stock.

Breathing Problems. Hydrocodone should not be taken if you have respiratory depression (breathing problems), severe asthma, or other lung problems. Taking hydrocodone can make breathing problems worse or lead to death.

Gut Blockage. Hydrocodone should not be taken if you have a blockage of your gut (bowel obstruction) or a narrowing of the stomach or intestines. Hydrocodone can make these conditions worse.

Slowed Gut Movement. Hydrocodone should not be taken if you have a paralytic ileus. This is when your intestines are unable to move food through them. Hydrocodone can make this worse.

What should I know about hydrocodone before using it?

Read and follow the instructions for the product you have. Taking this medicine the wrong way can cause serious side effects or may make it not work as well.

Do not take hydrocodone unless it has been prescribed to you by a health care provider. Take it as prescribed.

Do not share hydrocodone with other people, even if they have the same condition as you. It may harm them.

Keep hydrocodone out of the reach of children. Hydrocodone is a controlled substance because it can be misused or lead to dependence. Store hydrocodone in a safe place to protect it from theft. It is illegal to sell or give away this medicine.

Do not chew, cut, or crush hydrocodone. This can lead to overdose or death.

Do not pre-soak, lick, or wet the hydrocodone extended-release tablet before placing it in your mouth. The tablets can swell and make it hard for you to swallow them. Take the tablets one at a time by placing one in your mouth and swallowing it right away with enough water to make sure that the tablet reaches your stomach.

Hydrocodone can affect your alertness or coordination. Do not drive or do other activities that require alertness or coordination until you know how hydrocodone affects you.

People who are 65 and older can be at greater risk for some side effects from hydrocodone. Talk to your health care provider about your risks if you are in this age group.

Talk to your health care provider about a medicine called naloxone. Naloxone is a medicine that can be used as an emergency treatment for an opioid overdose, including accidental overdoses.

Long-term use of hydrocodone may affect your ability to become pregnant or get a partner pregnant. Talk with your health care provider if you have any concerns.

If you have been taking hydrocodone on a regular basis, do not stop taking it without talking to your health care provider. Stopping too quickly may cause serious side effects. Call your health care provider right away if you have any of the following symptoms.

  • Irritability
  • High or low energy or low mood
  • Feeling restless 
  • Changes in sleep habits
  • Headache
  • Nausea
  • Dizziness
  • Electric-shock like feelings
  • Confusion

Throw away any unused or expired hydrocodone by either taking the medicine to a U.S. Drug Enforcement Administration (DEA) collection site or medicine take-back program. If one is not available, you can mix the medicine with cat litter, dirt, or used coffee grounds, place the mixture in a plastic bag, and throw the plastic bag in the trash can. You can also flush hydrocodone down the toilet. You can find out more on how to properly throw away your medicines at www.fda.gov/drugdisposal.

What should I tell my health care provider before using hydrocodone?

Tell your health care provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if hydrocodone is right for you.

In particular, make sure that you discuss any of the following.

Substance Use Disorder or Alcohol Use Disorder. Talk to your health care provider if you have ever had a problem with alcohol, prescription medicines, or street drugs or live with someone who has this problem. Hydrocodone has a risk of being misused.

Other Medicines and Supplements. Hydrocodone may interact with other medicines and supplements. Before taking hydrocodone, tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.

Current and Past Health Conditions. Tell your health care provider if you have any of the following.

  • Head injury or brain problems, such as brain tumors or increased pressure around the brain
  • Seizures
  • Liver, kidney, or adrenal gland problems
  • Thyroid problems 
  • Problems peeing or prostate problems
  • Pancreas or gallbladder problems
  • Breathing problems, such as asthma or chronic obstructive pulmonary disease (COPD)
  • Low blood pressure
  • Heart failure, heart rhythm problems including QT prolongation, or problems with your electrolyte levels
  • History of an opioid overdose
  • Mental health conditions, such as depression

Pregnancy. Hydrocodone may cause harm to an unborn baby. Tell your health care provider if you are pregnant or plan to become pregnant. Your health care provider will advise you if you should take hydrocodone while you are pregnant or trying to get pregnant. If you take hydrocodone on a regular basis during pregnancy, your baby may have withdrawal symptoms that can be life-threatening. Tell your health care provider if you took hydrocodone during your pregnancy, especially near the end of your pregnancy.

Breastfeeding. Hydrocodone passes into breast milk. Tell your health care provider if you are breastfeeding or plan to breastfeed. Your health care provider will advise you if you should stop breastfeeding or stop hydrocodone. Monitor your baby for drowsiness and slowed breathing if you are breastfeeding while taking hydrocodone. Get help right away if you notice these things. Do not stop hydrocodone or breastfeeding without telling your health care provider.

Interactions

Does hydrocodone interact with foods or drinks?

There are no known interactions between hydrocodone and foods or nonalcoholic drinks.

Do not drink alcohol or use prescription or over-the-counter medicines that contain alcohol. The combination of alcohol and hydrocodone can increase your risk of serious side effects, including death.

Does hydrocodone interact with other medicines (drug interactions)?

Always tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

In particular, make sure that you discuss if you are using any of the following before taking hydrocodone.

  • Clarithromycin, erythromycin (Ery-Tab and others), or linezolid, which are used for bacterial infections
  • A monoamine oxidase inhibitor (MAOI) within the past two weeks, which is a medicine usually used for depression or Parkinson’s disease
  • Any medicine that affects serotonin in your body, such as medicines for depression, anxiety, or certain mental health conditions, some migraine medicines, and some medicines for nausea and vomiting. 
  • Fluconazole (Diflucan), itraconazole (Sporanox, Tolsura), ketoconazole, posaconazole (Noxafil), or voriconazole (Vfend), which are used for fungal infections
  • A protease inhibitor, such as atazanavir (Reyataz), nelfinavir (Viracept), or ritonavir (Norvir), which is a medicine commonly used to treat HIV
  • Rifampin (Rifadin), which is a medicine commonly used to treat an infection called tuberculosis
  • Carbamazepine (Carbatrol, Tegretol, and others) or phenytoin (Dilantin, Phenytek, and others), which is a medicine commonly used to treat seizures
  • A diuretic, also called a water pill, which is a medicine used to reduce edema (fluid retention) and blood pressure
  • An anticholinergic medicine, which includes antihistamines and medicines commonly used for overactive bladder, Parkinson’s disease, or stomach problems
  • A laxative, which is a medicine used to treat constipation by softening stools or stimulating your bowels
  • A mixed agonist/antagonist or partial agonist opioid analgesic, such as buprenorphine (Butrans, Sublocade), butorphanol, nalbuphine, pentazocine, and others, which is a medicine used to treat certain types of pain or opioid use disorder
  • Medicines that can cause QT prolongation, which is a potentially dangerous heart rhythm problem
  • Any other medicine that causes dizziness and sleepiness, such as prescription pain medicines (including opioids), sleep medicines, muscle relaxers, or medicines for anxiety (including benzodiazepines)

Many other medicines may alter the blood levels of hydrocodone. Tell your health care provider about all medicines that you take or have recently taken or stopped.

This may not be a complete list of medicines that can interact with hydrocodone. Always check with your health care provider.

Does interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose/Missed Dose

What should I do if I accidentally use too much hydrocodone?

If you or someone else has taken too much hydrocodone, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

What should I do if I miss a dose of hydrocodone?

If you miss a dose, skip the missed dose. Take the next dose at your usual scheduled time. Do not take double or extra doses. Do not take more than your prescribed dose. If you have any questions about missed doses, contact your health care provider.