How does this medication work? What will it do for me?

Hydrocodone belongs to the family of medications known as antitussives (cough suppressants). This medication is used to control coughing that is exhausting and nonproductive (nothing is coughed up). It works on the brain to decrease the urge to cough. Hydrocodone is a narcotic medication and therefore can be habit-forming if taken for long periods of time.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

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What form(s) does this medication come in?

Syrup
Each 5 mL of red, wild-cherry-flavoured syrup contains 5 mg of hydrocodone bitartrate. Nonmedicinal ingredients: artificial cherry flavor, caramel syrup, FD&C Red No. 2, hydrochloric acid, methylparaben, propylparaben, purified water, sorbitol solution 70%, and sucrose. The syrup does not contain alcohol, lactose, sodium, sulfite, or tartrazine.

Tablets
Each white, scored tablet embossed with "HYCODAN" on one side and blank on the other side contains 5 mg of hydrocodone bitartrate. Nonmedicinal ingredients: cornstarch, lactose, pregelatinized tapioca starch, stearic acid, talc, and zinc stearate. The tablets do not contain sodium or tartrazine.

How should I use this medication?

Note: A cough is a symptom. Before taking a cough suppressant, it is important to assess the underlying cause of the cough.

Adults: The recommended dose of hydrocodone for adults and children over 12 years is 5 mg (1 teaspoonful [5 mL] or 1 tablet) not less than 4 hours apart, after meals and at bedtime with food or a glass of milk. Do not exceed 30 mg (6 doses) in a 24-hour period. The maximum single dose for adults is 15 mg (3 tablets or 15 mL).

The maximum single dose for children over 12 years is 10 mg (2 tablets or 10 mL).

Children (6 to 12 years): ;The recommended dose is 2.5 mg (one-half teaspoonful [2.5 mL] or one-half tablet) not less than 4 hours apart, after meals and at bedtime with food or a glass of milk. Do not exceed 15 mg (6 doses) in a 24-hour period. The maximum single dose is 5 mg (1 tablet or 5 mL).

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are using the medication without consulting your doctor.

It is important to take this medication exactly as prescribed by your doctor. If your doctor has told you to take this medication regularly and miss a dose, take it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store this medication at room temperature, protect it from light and moisture, and keep it out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

Who should NOT take this medication?

Do not take hydrocodone if you:

  • are allergic to hydrocodone or any ingredients of the medication
  • are allergic to any of the other "opioid"-type medications (e.g., morphine, codeine)
  • are having difficulty breathing
  • have an intracranial (inside the head) lesion associated with increased pressure inside the head

Do not give this medication to children less than 6 years of age.

What side effects are possible with this medication?

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

  • blurred vision
  • constipation (more common with long-term use)
  • dizziness
  • drowsiness
  • dry mouth
  • false sense of well-being
  • increased blood pressure
  • lightheadedness, or feeling faint when rising from a sitting or lying position
  • nausea
  • unusual tiredness or weakness
  • vomiting

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

  • difficulty urinating
  • fast, slow, or pounding heartbeat
  • feelings of anxiety, fear or unreality
  • irregular breathing
  • mood or mental changes
  • shortness of breath, wheezing, or troubled breathing

Stop taking the medication and seek immediate medical attention if any of the following occur:

  • signs of serious allergic reaction, e.g.:
    • abdominal cramps
    • difficulty breathing
    • nausea and vomiting
    • swelling of the face and throat
  • signs of overdose
    • cold, clammy skin
    • confusion
    • convulsions (seizures)
    • dizziness (severe)
    • drowsiness (severe)
    • low blood pressure
    • nervousness or restlessness (severe)
    • pinpoint-sized pupils of eyes
    • slow heartbeat
    • slow or troubled breathing
    • weakness (severe)

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Are there any other precautions or warnings for this medication?

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

HEALTH CANADA ADVISORY

July 28, 2016

Health Canada has issued new restrictions concerning the use of prescription hydrocodone . To read the full Health Canada Advisory, visit Health Canada's web site at www.hc-sc.gc.ca.

Abdominal (stomach) conditions: Hydrocodone, like other narcotic medications may make the diagnosis of abdominal conditions more difficult or it may worsen these conditions. If you have abdominal problems discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Breathing: Hydrocodone can suppress breathing. Children are more likely to experience serious breathing problems, including death. For this reason, this medication should not be given to children less than 6 years old. If you are at risk for breathing difficulties – for example, if you have asthma – discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Constipation: Hydrocodone can be very constipating. Eating a high-fibre diet and following good bowel habits will help to minimize this effect. If you develop constipation easily or have chronic constipation, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Dependence and withdrawal: This medication contains hydrocodone. Physical dependence, psychological dependence, and abuse have occurred with the use of hydrocodone. People with a history of past or current substance use problems may be at greater risk of developing abuse or addiction while taking this medication. Abuse is not a problem with people who require this medication for pain relief. If you suddenly stop taking this medication, you may experience withdrawal symptoms such as anxiety, sweating, trouble sleeping, shaking, pain, nausea, tremors, diarrhea, and hallucinations. If you have been taking this medication for a while, it should be stopped gradually as directed by your doctor.

Drowsiness/reduced alertness: Hydrocodone may cause drowsiness. Do not drive, operate machinery, or perform any potentially hazardous tasks until you know how this medication affects you.

Head injury: People with head injuries or increased pressure in the head may have a higher risk of experiencing side effects (breathing problems) or worsening of their condition while taking this medication. Discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Other medical conditions: People about to undergo surgery of the biliary tract should use caution while taking hydrocodone as it may worsen their condition. Hydrocodone will worsen the effects of acute alcohol intoxication and delirium tremens.

Sedation with other medications: Since the sedating effects of this medication are additive to those of other sedating medications, avoid drinking alcohol or taking sleeping pills, sedatives, psychotherapeutic agents, or other medications with sedating effects while you're taking this medication. Tell your doctor about all of the medications you take.

Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. Hydrocodone crosses into the placenta, where it can affect the developing baby. Babies born to mothers who have been taking this medication regularly prior to delivery are likely to be physically dependent on the medication. Withdrawal signs include irritability and excessive crying, tremors, hyperactive reflexes, increased respiratory rate, increased stools, sneezing, yawning, vomiting, and fever.

Breast-feeding: It is not known if hydrocodone passes into breast milk. If you are a breast-feeding mother and are taking this medication, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: Children are at increased risk of experiencing serious side effects such as breathing problems. This medication should only be given to older children if the benefits outweigh the risks. This medication is not recommended for children less than 6 years of age.

What other drugs could interact with this medication?

There may be an interaction between hydrocodone and any of the following:

  • abiraterone
  • aclidinium
  • alcohol
  • amiodarone
  • amphetamines (e.g., dextroamphetamine, lisdexamphetamine)
  • antihistamines (e.g,. cetirizine, doxylamine, diphenhydramine, hydroxyzine, loratadine)
  • antipsychotics (e.g., chlorpromazine, clozapine, haloperidol, olanzapine, quetiapine, risperidone)
  • aprepitant
  • asunaprevir
  • atorvastatin
  • atropine
  • azelastine
  • “azole” antifungals (e.g., itraconazole, ketoconazole, voriconazole)
  • barbiturates (e.g., butalbital, pentobarbital, phenobarbital)
  • belladonna
  • benzodiazepines (e.g., alprazolam, diazepam, lorazepam)
  • benztropine
  • bicalutamide
  • boceprevir
  • bosentan
  • bromocriptine
  • buspirone
  • calcium channel blockers (e.g., amlodipine, diltiazem, nifedipine, verapamil)
  • cannabis
  • carbamazepine
  • ceritinib
  • chloral hydrate
  • cimetidine
  • cinacalcet
  • ciprofloxacin
  • cocaine
  • conivaptan
  • crizotinib
  • cyclosporine
  • dabrafenib
  • danazol
  • dasatinib
  • deferasirox
  • desmopressin
  • dextromethorphan
  • diuretics (water pills; e.g., furosemide, hydrochlorothiazide, triamterene)
  • dronabinol
  • droperidol
  • ergot alkaloids (e.g., ergotamine, dihydroergotamine disopyramide)
  • enzalutamide
  • flavoxate
  • general anesthetics (medications used to put people to sleep before surgery)
  • ginkgo biloba
  • glycopyrrolate
  • goldenseal
  • grapefruit juice
  • hepatitis C antiviral combinations (e.g., ombitasvir - paritaprevir - ritonavir - dasabuvir, ombitasvir - paritaprevir - ritonavir)
  • HIV non-nucleoside reverse transcriptase inhibitors (NNRTIs; e.g., delaviridine, efavirenz, etravirine, nevirapine)
  • HIV protease inhibitors (e.g., atazanavir, indinavir, ritonavir, saquinavir)
  • imatinib
  • ipratropium
  • isoniazid
  • ketotifen
  • lapatinib
  • licorice
  • lithium
  • lomitapide
  • macrolide antibiotics (e.g., clarithromycin, erythromycin)
  • magnesium sulphate
  • metronidazole
  • mifepristone
  • mirtazapine
  • mitotane
  • modafinil
  • monoamine oxidase inhibitors (MAOIs; e.g., moclobemide, rasagiline, selegiline, tranylcypromine)
  • muscle relaxants (e.g., baclofen, cyclobenzaprine, methocarbamol, orphenadrine)
  • other narcotic medications (e.g., codeine, fentanyl, morphine, oxycodone)
  • nabilone
  • naltrexone
  • nefazodone
  • norfloxacin
  • octreotide
  • oxcarbazepine
  • oxybutynin
  • pazopanib
  • pegvisomant
  • perampanel
  • phenytoin
  • pramipexole
  • primidone
  • quinidine
  • ropinirole
  • rufinamide
  • St. John's wort
  • scopolamine
  • seizure medications (e.g., clobazam, ethosuximide, felbamate, levetiracetam, phenobarbital, phenytoin, primidone, topiramate, valproic acid, zonisamide)
  • serotonin/norepinephrine reuptake inhibitors (SNRIs; e.g., desvenlafaxine, duloxetine, venlafaxine)
  • selective serotonin reuptake inhibitors (SSRIs; e.g., citalopram, duloxetine, fluoxetine, paroxetine, sertraline)
  • siltuximab
  • simeprevir
  • terbinafine
  • tetracycline
  • tetrahydrocannabinol (THC)
  • ticagrelor
  • tiotropium
  • tocilizumab
  • tolterodine
  • trazodone
  • tricyclic antidepressants (e.g., clomipramine, desipramine, imipramine)
  • "triptan" migraine medications (e.g., almotriptan, eletriptan, sumatriptan)
  • tryptophan
  • umeclidinium
  • vemurafenib
  • zolpidem
  • zopiclone

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

  • stop taking one of the medications,
  • change one of the medications to another,
  • change how you are taking one or both of the medications, or
  • leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.