Hydrocodone
Q) What is Hydrocodone?
A) Hydrocodone is an effective
antitussive (anti-cough) agent, and as an opiate it is also an effective
analgesic for mild to moderate pain control. Five mg of Hydrocodone is
equivalent to 30 mg of codeine when administered orally. Early comparisons
concluded that Hydrocodone and morphine were equivalent for pain control in
humans. However, it is now considered that a dose of 15 mg (1/4 gr) of
Hydrocodone is equivalent to 10 mg (1/6 gr) of morphine. Hydrocodone is
considered to be morphine-like in all respects.
There are over 200 products
containing Hydrocodone in the U.S. In its most usual product forms Hydrocodone
is combined with acetaminophen (Vicodin, Lortab), but it is also combined with
aspirin (Lortab ASA), ibuprofen (Vicoprofen), and antihistamines (Hycomine).
Both tablet and liquid forms of Hydrocodone are available (e.g., Tussionex)
Hydrocodone will react as a normal opiate in the available field test kits.
Hydrocodone is abused for its
opiate-like effects. It is equivalent to morphine in relieving abstinence
symptoms from chronic morphine administration. The Schedule III status of
Hydrocodone-containing products has made them available to widespread diversion
by "bogus call-in prescriptions" and thefts. Three dosage forms are
typically found (5, 7.5, and 10 mg) and their behavioral effects can last up to
5 hours. The drug is most often administered orally. The growing awareness and
concern about AIDS and blood-borne pathogens easily transmitted by syringe
needle use, has made the oral bioavailability of Hydrocodone attractive to the
typical opiate abuser.
As with most opiates, the adverse
effects of Hydrocodone abuse are dependence and tolerance development. Its
co-formulation with acetaminophen has also increased the likelihood of
acetaminophen-induced hepatic necrosis with high dose acute dosing, but slow
escalation of dose over time seems to protect the liver during high dose
chronic exposures seen with this drug.
Q) How is Hydrocodone used?
A) Hydrocodone when abused is
taken orally, chewed, crushed (then snorted like cocaine), or crushed (then
dissolved in water and injected like heroin).
Hydrocodone-containing products
are in tablet, capsule and liquid forms. A variety of colors, markings, and
packaging are available.
The major source of Hydrocodone to the street has been through bogus call-in
and forged prescriptions, professional diversion through unscrupulous
pharmacists, doctors, and dentists, and large-scale thefts. The pills have been
sold for $2 to $10 per tablet and $20 to $40 per 8 oz bottle on the street.
Q) What are the effects of
Hydrocodone?
A)
|
anxiety |
constipation |
decreased mental & physical performance |
|
difficulty breathing |
difficulty urination |
dizziness |
|
drowsiness |
dry throat |
emotional dependence |
|
exaggerated feeling of depression |
extreme calm (sedation) |
exaggerated sense of well-being |
|
fear |
itching |
mental clouding |
|
mood changes |
nausea & vomiting |
rash |
|
restlessness |
sluggishness |
tightness in chest |
Q) Can you overdose on
Hydrocodone?
A) Yes, overdose of Hydrocodone
can be fatal. If you suspect an overdose, seek emergency treatment immediately.
Symptoms of a Hydrocodone overdose include:
…
bluish tinge to skin
…
cold clammy skin
…
extreme sleepiness
…
heavy perspiration
…
limp muscles
…
nausea & vomiting
…
slowed heartbeat or slowed breathing
Q) Is Hydrocodone addictive?
A) Yes, there has been an
increasing trend of abuse in non-Chronic Pain suffering persons. The abuser of
these drugs has been shown not to be the inner city youth, but instead a famous
actor, a suburban real estate agent, or your next door neighbor. First time
abuse of these drugs has been surging, most commonly with the oxycodone and
Hydrocodone type painkillers. The two differ slightly in their chemical makeup
but have a similar effect on the body.
Every age group has been affected
by the relative ease of Hydrocodone availability and the perceived safety of
these products by professionals. Sometimes seen as a "white-collar"
addiction, Hydrocodone abuse has increased among all ethnic and economic
groups. DAWN data demographics suggest that the most likely Hydrocodone abuser
is a 20-40 yr. old, white, female, who uses the drug because she is dependent
or trying to commit suicide. However, Hydrocodone-related deaths have been
reported from every age grouping.
Q) What are other medications that
include Hydrocodone?
A) BRAND NAMES (of Hydrocodone with
Acetaminophen):
Allay; Amacodone; Anexsia; Anolor Dh 5; Bancap-HC; Co-Gesic; Dolacet;
Dolagesic; Dolphen; Duocet; Gesic 5; Hy-5; Hy-Phen; Hyco-Pap; Hycomed; Hycotab;
Hydrocet;
Hydrocodone w/Acetaminophen;
Hydrogesic; Lorcet; Lorcet 10/650; Lorcide Panseals; Lortab; Margesic; Medipain
5; Megagesic; Megamor; Norcet; Oncet; Panacet; Polygesic; Propain Hc;
Ro-Codone; Rogesic #3; Senefen III; Stagesic; Tycolet; Ultragesic; Vanacet;
Vapocet; Vendone; Vicodin; Vicodin ES; Zydone
Hydrocodone w/Ibuprofen; Vicoprofen
Q) What are the statistics of
Hydrocodone abuse?
A)
Hydrocodone abuse has been escalating over the last decade. There has been
large scale diversion of Hydrocodone. For example, an estimated 7 million dosage
units were diverted in 1994 and over 11 million in 1997. In 1998 there were
over 56 million new prescriptions written for Hydrocodone products and by 2000
there were over 89 million. From 1990 the average consumption nationwide has
increased by 300%. In the same period there has been a 500% increase in the
number of Emergency Department visits attributed to Hydrocodone abuse with
19,221 visits estimated in 2000. In 1997, there were over 1.3 million
Hydrocodone tablets seized and analyzed by the DEA laboratory system. A recent
petition submitted to the DEA has requested a review of the control status of
all Hydrocodone-containing products.
Hydrocodone bitartrate and
Acetaminophen
Hydrocodone bitartrate and Acetaminophen
Hydrocodone bitartrate and Acetaminophen
(high-droh-KOH-dohn, ah-seat-ah-MIN-oh-fen)
Pregnancy Category: C
Classification: Analgesic
See Also: See also Narcotic
Analgesics and Acetaminophen.
Content: Anexia 5/500:
Hydrocodone bitartrate, 5 mg, and Acetaminophen, 500 mg. Anexia 10/650 and
Lorcet 10/650: Hydrocodone bitartrate, 10 mg, and Acetaminophen, 650 mg. Anexia
7.5/650 and Lorcet Plus: Hydrocodone bitartrate, 7.5 mg, and Acetaminophen,
650 mg. Lortab 10/500: Hydrocodone bitartrate, 10 mg, and Acetaminophen,
500 mg. Zodone:Hydrocodone bitartrate 5 mg, 7.5 mg, or 10 mg with
Acetaminophemn, 400 mg.
Note: Hydrocodone bitartrate is a narcotic analgesic and Acetaminophen
is a nonnarcotic analgesic.
Action/Kinetics: Hydrocodone
produces its analgesic activity by an action on the CNS via opiate receptors.
The analgesic action of acetaminophen is produced by both peripheral and
central mechanisms.
Uses: Relief of moderate
to moderately severe pain.
Contraindications:
Hypersensitivity to acetaminophen or hydrocodone. Lactation.
Special Concerns: Use with
caution, if at all, in clients with head injuries as the CSF pressure may be
increased further. Use with caution in geriatric or debilitated clients; in
those with impaired hepatic or renal function; in hypothyroidism, Addison's
disease, prostatic hypertrophy, or urethral stricture; and in clients with
pulmonary disease. Use shortly before delivery may cause respiratory depression
in the newborn. Safety and efficacy have not been determined in children.
Side Effects: CNS: Lightheadedness,
dizziness, sedation, drowsiness, mental clouding, lethargy, impaired mental and
physical performance, anxiety, fear, dysphoria, psychologic dependence, mood
changes. GI: N&V. Respiratory: Respiratory depression
(dose-related), irregular and periodic breathing. GU: Ureteral spasm,
spasm of vesical sphincters, urinary retention.
Overdose Management: Symptoms:
Acetaminophen overdose may result in potentially fatal hepatic
necrosis. Also, renal tubular necrosis, hypoglycemic coma, and
thrombocytopenia. Symptoms of hepatotoxic overdose include N&V,
diaphoresis, and malaise. Symptoms of hydrocodone overdose include respiratory
depression, somnolence progressing to stupor or coma
skeletal muscle flaccidity, cold and clammy skin, bradycardia, and hypotension.
Severe overdose may cause apnea, circulatory collapse, cardiac
arrest, and death. Treatment (Acetaminophen):
Treatment (Hydrocodone):
Drug Interactions: 
Risk
of paralytic ileus 
Effect
of either the narcotic or the antidepressantEffect
of either the narcotic or the antidepressant
How Supplied: See Content
Dosage
ïTablets Analgesia.
1 tablet of Anexsia 7.5/650, Lorcet 10/650, or Lorcet Plus q 4-6 hr as needed
for pain. The total 24-hr dose should not exceed 6 tablets. 1-2 tablets of
Anexsia 5/500 q 4-6 hr as needed for pain. The total 24-hr dose should not
exceed 8 tablets.