Editing Hydrocodone (section)

== Medical uses ==
Hydrocodone is used to treat moderate to severe pain. In liquid formulations, it is used to treat cough.<ref name=AHFS2019/> In one study comparing the potency of hydrocodone to that of [[oxycodone]], it was found that it took 50% more hydrocodone to achieve the same degree of miosis (pupillary contraction).<ref name="pmid19118954">{{cite journal | vauthors = Zacny JP, Gutierrez S | title = Within-subject comparison of the psychopharmacological profiles of oral hydrocodone and oxycodone combination products in non-drug-abusing volunteers | journal = Drug and Alcohol Dependence | volume = 101 | issue = 1–2 | pages = 107–114 | date = April 2009 | pmid = 19118954 | doi = 10.1016/j.drugalcdep.2008.11.013 | url = https://zenodo.org/record/896375 | access-date = 25 August 2020 | archive-date = 18 January 2021 | archive-url = https://web.archive.org/web/20210118203050/https://zenodo.org/record/896375 | url-status = live }}</ref> The investigators interpreted this to mean that oxycodone is about 50% more potent than hydrocodone.

However, in a study of [[emergency department]] patients with fractures, it was found that an equal amount of either drug provided about the same degree of pain relief, indicating that there is little practical difference between them when used for that purpose.<ref name="pmid15805317">{{cite journal | vauthors = Marco CA, Plewa MC, Buderer N, Black C, Roberts A | title = Comparison of oxycodone and hydrocodone for the treatment of acute pain associated with fractures: a double-blind, randomized, controlled trial | journal = Academic Emergency Medicine | volume = 12 | issue = 4 | pages = 282–288 | date = April 2005 | pmid = 15805317 | doi = 10.1197/j.aem.2004.12.005 | doi-access = free }}</ref> Some references state that the analgesic action of hydrocodone begins in 20–30 minutes and lasts about 4–8 hours.<ref name="pmid21785485">{{cite journal | vauthors = Vallejo R, Barkin RL, Wang VC | title = Pharmacology of opioids in the treatment of chronic pain syndromes | journal = Pain Physician | volume = 14 | issue = 4 | pages = E343–E360 | date = 2011 | pmid = 21785485 | doi = 10.36076/ppj.2011/14/E343 | doi-access = free }}</ref> The manufacturer's information says onset of action is about 10–30 minutes and duration is about 4–6 hours.<ref name="Drugs.com-MMX-Vicodin">{{cite web |url=https://www.drugs.com/mmx/vicodin.html |title=Opioid (Narcotic Analgesics and Acetaminophen Systemic ) |access-date=22 March 2014 |archive-date=22 March 2014 |archive-url=https://web.archive.org/web/20140322074358/http://www.drugs.com/mmx/vicodin.html |url-status=dead }}</ref> Recommended dosing interval is 4–6 hours. Hydrocodone reaches peak serum levels after 1.3 hours.<ref>{{Cite web |date=18 October 2013 |title=Labeling-Package Insert: Hydrocodone/acetaminophen 7.5 mg/325 mg |url=https://www.accessdata.fda.gov/drugsatfda_docs/label/2013/040432s006,40556s012,40658s006,%2040846s005,%2089699s044lbl.pdf |access-date=22 January 2024 |website=Drugs@FDA: FDA-Approved Drugs |publisher=Chartwell |archive-date=27 April 2024 |archive-url=https://web.archive.org/web/20240427134028/https://www.accessdata.fda.gov/drugsatfda_docs/label/2013/040432s006,40556s012,40658s006,%2040846s005,%2089699s044lbl.pdf |url-status=live }}</ref>

===Available forms===
{{See also|Hydrocodone/paracetamol|Hydrocodone/ibuprofen|Hydrocodone/aspirin}}

Hydrocodone is available in a variety of formulations for oral administration:<ref name="McPherson2009">{{cite book|vauthors=McPherson ML|chapter=Appendix: Opioid Formulations|title=Demystifying Opioid Conversion Calculations: A Guide for Effective Dosing|chapter-url=https://books.google.com/books?id=6oBA9z5wl9wC&pg=PA187|date=24 August 2009|publisher=ASHP|isbn=978-1-58528-297-5|pages=187–188|access-date=23 September 2016|archive-date=12 January 2023|archive-url=https://web.archive.org/web/20230112203400/https://books.google.com/books?id=6oBA9z5wl9wC&pg=PA187|url-status=live}}</ref><ref name="Odom-ForrenDrain2008">{{cite book|vauthors=Odom-Forren J, Drain C|title=PeriAnesthesia Nursing: A Critical Care Approach|url=https://books.google.com/books?id=2DxxrrJafncC&pg=PT751|date=11 February 2008|publisher=Elsevier Health Sciences|isbn=978-1-4377-2610-7|pages=751–|access-date=23 September 2016|archive-date=12 January 2023|archive-url=https://web.archive.org/web/20230112203347/https://books.google.com/books?id=2DxxrrJafncC&pg=PT751|url-status=live}}</ref><ref name="Skidmore-Roth2013">{{cite book|vauthors=Skidmore-Roth L|chapter=Hydrocodone|title=Mosby's Drug Guide for Nursing Students, with 2014 Update|chapter-url=https://books.google.com/books?id=r71EBAAAQBAJ&pg=PA524|date=27 June 2013|publisher=Elsevier Health Sciences|isbn=978-0-323-22268-6|pages=524–|access-date=23 September 2016|archive-date=12 January 2023|archive-url=https://web.archive.org/web/20230112203414/https://books.google.com/books?id=r71EBAAAQBAJ&pg=PA524|url-status=live}}</ref>

* The original oral form of hydrocodone alone, Dicodid, as immediate-release 5- and 10-mg tablets is available for prescription in Continental Europe per national drug control and prescription laws and Title 76 of the Schengen Treaty, but [[dihydrocodeine]] has been more widely used for the same indications since the beginning in the early 1920s, with hydrocodone being regulated the same way as [[morphine]] in the German [[Betäubungsmittelgesetz]], the similarly named law in Switzerland and the Austrian [[Suchtmittelgesetz]], whereas dihydrocodeine is regulated like [[codeine]]. For a number of decades, the liquid hydrocodone products available have been cough medicines.
* Hydrocodone plus [[homatropine]] (Hycodan) in the form of small tablets for coughing and especially neuropathic moderate pain (the homatropine, an anticholinergic, is useful in both of those cases and is a deterrent to intentional overdose) was more widely used than Dicodid and was labelled as a cough medicine in the United States whilst Vicodin and similar drugs were the choices for analgesia.
* Extended-release hydrocodone in a time-release syrup also containing chlorphenamine/[[chlorpheniramine]] is a cough medicine called Tussionex in North America. In Europe, similar time-release syrups containing codeine (numerous), dihydrocodeine (Paracodin Retard Hustensaft), nicocodeine (Tusscodin), [[thebacon]], [[acetyldihydrocodeine]], [[dionine]], and [[nicodicodeine]] are used instead.
* Immediate-release hydrocodone with [[paracetamol]] (acetaminophen) (Vicodin, Lortab, Lorcet, Maxidone, Norco, Zydone)
* Immediate-release hydrocodone with [[ibuprofen]] (Vicoprofen, Ibudone, Reprexain)
* Immediate-release hydrocodone with [[aspirin]] (Alor 5/500, Azdone, Damason-P, Lortab ASA, Panasal 5/500)
* Controlled-release hydrocodone (Hysingla ER by [[Purdue Pharma]], Zohydro ER)<ref name="VadiveluSchermer2016">{{cite journal | vauthors = Vadivelu N, Schermer E, Kodumudi G, Berger JM | title = The Clinical Applications of Extended-Release Abuse-Deterrent Opioids | journal = CNS Drugs | volume = 30 | issue = 7 | pages = 637–646 | date = July 2016 | pmid = 27290716 | doi = 10.1007/s40263-016-0357-0 | s2cid = 26878027 }}</ref>
Hydrocodone is not available in [[parenteral]] or any other non-oral forms.<ref name="ChabnerLongo2010" /><ref name="ElliottSmith2016" />