HYDROCODONE BITARTRATE
| HYDROCODONE BITARTRATE (hye-droe-koe'done) Dihydrocodeinone Bitartrate, Hycodan, Robidone A, Vicodin (with acetaminophen) Classifications: narcotic (opiate) agonist analgesic; antitussive; Therapeutic: narcotic analgesic Prototype: Morphine Pregnancy Category: C Controlled Substance: Schedule III |
Availability
5 mg hydrocodone usually with 500 mg or more acetaminophen
Action
Morphine derivative similar to codeine but more addicting and with slightly greater antitussive activity, and analgesic effect. CNS depressant with moderate to severe relief of pain. Available in the United States only in combination with other drugs.
Therapeutic Effect
Suppresses cough reflex by direct action on cough center in medulla. CNS depressant with moderate to severe relief of pain.
Uses
Symptomatic relief of hyperactive or nonproductive cough and for relief of moderate to moderately severe pain. A common ingredient in a variety of proprietary mixtures.
Contraindications
Hypersensitivity to hydrocodone; children <2 y; pregnancy (category C); acute or severe asthmatic bronchitis; COPD; upper airway obstruction; lactation.
Cautious Use
Respiratory depression, asthma, emphysema; history of drug abuse or dependence; postoperative patients; hepatic or renal disease; renal impairment or failure; older adults, debilitated patients; children <1 y; patients; children weighing <50 kg; G6PD deficiency; GI disease; patients with preexisting increased intracranial pressure.
Route & Dosage
| Mild to Moderate Pain, Cough Adult: PO 5–10 mg q4–6h prn (max: 15 mg/dose) Child (2–12 y): PO 1.25–5 mg q4–6h (max: 10 mg/dose) |
Administration
Oral- Give with food or milk to prevent GI irritation.
- Preserve in tight, light-resistant containers.
Adverse Effects (≥1%)
GI: Dry mouth, constipation, nausea, vomiting. CNS: Light-headedness, sedation, dizziness, drowsiness, euphoria, dysphoria. Respiratory: Respiratory depression. Skin: Urticaria, rash, pruritus.Interactions
Drug: Alcohol and other cns depressants compound sedation and CNS depression. Herbal: St. John's wort increases sedation.Pharmacokinetics
Onset: 10–20 min. Duration: 3–6 h. Distribution: Crosses placenta; distributed into breast milk. Metabolism: In liver. Elimination: In urine. Half-Life: 3.8 h.Nursing Implications
Assessment & Drug Effects
- Monitor for effectiveness of drug for pain relief.
- Monitor for nausea and vomiting, especially in ambulatory patients.
- Monitor respiratory status and bowel elimination.
Patient & Family Education
- Avoid hazardous activities until response to drug is determined.
- Do not use alcohol or other CNS depressants; may cause additive CNS depression.
- Drink plenty of liquids for adequate hydration.
- Do not take larger doses than prescribed since abuse potential is high.
Common adverse effects in italic, life-threatening effects underlined; generic names in bold; classifications in SMALL CAPS; 
Canadian drug name; 
Prototype drug