Hydrocodone

Hydrocodone
Clinical data
Trade namesHysingla ER, Zohydro ER
Other namesDihydrocodeinone, hydrocodone bitartrate
AHFS/Drugs.comMonograph
MedlinePlusa601006
License data
Dependence
liability
High
Addiction
liability
High
Routes of
administration
Clinical: By mouth
Others: Intranasal, rectal
Drug classOpioid
ATC code
Legal status
Legal status
Pharmacokinetic data
BioavailabilityOral: 70%
Protein bindingLow
MetabolismLiver: CYP3A4 (major), CYP2D6 (minor)
MetabolitesNorhydrocodone
Hydromorphone
Others
Onset of action10–20 minutes
Elimination half-lifeAverage: 3.8 hours
Range: 3.3–4.4 hours
Duration of action4–8 hours
ExcretionUrine
Identifiers
  • 4,5α-epoxy-3-methoxy-17-methylmorphinan-6-one
CAS Number
PubChem CID
IUPHAR/BPS
DrugBank
ChemSpider
UNII
KEGG
ChEBI
ChEMBL
CompTox Dashboard (EPA)
ECHA InfoCard100.004.304
Chemical and physical data
FormulaC18H21NO3
Molar mass299.370 g·mol−1
3D model (JSmol)
  • O=C4[C@@H]5Oc1c2c(ccc1OC)C[C@H]3N(CC[C@]25[C@H]3CC4)C
  • InChI=1S/C18H21NO3/c1-19-8-7-18-11-4-5-13(20)17(18)22-16-14(21-2)6-3-10(15(16)18)9-12(11)19/h3,6,11-12,17H,4-5,7-9H2,1-2H3/t11-,12+,17-,18-/m0/s1 Y
  • Key:LLPOLZWFYMWNKH-CMKMFDCUSA-N Y
  (verify)

Hydrocodone, also known as dihydrocodeinone, is a semi-synthetic opioid used to treat pain and as a cough suppressant. It is taken by mouth. Typically, it is dispensed as the combination acetaminophen/hydrocodone or ibuprofen/hydrocodone for pain severe enough to require an opioid and in combination with homatropine methylbromide to relieve cough. It is also available by itself in a long-acting form sold under the brand name Zohydro ER, among others, to treat severe pain of a prolonged duration. Hydrocodone is a controlled drug: in the United States, it is classified as a Schedule II Controlled Substance.

Common side effects include dizziness, sleepiness, nausea, and constipation. Serious side effects may include low blood pressure, seizures, QT prolongation, respiratory depression, and serotonin syndrome. Rapidly decreasing the dose may result in opioid withdrawal. Use during pregnancy or breastfeeding is generally not recommended. Hydrocodone is believed to work by activating opioid receptors, mainly in the brain and spinal cord. Hydrocodone 10 mg is equivalent to about 10 mg of morphine by mouth.

Hydrocodone was patented in 1923, while the long-acting formulation was approved for medical use in the United States in 2013. It is most commonly prescribed in the United States, which consumed 99% of the worldwide supply as of 2010. In 2018, it was the 402nd most commonly prescribed medication in the United States, with more than 400,000 prescriptions. Hydrocodone is a semi-synthetic opioid, converted from codeine or less often from thebaine. Production using genetically engineered yeasts has been developed but is not used commercially.