Hydrocodone extended-release is a strong opioid pain medicine used to manage severe and long-lasting pain that requires around-the-clock treatment. It is prescribed when other pain medicines have not worked or cannot be tolerated.
Typical Cost
$150-$400/month
Status
C-II
Generic
Available
Codeine sulfate is the lowest-cost Opioid Analgesics at $10–$50/month/month
Uses & Indications
Hydrocodone bitartrate extended-release is indicated for the management of severe and persistent pain that requires daily, around-the-clock, long-term opioid treatment and for which alternative treatment options are inadequate. This medication is not intended for as-needed pain relief or for mild to moderate pain. It should only be prescribed by healthcare professionals experienced in the use of potent opioids for chronic pain management, and only when the potential benefits outweigh the risks of opioid use.
Dosage & Administration
Hydrocodone bitartrate extended-release is administered orally, typically once every 12 hours. The dosage must be individualized based on the patient's prior opioid exposure, level of pain, and response to treatment, starting with the lowest effective dose. Due to the extended-release formulation, tablets must be swallowed whole and not chewed, crushed, or dissolved, as this can lead to rapid release and absorption of a potentially fatal dose of hydrocodone. Dosage adjustments should be made cautiously, with close monitoring for adverse effects and efficacy.
How It Works
Hydrocodone is a full opioid agonist with a high affinity for mu-opioid receptors in the central nervous system. Its primary mechanism of action involves binding to these receptors, which leads to the inhibition of ascending pain pathways, altering the perception of and response to pain. This binding also produces generalized central nervous system depression, which contributes to its analgesic effects but also to its potential for respiratory depression and sedation.
Warnings & Precautions
Serious warnings include the risk of addiction, abuse, and misuse, which can lead to overdose and death. Life-threatening respiratory depression, especially during initiation or following a dose increase, is a significant concern. Accidental ingestion, particularly by children, can be fatal. Concomitant use with benzodiazepines or other central nervous system depressants can result in profound sedation, respiratory depression, coma, and death. Neonatal opioid withdrawal syndrome may occur with prolonged use during pregnancy.
Contraindications
Hydrocodone extended-release is contraindicated in patients with significant respiratory depression, acute or severe bronchial asthma in an unmonitored setting or in the absence of resuscitative equipment, known or suspected paralytic ileus, and hypersensitivity to hydrocodone or any component of the formulation. It is also contraindicated in patients who are not opioid-tolerant, as the extended-release formulation delivers a high dose of opioid that could be fatal.
Frequently Asked Questions
What is the main difference between Zohydro ER and Vicodin/Norco?
Zohydro ER contains only hydrocodone in an extended-release formulation, meaning it provides pain relief over a longer period. Vicodin and Norco are immediate-release combination products that contain hydrocodone along with acetaminophen (Tylenol).
Can I crush or chew Zohydro ER tablets?
No, you must swallow Zohydro ER tablets whole. Crushing, chewing, or dissolving the tablets can cause a rapid release of the entire dose of hydrocodone, leading to a potentially fatal overdose.
How often do I take Zohydro ER?
Zohydro ER is typically taken once every 12 hours. It's important to follow your doctor's specific dosing instructions and not to take more than prescribed.
What should I do if I miss a dose?
If you miss a dose, take it as soon as you remember, unless it is almost time for your next dose. In that case, skip the missed dose and resume your regular dosing schedule. Do not take two doses at once to make up for a missed dose.
Are there any foods or drinks I should avoid while taking Zohydro ER?
You should avoid consuming alcohol while taking Zohydro ER, as it can increase the risk of serious side effects like respiratory depression, sedation, and coma. Grapefruit juice may also interact with hydrocodone, so it's best to avoid it.
Medical Disclaimer
The information on RxGuide is intended for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician, pharmacist, or other qualified health provider with any questions you may have regarding a medical condition or medication. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.