Hydrocodon

Hydrocodone, sometimes spelled hydrocodon in informal usage, is an opioid analgesic used to relieve moderate to severe pain. It is commonly prescribed in formulations that combine hydrocodone with acetaminophen or ibuprofen, enhancing analgesia while limiting the opioid dose. In some products, hydrocodone is also used as an antitussive (cough suppressant). It is a semisynthetic derivative of codeine and was introduced in the mid-20th century.

Administration forms include immediate-release tablets and capsules, extended-release formulations for chronic pain, and oral solutions. The most common combination products pair hydrocodone with acetaminophen (for example, hydrocodone/acetaminophen). Because of abuse potential, hydrocodone formulations are tightly regulated in many countries. Cough-suppressant formulations containing hydrocodone exist but are less common today and are restricted in many jurisdictions.

Hydrocodone acts as a mu-opioid receptor agonist, providing analgesia and, at higher doses, sedation and euphoria. It is metabolized in the liver by enzymes including CYP2D6, which converts it to hydromorphone (an active metabolite), and CYP3A4, which forms norhydrocodone (less active). Genetic variations in CYP2D6 and drug interactions can alter analgesic effects and the risk of adverse effects.

Common adverse effects include constipation, nausea, drowsiness, and dizziness. Serious risks include respiratory depression, dependence, tolerance, withdrawal symptoms, and overdose. Safety concerns are heightened with concurrent alcohol or other central nervous system depressants. Naloxone can reverse an opioid overdose. Hydrocodone-containing products are controlled substances in many countries; in the United States they are Schedule II, reflecting high abuse potential. Use during pregnancy may cause neonatal opioid withdrawal syndrome.

Hydrocodone is a semisynthetic opioid derived from codeine, developed in the 20th century and widely used in the latter half of the century. Regulatory changes in the 2010s increased controls on hydrocodone-containing products to curb misuse.