Hydrocodone
 NAME OF DRUG: Hydrocodone (Vicodin, Hycodan, dihydrocodeinone, Dicodid, Coditrate) |
| PHYSICAL CHARACTERISTICS: Hydrocodone is an opioid analgesic and antitussive and occurs as fine, white crystals or as crystalline powder. Additionally, it is affected by light. |
| DOSAGE/OCCURRENCE/USAGE: Hydrocodone is a semisynthetic narcotic analgesic prepared from codeine with multiple actions qualitatively similar to those of codeine. It is mainly used as an antitussive in cough syrups and tablets in sub-analgesic doses (2.5 – 5 mg). Additionally, it is used for the relief of moderate to moderately severe pain. Hydromorphone is administered orally in 5 - 10 mg doses four times daily. |
| BLOOD CONCENTRATIONS VS. DOSAGE: Therapeutic plasma concentration is 1 – 30 ng/mL and the toxic plasma concentration is greater than 100 ng/mL. After oral administration of 10 mg of bitartrate, peak serum concentrations averaged 0.024 mg/L at 1.5 hours. The concentration declined to 0.007 mg/L by 8 hours and the terminal serum half-life was 3.8 hour. |
| URINE EXCRETION RATE: Hydrocodone is metabolized by O- and N- demethylation and reduction of the 6-keto group. About 26% of a single dose is excreted in a 72 hour urine collection that consists of unchanged drug (12%), norhydrocodone (5%), conjugated hydrocodone (4%), 6-hydrocodol (3%), and conjugated 6-hydromorphol (0.1%). |
| METABOLITES: Unchanged drug, norhydrocodone, conjugated hydrocodone, 6-hydrocodol, and conjugated 6-hydromorphol. |
| TOXICITY: At high doses or in sensitive patients, hydrocodone may produce dose-related respiratory depression by acting on the brain stem respiratory center. Hydrocodone may produce irregular and periodic breathing due to its affect on the center that controls respiratory rhythm. |
| REFERENCES:
Baselt, R C. Disposition of Toxic Drugs and Chemicals in Man, Second Edition. Davis,
Calif.: Biomedical Publications, 1982. Physicians’ Desk Reference, Forty-Eight Edition. Montvale, NJ: Medical Economics Data Production Company, 1994. Goldberger, Bruce A. Opiates Abused Drugs Monograph Series. Ed. Caplan, Yale H. Irving, TX: Abbott Laboratories, 1994. |