Hydrocodone
Pronunciation: (hye-droe-KOE-done).
- Generic name
- Hydrocodone
- Brand names
- Teva-Hydrocodone, Norco, Ratio-Hydrocodone, Hysingla ER, Zohydro ER, Hydrocan
- Drug class
- Opioid analgesic
Availability and supply rules vary by country
Trade names by country: United States · Canada
Australia: · Full directory
What Hydrocodone is and how it works
Uses, formulations, monitoring, and supply rules can differ by patient, product, and country. Follow the exact local product information and professional advice.
Mechanism of action: how Hydrocodone works
Hydrocodone is a semi-synthetic opioid agonist that primarily binds to mu-opioid receptors in the central nervous system. This binding inhibits ascending pain pathways, alters the perception of and response to pain, and produces generalized CNS depression. It also suppresses the cough reflex by direct action on the cough center in the medulla. (1)
What Hydrocodone is used for
Pain relief (moderate to severe)
Used for pain severe enough to require an opioid and for which alternative treatments are inadequate; often combined with acetaminophen or ibuprofen for enhanced pain relief. (2)
Cough suppression
Used in certain combination formulations to suppress cough, via direct action on the cough center in the brainstem. (2)
Before taking Hydrocodone
Do not take / not appropriate for
- significant respiratory depression, acute or severe bronchial asthma, known or suspected gastrointestinal obstruction (including paralytic ileus), and hypersensitivity to hydrocodone. (Contraindication) (2)
Tell your clinician about
(2)How to take Hydrocodone
- General Instructions: Take hydrocodone exactly as prescribed by your healthcare provider. Do not take more than the recommended dose or use it for longer than directed.. Adult Dosing: Typical starting dose for pain (immediate-release): 5–10 mg orally every 4–6 hours as needed. Extended-release formulations are dosed once or twice daily, individualized based on pain severity and previous opioid use.. Pediatric Dosing: Hydrocodone is generally not recommended for children under 18 years. Use in pediatric patients should be guided by a specialist and is rare.. Administration: Swallow tablets or capsules whole with water. Do not crush, chew, or dissolve extended-release tablets. Take with or without food, but take with food if stomach upset occurs.. When To Stop: Do not stop hydrocodone suddenly if you have been taking it regularly for more than a few days; consult your doctor for a gradual dose reduction to prevent withdrawal symptoms.. Storage: Store at room temperature, away from moisture and heat. Keep out of reach of children and in a secure place to prevent misuse.
- This page does not provide a dose calculator. Dosing must follow the prescriber, pharmacist, or product label.
Procedures and treatment changes
Tell the treating team before surgery, procedures, or any medicine change. Do not alter treatment without the responsible clinician. (2)
Missed dose
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and resume your regular schedule. Do not take two doses at once.
Overdose
An overdose of hydrocodone can be fatal, especially in children or anyone using it without a prescription. Symptoms include extreme drowsiness, slow or shallow breathing, pinpoint pupils, and loss of consciousness. Call emergency services or poison control immediately. Naloxone may be used as an antidote. (2)
Side effects
Side effects and their urgency vary; report severe, persistent, or concerning symptoms to a healthcare professional.
Nausea
Incidence: Reported in the clinician-authored database; frequency not established
Vomiting
Incidence: Reported in the clinician-authored database; frequency not established
Constipation
Incidence: Reported in the clinician-authored database; frequency not established
Drowsiness
Incidence: Reported in the clinician-authored database; frequency not established
Dizziness
Incidence: Reported in the clinician-authored database; frequency not established
Respiratory depression
Incidence: Reported in the clinician-authored database; frequency not established
Addiction
Incidence: Reported in the clinician-authored database; frequency not established
Lightheadedness
Incidence: Common (per FDA label)
Slow, shallow, or difficult breathing; extreme drowsiness or difficulty waking; pinpoint pupils — this is an FDA boxed-warning-level emergency
Incidence: Seek emergency help immediately; this can be life-threatening
For combination products containing acetaminophen: signs of liver problems (yellowing skin/eyes, dark urine, severe fatigue, abdominal pain)
Incidence: Rare but can be serious, especially if total daily acetaminophen from all sources exceeds 4,000 mg
Serious warnings
FDA BOXED WARNING (the label's highest-level safety warning) — serious
Symptoms: FDA BOXED WARNING (the label's highest-level safety warning): (1) Hydrocodone exposes users to the risks of opioid addiction, abuse, and misuse, which can lead to overdose and death. (2) Serious, life-threatening, or fatal respiratory depression may occur, with the greatest risk at the start of treatment or after a dose increase. (3) Accidental ingestion of even one dose, especially by a child, can be fatal — store and dispose of this medicine securely. (4) Prolonged use during pregnancy can cause neonatal opioid withdrawal syndrome in the newborn, which can be life-threatening if not recognized and treated. (5) Using CYP3A4 inhibitors together with hydrocodone can dangerously raise hydrocodone levels. (6) Using hydrocodone together with benzodiazepines or other CNS depressants (including alcohol) can cause profound sedation, respiratory depression, coma, and death.
Action: Follow the urgency stated and seek prompt or emergency care when indicated. (2)
FDA BOXED WARNING FOR ACETAMINOPHEN-CONTAINING COMBINATION PRODUCTS — serious
Symptoms: FDA BOXED WARNING FOR ACETAMINOPHEN-CONTAINING COMBINATION PRODUCTS: when hydrocodone is combined with acetaminophen (a very common combination), acetaminophen has been associated with cases of acute liver failure, sometimes resulting in liver transplant or death, particularly when the total daily acetaminophen dose from all sources exceeds 4,000 mg. Check every other medicine you take (including over-the-counter cold and pain products) for acetaminophen content to avoid exceeding this limit.
Action: Follow the urgency stated and seek prompt or emergency care when indicated. (2)
Hydrocodone products are a DEA Schedule II controlled substance in the United States, reflecting a high potential for abuse and dependence — serious
Symptoms: Hydrocodone products are a DEA Schedule II controlled substance in the United States, reflecting a high potential for abuse and dependence; prescriptions are subject to stricter legal controls (for example, no telephone refills) than many other medications.
Action: Follow the urgency stated and seek prompt or emergency care when indicated. (2)
Contraindications recorded in the clinician database — serious
Symptoms: Contraindications recorded in the clinician database: Contraindications include significant respiratory depression, acute or severe bronchial asthma, known or suspected gastrointestinal obstruction (including paralytic ileus), and hypersensitivity to hydrocodone (or to acetaminophen, for combination products). Use with caution in elderly, debilitated patients, those with hepatic or renal impairment, head injury, increased intracranial pressure, seizure disorders, or a history of substance use disorder.
Action: Follow the urgency stated and seek prompt or emergency care when indicated. (2)
Interactions
| Medicine or test | Effect | Action |
|---|---|---|
| Recorded interactions | Hydrocodone may interact with other medications that depress the central nervous system, such as benzodiazepines, other opioids, alcohol, sedatives, muscle relaxants, and certain antidepressants. CYP3A4 inhibitors (e.g., ketoconazole, erythromycin) can increase hydrocodone levels, while CYP3A4 inducers (e.g., rifampin, phenytoin) can decrease its effectiveness. Always inform your healthcare provider about all medicines and supplements you are taking. | (1) |
Pregnancy, breastfeeding, kidney/liver function, age
Pregnancy
Prolonged use of hydrocodone during pregnancy can cause neonatal opioid withdrawal syndrome in the newborn, which can be life-threatening if not recognized and treated promptly by the baby's care team. This is an FDA boxed-warning-level risk. Any use during pregnancy should be discussed with, and directed by, the treating clinician, who can weigh pain-management needs against this risk and consider alternatives where appropriate. (2)
Breastfeeding
Hydrocodone passes into human breast milk. If a breastfeeding parent takes hydrocodone, the infant should be watched for excessive sleepiness, unusual limpness, or breathing difficulty, and any of these should prompt urgent medical attention. Discuss breastfeeding plans with the treating clinician before and during use. (2)
Children
Frequency: Not applicable. Weight Based: Not recommended for pediatric use. Max Daily Dose: Not applicable. Max Single Dose: Not applicable. Age Restrictions: Safety not established in children (2)
Renal_impairment
Use with added caution and closer monitoring in patients with hepatic or renal impairment, since drug clearance can be reduced and side effects (including sedation and respiratory depression) may be more pronounced; the prescribing clinician individualizes the dose in this situation. (2)
Hepatic_impairment
Use with added caution and closer monitoring in patients with hepatic or renal impairment, since drug clearance can be reduced and side effects (including sedation and respiratory depression) may be more pronounced; the prescribing clinician individualizes the dose in this situation. (2)
Monitoring
(2)Storage
Store at room temperature, away from moisture and heat, in a secure location out of reach of children and others (this is a controlled substance with high misuse potential). When no longer needed, the FDA recommends disposing of unused hydrocodone tablets promptly, such as by flushing them down the toilet or using a drug take-back program, rather than leaving them in the household.
Professional information
Clinician-facing context only. This section does not replace current product labeling.
General
Indication: Pain relief (moderate to severe)
Dose summary: 10 mg to 20 mg orally every 4 to 6 hours as needed for pain
Renal context: No fixed renal-impairment dose reduction is specified; the prescriber typically starts with a lower dose and titrates more cautiously, since drug clearance and side-effect risk (sedation, respiratory depression) can be increased in renal impairment. (1) (2)
Frequently asked questions
What is hydrocodone used for?
Hydrocodone is used to relieve moderate to severe pain that is not controlled by non-opioid pain relievers. It is sometimes also used to suppress cough in certain formulations.
Is hydrocodone addictive?
Yes, hydrocodone has a high potential for addiction, abuse, and misuse. It should only be used as prescribed and for the shortest duration necessary.
Can I drink alcohol while taking hydrocodone?
No, drinking alcohol while taking hydrocodone increases the risk of severe side effects, including life-threatening respiratory depression.
What should I do if I miss a dose?
Take the missed dose as soon as you remember, unless it is almost time for your next dose. Do not double up doses.
How should hydrocodone be stored?
Store hydrocodone at room temperature, away from moisture and heat, and out of reach of children. Keep it in a secure place to prevent misuse. When you no longer need it, the FDA recommends disposing of unused tablets by flushing them or through a drug take-back program rather than keeping them in the home.
What are the signs of hydrocodone overdose?
Signs include extreme drowsiness, slow or shallow breathing, pinpoint pupils, and loss of consciousness. Seek emergency help immediately.
Can I stop taking hydrocodone suddenly?
Do not stop hydrocodone suddenly if you have been taking it regularly. Consult your doctor for a safe tapering plan to avoid withdrawal symptoms.
What happens if I take too much Hydrocodone?
Taking too much Hydrocodone can lead to a dangerous overdose. Symptoms may include severe drowsiness, slowed breathing, pinpoint pupils, cold and clammy skin, and loss of consciousness. If you suspect an overdose, seek immediate emergency medical attention. Naloxone may be administered to reverse the effects.
Is Hydrocodone safe during pregnancy?
Hydrocodone is generally not recommended during pregnancy due to potential risks to the fetus, including neonatal opioid withdrawal syndrome. It is crucial to consult your doctor if you are pregnant, planning to become pregnant, or breastfeeding, to discuss the risks and benefits and explore alternative pain management options.
What is the mechanism of action of Hydrocodone?
Hydrocodone is a semi-synthetic opioid agonist that primarily binds to mu-opioid receptors in the central nervous system. This binding inhibits ascending pain pathways, alters the perception of and response to pain, and produces generalized CNS depression. It also suppresses the cough reflex by direct action on the cough center in the medulla. (1)
What is the generic name of Hydrocodone?
The generic name is Hydrocodone. It is sold under brand names including Teva-Hydrocodone, Norco, Ratio-Hydrocodone, Hysingla ER, Zohydro ER, Hydrocan.
What class of drug is Hydrocodone?
Hydrocodone is classed as: Opioid analgesic.
References
- Hydrocodone — internal medicine recordMedGuideGlobal clinician-authored medicine record · United States · dated 2026-08-06 · accessed 2026-08-06 · source 1
- HYDROCODONE BITARTRATE AND ACETAMINOPHEN tablet (label)U.S. Food and Drug Administration (DailyMed) · United States · accessed 2026-08-06 · source 2
- HYDROCODONE BITARTRATE AND ACETAMINOPHEN SOLUTION [EYWA PHARMA INC] — US prescribing information (DailyMed SPL)U.S. National Library of Medicine (DailyMed) · US · accessed 2026-08-14 · source 3
- Acetaminophen — patient drug information (MedlinePlus)U.S. National Library of Medicine (MedlinePlus) · US · accessed 2026-08-14 · source 4
- Hydrocodone Bitartrate and Acetaminophen — FDA approval record (Drugs@FDA ANDA202991)U.S. Food and Drug Administration · US · accessed 2026-08-14 · source 5
- Hydrocodone — RxNorm normalized drug concept (RXCUI 142439)U.S. National Library of Medicine (RxNorm) · US · accessed 2026-08-14 · source 6
Brand names by country
Single-ingredient Hydrocodone names are shown separately by country. Product availability, strengths, and supply rules can change; combination products are not included here.
Priority countries
United States
- Hysingla ER20 mg, 40 mg, 80 mg, 30 mg, 60 mg, 100 mg · knoa pharma llc
Canada
- HYCODAN