Drugs On Review

Archive for the ‘Semi-Synthetic Opioid’ Category

What is Hydrocodone?

Hydrocodone is a semi-synthetic opioid which is used as an active ingredient in many prescription drugs. It is always combined with another active ingredient, usually acetaminophen. It is never prescribed alone. Hydrocodone is used primarily as an analgesic but is also useful as a suppressant for non-productive cough. The drug was first synthesized in Germany in 1920.

Hydrocodone is derived from codeine and is similar in its action, but six times stronger. It is highly effective for pain relief and cough suppression. It is believed that hydrocodone, like all opioid analgesics suppress pain by blocking opioid receptors in the central nervous system.

What does Hydrocodone look like?

Hydrocodone is not available as a single preparation. It is normally sold on prescription in combined formulations, usually with acetaminophen.

Hydrocodone dosing and administration

Most preparations containing hydrocodone are recommended to be taken four to six times daily as needed for pain or cough suppression. Because hydrocodone is most commonly combined with acetaminophen, the maximum daily dosage is limited by the toxicity of acetaminophen. This drug may cause liver damage and daily limits should be strictly observed. Hydrocodone should be taken with food to minimize the stomach upset which is a common side effect.

Common adverse effects from Hydrocodone

The most common side effects of hydrocodone are stomach upset, nausea, vomiting, vertigo and constipation. More serious side effects include addiction, anxiety, bradycardia, low blood pressure, dysuria, lethargy, loss of balance and allergic reactions. Some hydrocodone formulations contain sulfates or tartrazine, both of which may cause an allergic reaction in susceptible individuals.

Hydrocodone warnings and precautions

Alcohol may increase the narcotic effect of hydrocodone and cause severely increased side effects. In addition, hydrocodone is most commonly compounded with acetaminophen, and alcohol may increase the liver toxicity of this drug. Alcohol should therefore be avoided when using hydrocodone. Hydrocodone may give a positive result in drug testing for opiates. The respiratory depressant effect of hydrocodone may be potentiated in individuals with elevated intracranial pressure or head trauma. You should inform your doctor if you have a history of lung disease, drug or alcohol dependence, kidney or liver disease, head injury, hypothyroidism, Addison’s disease, enlarged prostate or any kind of allergy. You should also tell your doctor if you are pregnant or may become pregnant or if you are breastfeeding. Because of its extreme potential for addiction, hydrocodone should not be taken at higher doses than necessary or for longer periods than necessary. If you have a history of any kind of substance abuse, including alcohol, you should discuss alternative pain treatments with your doctor. Hydrocodone may mask symptoms of many abdominal conditions and interfere with diagnosis of these.

Interactions with Hydrocodone

As well as alcohol, hydrocodone can interact with cocaine, amphetamines, methylphenidate, benzodiazepines and other narcotics and barbiturates. These combinations may lead to severe effects including heart failure, myocardial infarct, respiratory failure, liver or kidney failure, coma and death.

What is Oxycodone?

Oxycodone is an opioid derived from the natural opiate thebaine, itself derived from opium. It was one of the first-generation semi-synthetic opiates developed in the early 20th century as replacements for morphine, heroin and codeine. Oxycodone is a component in many compounded analgesics. It is most commonly used in combination with acetaminophen or NSAIDs such as ibuprofen. It is a narcotic analgesic used to control moderate to severe pain and for suppression of chronic non-productive cough. It is of particular use for palliative care of dying patients as it assists in relieving the dyspnea which is often present.

Oxycodone is a fast-acting narcotic and recent research suggests that it acts through a number of different receptors. Peak plasma level is reached within about an hour. It is distributed by the by the blood to skeletal muscle and various organs including the brain. The analgesic effect usually begins within ten to fifteen minutes.

What does Oxycodone look like?

Oxycontin is available in a large number of forms, both alone and compounded.

Oxycodone dosing and administration

The standard starting dose of oxycodone is 5 mg by mouth every six hours as needed. If this is ineffective, the doctor may increase this until the desired effect is released. Once the level has been found, the doctor may switch the patient to extended release oxycodone between 10 and 40 mg every twelve hours. Maximum dosage is limited by the side effects of the drug, which may vary in individual patients according to various factors, but especially the tolerance to opioid medication.

Common adverse effects from Oxycodone

Common side effects of Oxycodone included nausea and vomiting, lethargy, constipation, vertigo, itching, headaches, dry mouth, weakness and sweating. Less common but more serious side effects may include addiction, loss of balance, mood swings, severe constipation, confusion, bradycardia and hypotension, dysuria, respiratory depression, severe lethargy and seizures. It should be noted that non-allergic itching is a common side effect and does not indicate allergy if no other symptoms of this are present.

Oxycodone warnings and precautions

Before taking oxycodone you should inform your doctor if you are suffering from any lung disease, any head injury, liver or kidney disease, hypotension, seizures or epilepsy, gallbladder or pancreas disease, hypothyroidism, asthma Addison’s disease, an enlarged prostate or any allergies. You should also inform your doctor if you are pregnant or may become pregnant, or if you are breastfeeding while taking oxycodone. The use of alcohol should be avoided because of the extreme danger of respiratory depression.

Interactions with Oxycodone

Drugs which may interact with oxycodone include alvimopan, all antidepressants, antihistamines, most antipsychotics, barbiturates, benzodiazepines, muscle relaxants, monoamine oxidase inhibitors and other narcotics, opioids and sleep medications. Alcohol increases the risk of side effects from oxycodone. The use of any drugs which act on the central nervous system may both potentiate the action of oxycodone and increase the risk of severe side effects.