Hydrocodone - Oral

Hydrocodone is a strong painkiller. It helps relieve severe persistent pain which can't be relieved by other pain medications.

Take Hydrocodone exactly as directed by your doctor or according to the instructions on the label. Do not take more or less than instructed by your doctor.

This medicine is available as an extended-release type of capsule or tablet (usually labelled as "ER"). Swallow it whole. Do not divide, chew, crush, or dissolve the capsule or tablet.

Do not lick, pre-soak, or wet the tablet before taking it. Take one tablet at a time with enough water to ensure complete swallowing immediately after placing it in the mouth.

The dose of this medicine will be decided by your doctor. Your doctor will advise you on the treatment timeframe depending on the previous painkiller you used, the severity of your condition, and your response to the medication.

Do not stop taking Hydrocodone suddenly as it may worsen your condition. Your doctor will gradually reduce the dose before stopping it completely. Follow your doctor's instructions carefully.

Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and return to your normal dosing schedule.

DO NOT double a dose under any circumstances.

If you often forget to take your medicine, let your doctor and pharmacist know.

Alert your doctor if you have the following conditions:

• severe respiratory depression (slow or ineffective breathing)
• sudden or severe asthma attack
• known or suspected blockage in the stomach or intestine e.g. paralytic ileus (bowel obstruction caused by slow movement or paralysis of the intestines)

as Hydrocodone may not be suitable for you.

Inform your doctor if you have the following conditions:

• personal or family history of drug or alcohol addiction or abuse
• mental illness e.g. depression, anxiety
• hypovolaemia (low volume of circulating fluids in the body)
• increased pressure in the brain
• head injury
• allergies to other similar painkillers e.g. oxycodone, codeine
• epilepsy (fits or seizures)
• cancer of the oesophagus or colon
• heart disease e.g. heart failure (weakness and inability of the heart to pump blood), irregular heartbeat, congenital long QT syndrome (an inherited disease causing abnormally fast and erratic heartbeats)
• Addison's disease (a rare disorder where the adrenal glands produce insufficient amounts of certain hormones)
• pancreatitis (inflammation of the pancreas)
• problems with the gallbladder and bile ducts (a tube-like channel which carries bile from the liver to the upper portion of the small intestine)
• enlarged prostate gland or problems urinating
• sleep-related disorders e.g. sleep apnoea (sleep disorder that causes interrupted breathing during sleep)
• thyroid problems
• chronic obstructive pulmonary disease or COPD (a long-term lung disease that causes airflow obstruction making it hard to breathe)
• moderate to severe kidney disease
• severe liver disease

Let your doctor know if you are pregnant or breastfeeding.

Be sure to check with your doctor or pharmacist before giving Hydrocodone to the elderly or debilitated individual (physically or mentally weak, usually due to illness or old age). Elderly people and debilitated individuals may be more sensitive to the side effects.

Avoid long-term use of any painkillers.

Why is it important to keep my appointments with the doctor?

Keep your appointments with your doctor. Your doctor needs to monitor your condition and check your response to the medication regularly.

• Routine tests (e.g. lung or bowel function) may be done while you are being treated with this medicine. Your doctor will advise you about how often you need to have these tests.
• Your blood pressure may fall to unsafe levels without you noticing it. Monitor your blood pressure regularly during treatment.
• Regular monitoring of pain relief, mental status, and signs and symptoms of substance abuse, misuse, or addiction may also be needed.

Hydrocodone may cause drowsiness or dizziness. If affected, do not drive or take part in any activity in which you need to be alert.

This medicine may cause your blood pressure to fall suddenly when you get up from a sitting or lying down position and you may feel giddy. To minimise this problem, stand up slowly.

Other side effects include any of the following: nausea, vomiting, diarrhoea, stomach pain, indigestion, dry mouth, tiredness, cough, stuffy nose, ringing in the ears, back pain, muscle or joint pain, difficulty sleeping, rashes, and itching.

Some side effects may need immediate medical help. Alert your doctor quickly if you experience any of the following:

• slow, shallow or trouble breathing
• severe constipation or abdominal pain
• fast heartbeat, chest pain or pressure
• new or worsening pain, increased sensitivity to pain
• unusual changes in mood or behaviour (being too depressed or agitated)
• severe tiredness or weakness, severe dizziness or passing out, decreased appetite, severe nausea or vomiting

Inform your doctor if any of these side effects do not go away or are severe, or if you experience other side effects.

Inform your doctor and pharmacist if you are taking any of these medicines:

• other strong painkillers e.g. codeine, morphine, buprenorphine
• medicines for mood disorders
• medicines for anxiety
• medicines to treat depression e.g. amitriptyline, mirtazapine, tranylcypromine, trazodone
• medicines used to help relax muscles and relieve pain or spasms e.g. cyclobenzaprine, metaxalone
• certain antibiotics e.g. erythromycin, clarithromycin
• medicines to treat fungal infection e.g. ketoconazole, voriconazole
• medicines for epilepsy (fits or seizures) e.g. carbamazepine, phenytoin
• rifampicin (medicine to treat TB, a lung infection known as tuberculosis)
• ritonavir (medicine for HIV infection)

This list does not include all medicines that may interact with Hydrocodone.

Always notify your doctor and pharmacist if you are taking any other medicines, including herbal tonics such as traditional Chinese medicines, supplements, and medicines that you buy without a prescription.

Avoid alcohol. Alcohol intake may worsen the dizziness and drowsiness caused by Hydrocodone.

Store in a cool, dry place away from the reach of children.

Medicines must not be used past the expiry date.