Hydrocodone ER (q12h)
ZOHYDRO ER
What it isFirst single-agent hydrocodone (ZOHYDRO ER, 2013) — q12h ER capsule with no acetaminophen, freeing dosing from APAP hepatotoxicity limits.
Why this oneSame molecule and receptor pharmacology as the parent card — the formulation (and its label) is the difference.
What limits itClass warnings of the parent molecule apply unchanged.
FDA-approved for
- chronic pain (around-the-clock) (2013)
FDA label
Read the full label on DailyMed ↗
| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Pain severe enough to require daily, around-the-clock, long-term opioid treatment when alternatives are inadequate | Adults | 10 mg q12h (opioid-naïve/non-tolerant) | Individualized | Individualized (>80 mg/day only in opioid-tolerant) |
Titration Adjust in increments of 10 mg q12h no more often than every 3–7 days
Renal Initiate at a low dose; monitor for respiratory depression and sedation
Hepatic Mild–moderate: no starting-dose adjustment; severe: start 10 mg q12h
Dose every 12 hours; 50 mg capsule, single dose >40 mg, or total daily dose >80 mg only for opioid-tolerant patients
Instructions
- Swallow capsules whole; do not cut, break, chew, crush, or dissolve
- Not for as-needed (prn) use
- Do not consume alcohol or alcohol-containing products
- To discontinue, taper gradually every 2–4 days; do not stop abruptly
Contraindications
- Significant respiratory depression
- Acute or severe bronchial asthma in an unmonitored setting or in the absence of resuscitative equipment
- Known or suspected paralytic ileus
Cautions
- Life-threatening respiratory depression
- Neonatal opioid withdrawal syndrome
- Interactions with other CNS depressants
- Hypotensive effect
- Gastrointestinal conditions (e.g., ileus)
- Seizures
- Adrenal insufficiency (opioid class)
Adverse reactions
- Constipation
- Nausea
- Somnolence
- Fatigue
- Headache
- Dizziness
- Dry mouth
- Vomiting
- Pruritus
- Abdominal pain
- Peripheral edema
- Tremor
Pregnancy Prolonged use during pregnancy can cause neonatal opioid withdrawal syndrome
Lactation Not recommended
⚠ BOXED WARNINGS
- Addiction, abuse and misuse
- Life-threatening respiratory depression
- Risk from concomitant use with benzodiazepines
Classes and tags
Clinical profile
Mechanism of action: Hydrocodone ER (q12h) ballicule
Open Hydrocodone ER (q12h) in the interactive console ↗
Memory aids: mascots and interaction avatars
Viking for Vicodin (combo with acetaminophen)
