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Dosing and Administration

Refer to the Prescribing Information for complete and up-to-date dosing and administration information. Swallow capsules whole. Crushing, chewing or dissolving the capsules will result in uncontrolled delivery of hydrocodone and can lead to overdose or death. Initial Dosing. Wiki

 As First Opioid Analgesic: 10 mg every 12 hours

 In Opioid Non-tolerant Patients: 10 mg every 12 hours

 Conversion from Other Oral Opioids to Hydrocodone ER: According to the Prescribing Information, conversion (not equianalgesic) doses for other opioids when switching to hydrocodone 10 mg are as follows: oxycodone 10 mg; methadone 10 mg1; oxymorphone 5 mg; hydromorphone 3.75 mg; morphine 15 mg; or codeine 100 mg.

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 Conversion from Transdermal Fentanyl to Hydrocodone ER: Hydrocodone ER

treatment can be initiated 18 hours following the removal of the transdermal fentanyl patch. Although there has been no systematic assessment of such conversion, a conservative hydrocodone dose, approximately 10 mg every 12 hours of hydrocodone ER, should be initially substituted for each 25 mcg/hr fentanyl transdermal patch. Follow the patient closely during conversion from transdermal fentanyl to hydrocodone ER, as there is limited documented experience with this conversion.

Uses

Management of pain NOT severe enough to require daily, around-the-clock, long-term opioid treatment and for which alternative treatment options are NEITHER TRIED NOR SHOWN TO BE INADEQUATE.

Contraindications

 Significant respiratory depression

 Acute or severe bronchial asthma or hypercarbia

 Paralytic ileus, known or suspected

 Hypersensitivity to any components or hydrocodone bitartrate

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 In patients with head injury or increased intracranial pressure, monitor for sedation and respiratory depression. Avoid use of HC ER in patients with impaired consciousness or coma susceptible to intracranial effects of CO2 retention.

 Prolonged gastric obstruction may occur in patients with gastrointestinal obstruction.

 Concomitant use of CYP3A4 inhibitors may increase opioid effects.

 Impaired mental or physical abilities; use caution with potentially hazardous activities.

 Misuse, abuse, diversion; CII controlled substance with high potential for abuse

 Interactions with CNS depressants; consider dose reduction of one or both drugs

 In elderly, cachectic, debilitated patients and those with chronic pulmonary disease, monitor closely because of increased risk for life-threatening respiratory depression.

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