Drug/Small Molecule:
hydrocodone

2D structure

Overview

Generic Names: Dihydrocodeinone; Hidrocodona [INN-Spanish]; Hydrocodon; Hydrocodonum [INN-Latin]; Hydrocone; Hydroconum; Idrocodone [Dcit]
Trade Names: Bekadid; Codinovo; Dico; Dicodid; Multacodin
Brand Mixtures: Amacodone (acetaminophen + hydrocodone bitartrate); Anexsia (acetaminophen + hydrocodone bitartrate); Anodynos (acetaminophen + hydrocodone bitartrate); Bancap (acetaminophen + hydrocodone bitartrate); Caldomine DH Adulte (Hydrocodone Bitartrate + Pheniramine Maleate + Phenylpropanolamine Hydrochloride + Pyrilamine Maleate); Caldomine DH Enfant (Hydrocodone Bitartrate + Pheniramine Maleate + Phenylpropanolamine Hydrochloride + Pyrilamine Maleate); CoGesic (acetaminophen + hydrocodone bitartrate); Coristine-DH Liq (Hydrocodone Bitartrate + Phenylephrine Hydrochloride); Dalmacol (Alcohol Anhydrous + Doxylamine Succinate + Etafedrin Hydrochloride + Hydrocodone Bitartrate + Sodium Citrate); Dimetane Expectorant-DC Syr (Brompheniramine Maleate + Guaifenesin + Hydrocodone Bitartrate + Phenylephrine Hydrochloride + Phenylpropanolamine Hydrochloride); Dimetane Expectorant-DC Syrup (Brompheniramine Maleate + Guaifenesin + Hydrocodone Bitartrate + Phenylephrine Hydrochloride); Dolacet (acetaminophen + hydrocodone bitartrate); Duradyne (acetaminophen + hydrocodone bitartrate); Hycomine-S (Ammonium Chloride + Hydrocodone Bitartrate + Phenylephrine Hydrochloride + Pyrilamine Maleate); Hydrocet (acetaminophen + hydrocodone bitartrate); Hydrogesic (acetaminophen + hydrocodone bitartrate); Lorcet (acetaminophen + hydrocodone bitartrate); Lortab (acetaminophen + hydrocodone bitartrate); Margesic (acetaminophen + hydrocodone bitartrate); Mercodol with Decapryn (Doxylamine Succinate + Etafedrin Hydrochloride + Hydrocodone Bitartrate + Sodium Citrate); Norcet (acetaminophen + hydrocodone bitartrate); Novahistex Dh Expectorant (Guaifenesin + Hydrocodone Bitartrate + Phenylephrine Hydrochloride); Novahistex Dh Syrup (Hydrocodone Bitartrate + Phenylephrine Hydrochloride); Ratio-Calmydone (Doxylamine Succinate + Etafedrin Hydrochloride + Hydrocodone Bitartrate + Sodium Citrate); Ratio-Coristex-DH (Hydrocodone Bitartrate + Phenylephrine Hydrochloride); Solucodan Syrup (Hydrocodone Bitartrate + Menthol + Potassium Guaiacol Sulphonate + Sodium Citrate); Solucodan-H (Diphenylpyraline Hydrochloride + Hydrocodone Bitartrate + Menthol + Potassium Guaiacol Sulphonate + Sodium Citrate); Stagesic (acetaminophen + hydrocodone bitartrate); TGesic (acetaminophen + hydrocodone bitartrate); Triaminic Expectorant DH Syrup (Guaifenesin + Hydrocodone Bitartrate + Pheniramine Maleate + Phenylpropanolamine Hydrochloride + Pyrilamine Maleate); Tussaminic DH Forte Syrup (Hydrocodone Bitartrate + Pheniramine Maleate + Phenylpropanolamine Hydrochloride + Pyrilamine Maleate); Tussaminic DH Pediatric Syrup (Hydrocodone Bitartrate + Pheniramine Maleate + Phenylpropanolamine Hydrochloride + Pyrilamine Maleate); Vicodin (acetaminophen + hydrocodone bitartrate); Zydone (acetaminophen + hydrocodone bitartrate)
PharmGKB Accession Id: PA449900

Description

Narcotic analgesic related to codeine, but more potent and more addicting by weight. It is used also as cough suppressant. PubChem (source: Drug Bank)

Indication

For relief of moderate to moderately severe pain. (source: Drug Bank)

ATC Therapeutic Category

  • R05DA:Opium alkaloids and derivatives

Pharmacology, Interactions, and Contraindications

Mechanism Of Action

Hydrocodone acts as a weak agonist at OP1, OP2, and OP3 opiate receptors within the central nervous system (CNS). Hydrocodone primarily affects OP3 receptors, which are coupled with G-protein receptors and function as modulators, both positive and negative, of synaptic transmission via G-proteins that activate effector proteins. Binding of the opiate stimulates the exchange of GTP for GDP on the G-protein complex. As the effector system is adenylate cyclase and cAMP located at the inner surface of the plasma membrane, opioids decrease intracellular cAMP by inhibiting adenylate cyclase. Subsequently, the release of nociceptive neurotransmitters such as substance P, GABA, dopamine, acetylcholine, and noradrenaline is inhibited. Opioids such as hydrocodone also inhibit the release of vasopressin, somatostatin, insulin, and glucagon. Opioids close N-type voltage-operated calcium channels (OP2-receptor agonist) and open calcium-dependent inwardly rectifying potassium channels (OP3 and OP1 receptor agonist). This results in hyperpolarization and reduced neuronal excitability. (source: Drug Bank)

Pharmacology

Hydrocodone, a semisynthetic opiate agonist and hydrogenated ketone derivative, is similar to other phenanthrene derivatives, such as codeine. Used as an analgesic, hydrocodone is combined with acetaminophen, ibuprofen, or aspirin to treat pain. Used as an antitussive, hydrocodone is combined with phenylephrine, pseudoephedrine, phenylpropanolamine, guaifenesin, pyrilamine, pheniramine, or chlorpheniramine. (source: Drug Bank)

Food Interactions

Avoid alcohol.
Take with food.
To avoid constipation: increase your daily intake of fiber (beans, whole grains, vegetables). (source: Drug Bank)

Absorption, Distribution, Metabolism, Elimination & Toxicity

Biotransformation

Hepatic and also in intestinal mucosa. (source: Drug Bank)

Protein Binding

As most agents in the 5-ring morphinan group of semi-synthetic opioids bind plasma protein to a similar degree (range 19% hydromorphone to 45% oxycodone), hydrocodone is expected to fall within this range. (source: Drug Bank)

Absorption

Well absorbed from the gastrointestinal tract. (source: Drug Bank)

Toxicity

Symptoms of overdose include respiratory depression (a decrease in respiratory rate and/or tidal volume, Cheyne-Stokes respiration, cyanosis), extreme somnolence progressing to stupor or coma, skeletal muscle flaccidity, dizziness, ringing in the ears, confusion, blurred vision, eye problems, cold and clammy skin, and sometimes bradycardia and hypotension. In severe overdose, apnea, circulatory collapse, cardiac arrest and death may occur. LD<sub>50</sub>=85.7mg/kg (subcutaneous, in mice). (source: Drug Bank)

Isomeric SMILES Code:

CN1CC[C@]23c4c5ccc(c4O[C@H]2C(=O)CC[C@H]3[C@H]1C5)OC (source: Drug Bank)

The following genes are in curated knowledge about this drug.

  Gene Relationship Evidence
Phenotype data available Genotype Data Available Literature annotations available Has annotations
CYP2D6
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  • PK
  • FA
  • GN
Publications
Phenotype data available Genotype Data Available Literature annotations available Not annotated
CYP3A
  •   
  •   
  • PK
  •   
  •   
Publications
Phenotype data available Genotype Data Available Literature annotations available Has annotations
CYP3A4
  •   
  •   
  • PK
  • FA
  •   
Publications
Phenotype data available Genotype Data Available Literature annotations available Has annotations
CYP3A5
  •   
  •   
  • PK
  •   
  •   
Publications

A list of non-curated publications that mention this drug along with other genes is available.

Drug Targets

Gene Description
OPRD1 Uncurated Annotation (source: Drug Bank)
OPRK1 Uncurated Annotation (source: Drug Bank)
OPRM1 Uncurated Annotation (source: Drug Bank)

The following drugs are in curated knowledge about this drug.

  Drug Relationship Evidence
Phenotype data available Genotype Data Available Literature annotations available Not annotated
ketoconazole
  •   
  •   
  • PK
  • FA
  •   
Publications
Phenotype data available Genotype Data Available Literature annotations available Not annotated
quinidine
  •   
  •   
  • PK
  • FA
  •   
Publications
Phenotype data available Genotype Data Available Literature annotations available Not annotated
troleandomycin
  •   
  •   
  • PK
  • FA
  •   
Publications

A list of non-curated publications that mention this drug along with other drugs is available.

Drug Interactions

Drug Description
cimetidine Uncurated Annotation Cimetidine increases the effect of the narcotic (source: Drug Bank)
naltrexone Uncurated Annotation Naltrexone may precipitate a withdrawal syndrome in opiod-dependent individual (source: Drug Bank)

Curated Information

The following diseases are in curated knowledge about this drug.

  Disease Relationship Evidence
No phenotype data No genotype data Literature annotations available Not annotated
Pain
  •   
  •   
  •   
  •   
  • GN
Publications

Non-Curated Information

A list of non-curated publications that mention this drug along with other diseases is available.

LinkOuts

Web Resource:
Wikipedia
DrugBank:
DB00956
KEGG Compound ID:
C08024
PubChem Compound ID:
5284569
PubChem Substance ID:
173376

Common Searches

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Non-Curated Publications

A list of non-curated publications that mention this drug is available.

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