Description

Buy Hydrocodone Online Without Prescription 

Applies to hydrocodone: oral capsule extended release, oral liquid, oral syrup, oral tablet, oral tablet extended release Along with its needed effects, hydrocodone may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention. Check with your doctor immediately if any of the following side effects occur while taking hydrocodone:

Less Common

Bloating or swelling of the face, arms, hands, lower legs, or feet

body aches or pain

chills

cough

depression

difficult or labored breathing

ear congestion

fear or nervousness

fever

headache

loss of voice

nasal congestion

rapid weight gain

runny nose

sneezing

sore throat

tightness in the chest

tingling of the hands or feet

unusual tiredness or weakness

unusual weight gain or loss

Get emergency help immediately if any of the following symptoms of overdose occur while taking hydrocodone:

Symptoms of Overdose

Blue lips and fingernails

blurred vision

change in consciousness

chest pain or discomfort

cold and clammy skin

confusion

constricted pupil (black part of the eye)

coughing that sometimes produces a pink frothy sputum

decreased awareness or responsiveness

dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position

increased sweating

irregular, fast or slow, or shallow breathing

lightheadedness, dizziness, or fainting

pale skin

sleepiness or unusual drowsiness

slow or irregular heartbeat

weak muscle tone

 

Some side effects of hydrocodone may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More Common

Difficulty having a bowel movement (stool)

nausea

Less Common

Abdominal or stomach pain or discomfort

back pain

bladder pain

bloody or cloudy urine

difficult, burning, or painful urination

dry mouth

frequent urge to urinate

heartburn

itching skin

lower back or side pain

muscle spasms

vomiting

 

For Healthcare Professionals

Applies to hydrocodone: compounding powder, oral capsule extended release, oral tablet extended release

General

The most commonly reported side effects included constipation, nausea, vomiting, fatigue, upper respiratory tract infection, dizziness, headache, and somnolence.[Ref] Buy Hydrocodone Online Without Prescription

Respiratory

Common (1% to 10%): Upper respiratory tract infection, cough, bronchitis, nasopharyngitis, sinusitis, nasal congestion

Uncommon (0.1% to 1%): Dyspnea[Ref]

 

Cardiovascular

Common (1 to 10%): Hot flush, hypertension, chest pain, peripheral edema

Rare (less than 0.1%): Hypotension, orthostatic hypotension, palpitations, presyncope, syncope

Frequency not reported: QTC interval prolongation[Ref]

QT interval prolongation has been observed in healthy subjects following daily dosing with hydrocodone extended-release tablets. The difference in QT interval at steady state was found to be 6 milliseconds, 7 milliseconds, and 10 milliseconds at doses of 80 mg, 120 mg and 160 mg, daily, respectively.[Ref]

Gastrointestinal

Very common (10% or more): Constipation (up to 11%), nausea (up to 10%)

Common (1% to 10%): Dry mouth, vomiting, abdominal pain or discomfort, gastroesophageal reflux disease, diarrhea, dyspepsia

Rare (less than 0.1%): Dysphagia, esophageal obstruction, retching, chocking

Very rare (less than 0.01%): Difficulty swallowing tablet[Ref]

In clinical trials with extended release tablets, 11 or 2476 subjects reported difficulty swallowing the tablets. These reports included esophageal obstruction, dysphagia, and choking. One case required medical intervention to remove the tablet.[Ref]

Nervous system

Common (1% to 10%): Somnolence, fatigue, headache, tremor, dizziness, lethargy, migraine, paresthesia, sedation

Uncommon (0.1% to 1%): Abnormal thinking[Ref]

Other

Common (1% to 10%): Pain, pyrexia, fatigue, tinnitus, chills

Uncommon (0.1% to 1%): Asthenia, neonatal abstinence syndrome, drug withdrawal[Ref]

Psychiatric

Common (1 to 10%): Anxiety, depression, insomnia

Uncommon (0.1% to 1%): Agitation, altered mood, irritability, libido decreased[Ref]

Metabolic

Common (1% to 10%): Dehydration, hypokalemia, increased blood cholesterol, decreased appetite

Uncommon (0.1% to 1%): Thirst[Ref]

Hepatic

Common (1 to 10%): Increased gamma-glutamyltransferase[Ref]

Musculoskeletal

Common (1% to 10%): Back pain, muscle spasms , contusion, fall, foot fracture, joint injury or sprain, muscle strain, arthralgia, musculoskeletal pain, myalgia, neck pain, osteoarthritis, pain in extremity

Uncommon (0.1% to 1%): Muscle twitching[Ref]

Hypersensitivity

Uncommon (0.1% to 1%): Drug hypersensitivity[Ref]

Endocrine

Uncommon (0.1% to 1%): Hypogonadism[Ref]

Dermatologic

Common (1% to 10%): Pruritus, skin laceration, hyperhidrosis, night sweats, rash[Ref]

 

Genitourinary

Common (1% to 10%): Urinary tract infection

Uncommon (0.1% to 1%): Urinary retention

Hydrocodone Dosage

Medically reviewed on December 12, 2017.

Overview

Side Effects

Dosage

Professional

Tips

Interactions

More

Applies to the following strengths: 10 mg; 15 mg; 20 mg; 30 mg; 40 mg; 50 mg; 60 mg; 80 mg; 100 mg; 120 mg

 

Usual Adult Dose for:

Chronic Pain

Additional dosage information:

Renal Dose Adjustments

Liver Dose Adjustments

Dose Adjustments

Precautions

Dialysis

Other Comments

Usual Adult Dose for Chronic Pain

The following dosing recommendations can only be considered suggested approaches to what is actually a series of clinical decisions over time; each patient should be managed individually.

 

As First Opioid Analgesic and For Patients who are NOT Opioid Tolerant:

Extended-Release Capsules (Zohydro(R) ER): Initial dose: 10 mg orally every 12 hours

Extended-Release Tablets (Hysingla(R) ER): Initial dose: 20 mg orally every 24 hours

 

Comments:

-Use of higher starting doses in patients who are not opioid tolerant may cause fatal respiratory depression; monitor patients closely for respiratory depression, especially during the first 24 to 72 hours.

-An opioid tolerant patient is one who has been receiving for 1-week or longer at least: oral morphine 60 mg/day, fentanyl transdermal patch 25 mcg per hour, oral oxycodone 30 mg/day, oral hydromorphone 8 mg/day, oral oxymorphone 25 mg/day, or an equianalgesic dose of another opioid.

 

TITRATION AND MAINTENANCE:

Individually titrate to a dose that provides adequate analgesia and minimizes adverse reactions.

–Dose adjustments to hydrocodone extended-release capsules should be made in 10 mg increments every 12 hours, every 3 to 7 days.

–Dose adjustments to hydrocodone extended-release tablets should be made in 10 to 20 mg increments every 24 hours, every 3 to 5 days.

–If unacceptable side effects occur, the dose may be reduced.

Breakthrough Pain: If the level of pain increases after dose stabilization, attempt to identify the source before increasing dose; rescue medication with appropriate immediate-release analgesia may be helpful

 

DOSE CONVERSIONS: Dose conversions should be done carefully and with close monitoring due to large patient variability in regards to opioid analgesic response. Discontinue all other around the clock opioid drugs when initiating therapy with extended-release hydrocodone.

 

Hydrocodone Extended-Release (ER) CAPSULES:

-The 50 mg capsules, a single dose greater than 40 mg, or a total daily dose greater than 80 mg are reserved for opioid tolerant individuals.

CONVERSION FROM OTHER ORAL OPIOIDS:

-Published potency tables can be used to estimate a patient’s 24-hour oral hydrocodone requirement; however, due to substantial inter-patient variability, it is best to underestimate a patient’s 24-hour requirement and provide rescue medication as the dose is titrated.

-Alternatively, the following conversion factors (CF) may be used to convert selected oral opioids to the hydrocodone extended-release capsule: Hydrocodone, CF=1; Oxycodone, CF=1; Methadone, CF= 1, Oxymorphone, CF=2; Hydromorphone, CF=2.67; Morphine, CF=0.67; Codeine, CF=0.1.

-These CFs cannot be used to convert from hydrocodone extended-release to the selected oral opioid as doing so will result in overestimation of the oral opioid dose and may result in fatal respiratory depression.

-Example: Sum the total daily dose of prior oral opioid; multiply that sum by the CF to obtain 24-hour oral hydrocodone requirement; divide 24-hour requirement by 2 (round down, if necessary ) and give 1 dose orally every 12 hours.

CONVERSION FROM TRANSDERMAL FENTANYL: Remove the transdermal fentanyl patch and 18 hours later initiate hydrocodone extended-release capsules at 10 mg every 12 hours for each 25 mcg/hr fentanyl transdermal patch; monitor closely as there is limited documented experience with this conversion.

 

Hydrocodone Extended-Release (ER) TABLETS:

-Daily dose greater than or equal to 80 mg are reserved for use in opioid tolerant individuals.

-CONVERSION FROM ORAL HYDROCODONE FORMULATIONS: Administer patient’s total daily oral hydrocodone dose as extended-release tablet orally once a day.

-CONVERSION FROM OTHER ORAL OPIOIDS:

-Published potency tables can be used to estimate a patient’s 24-hour oral hydrocodone requirement; however, due to substantial inter-patient variability, it is best to underestimate a patient’s 24-hour requirement and provide rescue medication as the dose is titrated.

-To obtain the initial hydrocodone extended-release tablet dose, use the following conversion factors (CF) to convert selected oral opioids and then reduce that dose by 25%. Tramadol, CF=0.1; Oxycodone, CF=1; Methadone, CF= 1.5, Oxymorphone, CF=2; Hydromorphone, CF=4; Morphine, CF=0.5; Codeine, CF=0.15.

-These CFs cannot be used to convert from hydrocodone extended-release to the selected oral opioid as doing so will result in overestimation of the oral opioid dose and may result in fatal respiratory depression.

-Example: Sum the total daily dose of prior oral opioid; multiply that sum by the CF to obtain 24-hour oral hydrocodone requirement; reduce that hydrocodone requirement by 25% to account for interpatient variability, round down, if necessary; administer calculated dose orally once a day.

CONVERSION FROM TRANSDERMAL FENTANYL: Remove the transdermal fentanyl patch and 18 hours later initiate hydrocodone extended-release tablets at 20 mg every 24 hours for each 25 mcg/hr fentanyl transdermal patch; monitor closely as there is limited documented experience with this conversion.

CONVERSION FROM TRANSDERMAL BUPRENORPHINE: Patients receiving transdermal buprenorphine 20 mcg/hr or less should initiate extended-release hydrocodone tablets at 20 mg every 24 hours; monitor closely as there is limited documented experience with this conversion. Buy Hydrocodone Online Without Prescription