Hydrocodone-Homatropine (Hycodan) Risks, Warnings, and Complications

MISUSE, ABUSE, AND ADDICTION: Hydrocodone, administered even at the recommended doses, can be habit-forming. Taking this opioid medication can lead to misuse, abuse, and addiction (psychological and physical dependence). Taking hydrocodone without a doctor’s prescription, at higher doses, or for a longer duration than prescribed increases the risk of drug abuse. People with a history of alcohol abuse or substance use disorder are at a higher risk of developing an addiction. 

Your doctor will carefully weigh the pros and cons of prescribing hydrocodone and homatropine for cough. They will prescribe this medication only when the cause of your cough has been determined. You should take the lowest effective dose of hydrocodone-homatropine for the shortest time possible to control your cough.

LIFE-THREATENING RESPIRATORY DEPRESSION: Hydrocodone can cause dose-related respiratory depression (dangerously slowed, shallow, or stopped breathing), which can be fatal. These effects occur most commonly when you first start taking the medication but can occur at any time during the clinical course. People with chronic lung disorders like asthma, chronic obstructive pulmonary disease, chronic bronchitis, and obstructive sleep apnea, elderly patients, and the pediatric population (children under 6 years of age) are at the highest risk of this serious complication. Drinking alcohol and taking certain other drugs that are also CNS depressants (for example, anti-anxiety medications such as benzodiazepines, sedatives, and muscle relaxants) can raise the risk of serious breathing problems.

 Watch out for slow breathing, especially in the first 24-72 hours of taking hydrocodone-homatropine. Call your doctor immediately or seek emergency medical care if you develop problems with breathing. Use a dose-measuring cup or syringe to measure the correct dose of the oral solution to prevent an overdose. Never give hydrocodone-homatropine to children below 6 years of age. Give your healthcare provider a full list of all your medications to prevent potentially dangerous drug interactions. 

DROWSINESS, DIZZINESS, AND DIFFICULTY CONCENTRATING: Taking opioid medicines such as hydrocodone can cause sleepiness, lightheadedness, and mental clouding. A severe impairment in mental alertness can be dangerous during potentially hazardous tasks like driving or operating machinery. The risk is higher if you're taking other medications that also cause drowsiness, such as sedatives, sleep aids, benzodiazepines, and muscle relaxants. Older adults (aged 65 years and above) are at a higher risk of these side effects. Drinking alcohol can make these symptoms worse. Do not drive or do other potentially hazardous activities until you know how this medication affects you. 

DRUG INTERACTIONS: Taking hydrocodone-homatropine with other medications that can depress respiration, such as sedatives, hypnotics, tranquilizers, anti-anxiety drugs, muscle relaxers, other opioid drugs, antipsychotics, and alcohol, can lead to life-threatening breathing problems. The risk of serious breathing problems is higher in people with chronic lung conditions and in elderly and debilitated individuals.

Your doctor will prescribe hydrocodone-homatropine for cough only when absolutely necessary. You may need to take a lower dose if you are on other CNS depressant drugs. Give your doctor and pharmacist a complete list of your medications to prevent drug interactions. Seek emergency medical attention if you develop slowed breathing while on hydrocodone-homatropine.

RISKS IN PEOPLE WITH CERTAIN MEDICAL CONDITIONS: People with certain health conditions, such as acute abdominal conditions (paralytic ileus, acute pancreatitis), head injury, increased intracranial pressure, intracranial lesions, brain tumors, impaired consciousness, or seizure disorders are at an increased risk of complications from hydrocodone-homatropine use. Give your healthcare professional a complete medical history before starting this medication.

SEVERE HYPOTENSION: Hydrocodone-homatropine can cause hypotension (a fall in blood pressure) with symptoms such as dizziness and fainting, especially when going from a sitting or lying position to standing. Get out of bed slowly to lower the risk of falls. Tell your doctor if you take a blood pressure medication or experience dizziness or lightheadedness.

NEONATAL OPIOID WITHDRAWAL SYNDROME: Taking hydrocodone or other opioids during pregnancy can expose the developing baby to the drug and cause the baby to develop a physical dependence on opioids. After birth, the baby can experience life-threatening opioid withdrawal symptoms. This condition is called neonatal opioid withdrawal syndrome. Doctors do not usually prescribe opioids to pregnant women due to the risk of fetal harm. If you take hydrocodone while you’re pregnant, watch out for signs of neonatal opioid withdrawal syndrome in your baby after birth (signs and symptoms may include high-pitched crying, poor feeding, poor sleep, irritability, and seizures).

ADRENAL INSUFFICIENCY: Use of hydrocodone and other opioids, especially for periods longer than one month, can lead to adrenal insufficiency (decreased adrenal hormone levels). Symptoms may include nausea, vomiting, loss of appetite, weakness, tiredness, dizziness, and low blood pressure. Tell your doctor right away if you experience these symptoms. You may need to stop taking hydrocodone and be treated with corticosteroids.

LABORATORY TESTS: Opioids can alter the results of certain laboratory tests, such as liver enzymes. Tell all your healthcare professionals, including laboratory personnel, that you are on hydrocodone-homatropine before any lab tests.