hydrocodone/ homatropine

Addiction, Abuse, and Misuse

Schedule II controlled substance combination containing an opioid agonist w/ risk of addiction, abuse, and misuse, which can lead to overdose and death; reserve for use in adult pts w/ adequate assessment of cough etiology for whom benefits of cough suppression outweigh risks; assess opioid abuse or addiction risk prior to prescribing; prescribe for shortest duration consistent w/ tx goals and only refill after reevaluation of need for continued tx; regularly reassess all pts for misuse, abuse, and addiction

Respiratory Depression

serious, life-threatening, or fatal cases may occur; monitor for resp. depression, esp. during tx initiation or in high risk pts

Accidental Ingestion

accidental ingestion of even one dose, esp. by children, can result in fatal hydrocodone overdose

Medication Error Risk

ensure accuracy when prescribing, dispensing, and administering; dosing errors can result in accidental overdose and death; always use accurate mL measuring device when measuring and administering oral liquid forms

CYP450 Interactions

concomitant use w/ CYP450 3A4 inhibitors or D/C of concomitant CYP450 3A4 inducers may incr. hydrocodone conc. which may incr. or prolong adverse effects incl. potentially fatal resp. depression; monitor pts receiving any concomitant CYP450 3A4 inhibitor or inducer

Risks from Concomitant Use w/ Benzodiazepines, CNS Depressants

concomitant opioid use w/ benzodiazepines or other CNS depressants, incl. alcohol, may result in profound sedation, resp. depression, coma, and death; avoid use of opioid cough medications in pts taking benzodiazepines, other CNS depressants, or alcohol

Avoid Alcohol

instruct pts not to consume alcoholic beverages or use alcohol-containing prescription or non-prescription medications; alcohol consumption during tx may result in incr. plasma levels and potentially fatal hydrocodone overdose

Neonatal Opioid Withdrawal Syndrome

use not recommended in pregnant pts; extended use in pregnant pts can lead to potentially life-threatening neonatal opioid withdrawal syndrome; advise pregnant pts of risks and ensure tx by neonatology experts avail. at delivery if extended opioid use required