Hydrocodone
Prescription ·Exploratory record · not publication-reviewed ·Updated July 13, 2026
A semi-synthetic opioid commonly prescribed in combination with acetaminophen (Vicodin, Norco) for the management of pain severe enough to require opioid treatment and for which alternative treatments are inadequate. Hydrocodone is the most frequently prescribed opioid in the United States and is a Schedule II controlled substance.
Exploratory record, not a reviewed medical publication.
See the editorial and medical-review policies for the publication gate.
This generated database record has not completed a claim-level review by a qualified human medical reviewer. Bibliography links and evidence labels are not approval. The page remains available for reference and is excluded from search indexing.
What the research says.
A quick, data-only summary. The full evidence, dosing, and sources are below.
A semi-synthetic opioid commonly prescribed in combination with acetaminophen (Vicodin, Norco) for the management of pain severe enough to require opioid treatment and for which alternative treatments are inadequate. NutriStack rates the supporting evidence as strong. Common adult dosing is Combination products: 5–10 mg hydrocodone/325 mg acetaminophen every 4–6 hours as needed; ER: 10–20 mg every 12 hours initially (as prescribed by your physician), though a prescriber sets the actual dose. This profile indexes 10 sources.
- Constipation
- Nausea and vomiting
- Drowsiness and sedation
- Significant respiratory depression
- Acute or severe bronchial asthma in unmonitored settings
The bottom line
Evidence rating strong. Most-documented uses: effective management of moderate to moderately severe pain, combination with acetaminophen provides multimodal analgesia, available in extended-release single-entity formulations. 10 sources indexed (2012–2026), with 0 interaction records on file.
How it works, mechanistically.
Core mechanism
Acts as a full agonist primarily at mu-opioid receptors in the central nervous system, producing analgesia by altering pain perception at the spinal cord and higher cortical levels. Hydrocodone is metabolized by CYP2D6 to hydromorphone, a more potent active metabolite, and by CYP3A4 to norhydrocodone. It also has antitussive activity via central cough suppression.1,4
Dosing & protocol.
Can be taken with or without food; food does not significantly affect absorption; swallow ER formulations whole
Full safety detail.
Side effects
- Constipation
- Nausea and vomiting
- Drowsiness and sedation
- Dizziness and lightheadedness
- Respiratory depression
- Physical dependence and tolerance
- Pruritus
- Hepatotoxicity risk from acetaminophen component (if exceeding dose limits)
Contraindications
Sources, by evidence tier.
Numbered references. Citations throughout the page link here.
Meta-analyses & systematic reviews
1- 1Effects of hydrocodone rescheduling on opioid use outcomes: A systematic reviewPMIDUsmani SA, Hollmann J, Goodin A et al. · Journal of the American Pharmacists Association : JAPhA · 2021
Usmani SA, Hollmann J, Goodin A et al.. Effects of hydrocodone rescheduling on opioid use outcomes: A systematic review. Journal of the American Pharmacists Association : JAPhA. 2021
Randomized controlled trials
1- 2A randomized, 14-day, double-blind study evaluating conversion from hydrocodone/acetaminophen (Vicodin) to buprenorphine transdermal system 10 μg/h or 20 μg/h in patients with osteoarthritis painPMIDRipa SR, McCarberg BH, Munera C et al. · Expert opinion on pharmacotherapy · 2012
Ripa SR, McCarberg BH, Munera C et al.. A randomized, 14-day, double-blind study evaluating conversion from hydrocodone/acetaminophen (Vicodin) to buprenorphine transdermal system 10 μg/h or 20 μg/h in patients with osteoarthritis pain. Expert opinion on pharmacotherapy. 2012
Reviews & position papers
4- 3Hydrocodone and AcetaminophenPMIDHabibi M, Kim PY · 2026
Habibi M, Kim PY. Hydrocodone and Acetaminophen. 2026
- 4Opioid overdose associated with concomitant use of hydrocodone and selective serotonin reuptake inhibitorsPMIDBea S, Huybrechts KF, Glynn RJ et al. · BMC medicine · 2025
Bea S, Huybrechts KF, Glynn RJ et al.. Opioid overdose associated with concomitant use of hydrocodone and selective serotonin reuptake inhibitors. BMC medicine. 2025
- 5Drug-Drug Interaction Between Orally Administered Hydrocodone-Acetaminophen and Inhalation of Cannabis Smoke: A Case ReportPMIDBindler RJ, Watson CJW, Lyons AJ et al. · Hospital pharmacy · 2022
Bindler RJ, Watson CJW, Lyons AJ et al.. Drug-Drug Interaction Between Orally Administered Hydrocodone-Acetaminophen and Inhalation of Cannabis Smoke: A Case Report. Hospital pharmacy. 2022
- 6Hydrocodone Bitartrate ER (Hysingla(®) ER): A Review in Chronic PainPMIDDhillon S · Clinical drug investigation · 2016
Dhillon S. Hydrocodone Bitartrate ER (Hysingla(®) ER): A Review in Chronic Pain. Clinical drug investigation. 2016
Reference material
4- 7Dowell D et al. CDC Clinical Practice Guideline for Prescribing Opioids for Pain, United States, 2022. MMWR. 2022.Source linkedPMID
- 8Argoff CE et al. Rational unanticipated positive drug tests, issues of unused opioids and their potential for diversion: the role of drug testing. Pain Med. 2014.Source linkedPMID
- 9Manchikanti L et al. Comparative evaluation of the opioid use in the management of chronic pain. Pain Physician. 2011.Source linkedPMID
- 10Coates S, Lazarus P. Hydrocodone, Oxycodone, and Morphine Metabolism and Drug-Drug Interactions. The Journal of pharmacology and experimental therapeutics. 2023Source linkedPMID
Common questions.
Quick answers about Hydrocodone, drawn from the data on this page.
What is Hydrocodone?
A semi-synthetic opioid commonly prescribed in combination with acetaminophen (Vicodin, Norco) for the management of pain severe enough to require opioid treatment and for which alternative treatments are inadequate. Hydrocodone is the most frequently prescribed opioid in the United States and is a Schedule II controlled substance.
What is Hydrocodone used for?
Commonly cited benefits of Hydrocodone include: Effective management of moderate to moderately severe pain; Combination with acetaminophen provides multimodal analgesia; Available in extended-release single-entity formulations; Antitussive properties. NutriStack rates the overall evidence as strong.
What is a typical dose of Hydrocodone?
A typical adult dose of Hydrocodone is Combination products: 5–10 mg hydrocodone/325 mg acetaminophen every 4–6 hours as needed; ER: 10–20 mg every 12 hours initially (as prescribed by your physician). The commonly recommended form is Combination tablet (with acetaminophen) or extended-release capsule (single entity). These are general ranges, not personalized advice; confirm the right dose with a clinician.
What are the side effects of Hydrocodone?
Reported side effects include constipation, nausea and vomiting, drowsiness and sedation, dizziness and lightheadedness, respiratory depression, physical dependence and tolerance. This is educational information; check with a healthcare professional before use.
How strong is the evidence for Hydrocodone?
NutriStack rates this as Strong, meaning multiple high-quality meta-analyses or systematic reviews converge on the same finding. Full tier criteria are at https://nutristackapp.com/methodology/evidence-tiers.
Use this with your stack
Hydrocodone in NutriStack.
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