Hydrocodone ER (q12h)

ZOHYDRO ER

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Pronunciation: hye-droe-KOE-doen

Hydrocodone ER (q12h) ballicule: receptor binding, kinetics and half-life diagram — Mechanism of action: Hydrocodone ER (q12h) ballicule

Hydrocodone ER (q12h) VICODIN / NORCO mascot mnemonic cartoon — Visual mnemonic: Hydrocodone ER (q12h) mascot
**“Viking Hydrant code”**
Viking for Vicodin (combo with acetaminophen)

What it isFirst single-agent hydrocodone (ZOHYDRO ER, 2013) — q12h ER capsule with no acetaminophen, freeing dosing from APAP hepatotoxicity limits.

Why this oneSame molecule and receptor pharmacology as the parent card — the formulation (and its label) is the difference.

What limits itClass warnings of the parent molecule apply unchanged.

Hydrocodone ER (q12h) molecular structure (skeletal formula) — Molecular structure: Hydrocodone ER (q12h)

FDA-approved for

chronic pain (around-the-clock) (2013)

FDA label

Read the full label on DailyMed ↗

BOXED WARNING Addiction, abuse, and misuse; life-threatening respiratory depression; accidental ingestion; neonatal opioid withdrawal syndrome; interaction with alcohol; CYP3A4 interaction

FDA dosing	Population	Start	Target	Max
Pain severe enough to require daily, around-the-clock, long-term opioid treatment when alternatives are inadequate	Adults	10 mg q12h (opioid-naïve/non-tolerant)	Individualized	Individualized (>80 mg/day only in opioid-tolerant)

Titration Adjust in increments of 10 mg q12h no more often than every 3–7 days

Renal Initiate at a low dose; monitor for respiratory depression and sedation

Hepatic Mild–moderate: no starting-dose adjustment; severe: start 10 mg q12h

Dose every 12 hours; 50 mg capsule, single dose >40 mg, or total daily dose >80 mg only for opioid-tolerant patients

Instructions

Swallow capsules whole; do not cut, break, chew, crush, or dissolve
Not for as-needed (prn) use
Do not consume alcohol or alcohol-containing products
To discontinue, taper gradually every 2–4 days; do not stop abruptly

Available strengths

ER cap 10, 15, 20, 30, 40, 50 mg
ER tab 20, 30, 40, 60, 80, 100, 120 mg

Contraindications

Significant respiratory depression
Acute or severe bronchial asthma in an unmonitored setting or in the absence of resuscitative equipment
Known or suspected paralytic ileus

Cautions

Life-threatening respiratory depression
Neonatal opioid withdrawal syndrome
Interactions with other CNS depressants
Hypotensive effect
Gastrointestinal conditions (e.g., ileus)
Seizures
Adrenal insufficiency (opioid class)

Adverse reactions

Constipation
Nausea
Somnolence
Fatigue
Headache
Dizziness
Dry mouth
Vomiting
Pruritus
Abdominal pain
Peripheral edema
Tremor

Pregnancy Prolonged use during pregnancy can cause neonatal opioid withdrawal syndrome

Lactation Not recommended

Cost

Hydrocodone ER (q12h) (ZOHYDRO ER)

What pharmacies pay · NADAC 9/30/26

Strength		#/mo	generic $/mo	CostPlus
10 mg	ER cap	60 BID		not offered
15 mg	ER cap	60 BID	$476.82	not offered
20 mg	ER cap	60 BID	$412.49	not offered
30 mg	ER cap	60 BID	$432.69	not offered
40 mg	ER cap	60 BID		not offered
50 mg	ER cap	60 BID		not offered

Other forms: Hydrocodone ER (q24h) (HYSINGLA ER)

Available combined with: hydrocodone / acetaminophen

⚠ BOXED WARNINGS

Addiction, abuse and misuse
Life-threatening respiratory depression
Risk from concomitant use with benzodiazepines

Classes and tags

Clinical profile

Therapeutic safety burden3 / 4

Overdose danger4 / 4

Weight-gain liability0 / 4

Sedation liability2 / 4

QT / Torsades0 / 4

Direct muscarinic antagonism0 / 4

Embryofetal risk2 / 4

Legacy pregnancy categoryC

Defining liabilityRespiratory depression, dependence and overdose; risk rises sharply with sedatives or impaired clearance.

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Memory aids: interaction avatars

CYP2D6 substrate

CYP3A4 substrate

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