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Hydrocodone

Opioidoral · inferred

Semi-synthetic opioid analgesic. Metabolized by CYP2D6 to hydromorphone (active, more potent) and by CYP3A4 to norhydrocodone (weakly active). Half-life ~3.8 hours for immediate release. Detectable in urine for 2-4 days.

Projected serum levels — 5 mg, as needed (shown daily)

Hydrocodone
Hydrocodone modeled serum levels, 5 mg as needed (shown daily) over 15 days Population-based pharmacokinetic estimate. Steady state reached after approximately 1 days. 0 1.3 2.5 3.8 5 Day 0 Day 4 Day 8 Day 11 Day 15 Time on a regular schedule ≈ steady state · day 1

Maintenance schedule: 5 mg as needed (shown daily) (oral).

Modeled steady state after ~1 days: peak ≈ 2.8 mg, trough ≈ 0.060 mg body load. Population-based estimate over 15 days for a 5 mg dose at a 70 kg reference body mass — the interactive app scales curves to your doses, timing, and body mass.

Key facts

Category
Opioid
Route modeled
Oral
Model confidence
inferred
Half-life
4 h
Common dose
5 mg
Suggested maximum
60 mg/day
Reference dose range
2.5–60 mg (single dose)
Suggested cadence
as needed (shown daily)
Validated against
10 mg oral — Cmax 0.025 mg/L at 1.3 h

Documented interactions

  • danger
    1,4-BDO (1,4-Butanediol) + Hydrocodone Contraindicated

    1,4-BDO converts to GHB. Combined with opioid respiratory depression, frequently fatal.

  • danger
    7-Hydroxymitragynine (7-OH) + Hydrocodone Contraindicated

    7-Hydroxymitragynine is a potent mu-opioid agonist. Combined with hydrocodone, additive respiratory depression risk is life-threatening.

  • danger
    Carbamazepine (Tegretol) + Hydrocodone CYP induction

    Carbamazepine (Tegretol) inducer of CYP3A4 predicted to change Hydrocodone AUC by ~0.36x

  • danger
    Cocaine + Hydrocodone Contraindicated

    Speedball combination: cocaine masks opioid sedation, risking accidental overdose.

  • danger
    Codeine + Hydrocodone Contraindicated

    Combining opioids causes additive respiratory depression.

  • danger
    Efavirenz (Sustiva) + Hydrocodone CYP induction

    Efavirenz (Sustiva) inducer of CYP3A4 predicted to change Hydrocodone AUC by ~0.24x

Serum checks 133 modeled interaction pairings for hydrocodone across your whole stack — absorption conflicts, enzyme inhibition, and nutrient depletion included.

Research behind this entry

  1. Excretion Profile of Hydrocodone, Hydromorphone and Norhydrocodone in Urine Following Single Dose Administration of Hydrocodone to Healthy Volunteers Kerrigan S, Goldberger BA · Journal of Analytical Toxicology, 2012 DOI

    Characterized urinary excretion of hydrocodone and metabolites hydromorphone and norhydrocodone after a single 10 mg oral dose in healthy volunteers.

  2. In Vivo Activity of Norhydrocodone: An Active Metabolite of Hydrocodone Navarro HA et al. · Journal of Pharmacology and Experimental Therapeutics, 2013 DOI

    Demonstrated that norhydrocodone, formed via CYP3A4 N-demethylation, is an active metabolite contributing to therapeutic and toxic effects of hydrocodone.

  3. Preclinical and Clinical Pharmacology of Hydrocodone for Chronic Pain: A Mini Review Trescot AM · Frontiers in Pharmacology, 2018 DOI

    Reviewed hydrocodone pharmacology including CYP2D6-mediated O-demethylation to hydromorphone, CYP3A4-mediated N-demethylation to norhydrocodone, and clinical implications for pain management.

  4. Effect of Opioid vs Nonopioid Medications on Pain-Related Function in Patients With Chronic Back Pain or Hip or Knee Osteoarthritis Pain: The SPACE Randomized Clinical Trial Krebs EE et al. · JAMA, 2018 DOI

    12-month RCT of 240 veterans found opioids (including hydrocodone) were NOT superior to non-opioid therapy for pain-related function in chronic musculoskeletal pain; pain intensity was actually worse in the opioid group.

5 published studies referenced in the app, each with a plain-language summary.