antoinette - I am bumping this up out of curiosity myself as to why there is no long acting HYDROcodone, like their is for oxycodone. You didn't get many replies, maybe because it was a slow weekend...
Thanks for bumping it. I think I had asked the question in passing in one of my past posts or maybe it was on another board but I have never gotten an answer. I would ask my PM doc but thank God I have no reason to see her these days.
I figured Shoreline would know since he is so knowledgable about these things. Hope this will draw some attention to the question.
hey, that is a very good question. we here in Canada do not have hydrocodone at all for pain relief. some of our prescription cough syrups do contain hydrocodone, but I am not sure why we do not even use it for short acting pain relief let alone la. although I have heard of some pharmacies through out the USA compounding hydrocodone to make a long acting version which I also think contains dextromethmorphan as an ingrediant. But I know only certain specialty pharms compound it for chronic doseing as an la med.
Hydromorphone (known as Dilaudid and formerly as Palladone) is a different med then Hydrocodone (known as Vicodin, Lortab, and Norco among others).
The op asked about why Hydrocodone is not available as a LA narcotic without the apap or aspirin, just alone, like oxycontin. This is a question I myself posed about two years ago. The reason basically boils down to the fact that pure hydrocodone without any other medications such as tylenol, ibuprofen or aspirin, is actually considered a Schedule II narcotic. While the commercially available hydrocodone products such as vicodin, vicoprofen, norco, etc. (which do contain the other medications) are considered Schedule III narcotics. Because CII narcotics are so heavily regulated, the drug companies ability to market the drug is restricted and their overall sales would be significantly reduced as a result of being CII. So by combining the hydrocodone with the other meds, they are able to sell them as CIII drugs and basically make a whole lot more money. (Vicodin is the #1 selling prescription drug on the market, out of the hundreds of different blockbuster meds- period!!) And apparently the DEA laws limit the ratio of hydrocodone to apap, aspirin, or ibuprofen to such a low level (in order to maintain CIII status) that making a LA CIII hydrocodone product would not be effective, feasable, legal or safe due to the high amount of apap, aspirin, ibuprofen that would have to be used to keep the ratio at CIII required levels. BTW, Hydromorphone is a much more potent narcotic (available only alone, not as a combo drug and always CII) that is used orally as dilaudid and IV/IM as well and orally is about 7X more potent then hydrocodone mg for mg. Palladone in the USA was briefly available as a long acting oral version of hydromorphone, but as the previous poster stated, was pulled due to premature dissolution of the pill by small doses of concurrrently administered alcohol, leading to possible acute hydromorphone toxicity and resultant respiratory depression. Ironically, if US formulated Palladone (24 hour dosing in 8, 12, 16, 24, & 32 mg dosages) was so dangerous, why is it still available in Canada (with 12 hours dosing in the same dosage strengths, thereby twice as potent to start with)?
Hydrocodone, oxycodone, and codeine are PRO drugs. They require activation by enzymes in the body to become effective. Hydrocodone, oxycodone, and codeine are converted into hydromorphone, oxymorphone, and morphine, respectively. Interestingly, up to 10% of the population are poor metabolizers and would need higher doses of the PRO drugs or would need to take the active metabolite instead of the PRO drug.
That's absolutely correct, wren, most people actually don't realize the correlation between the various narcotics and how they relate chemically, but docs should be versed in those intricacies of opioid pain relievers, but all too often they are not. Catnap, you were under the wrong impression. Read the previous post for the full explanation.
I was always thinking the same thing myself.
It might have something to do with what hydrocodone turn into when in the body, and there may be a drug out like that already , who knows ?
Maybe ask a doc or a pharmacist.
FWIW the FDA is retesting a new long acting hydrocodone. If you do some research on trials and studies from the FDA you can find more information regarding the subject.
I'm not familiar with any in the past that have been on the market.