Hydrocodone Bitartrate

By Rania Gollakner, BS, DVM, MPH

What is hydrocodone bitartrate?

Hydrocodone bitartrate (brand names: Tussigon®, Hycodan®, Vicodin®, Norco®, Lortabs®) is an opiate agonist used to treat pain and cough in dogs.

Its use in dogs to treat pain and cough is ‘off label’ or ‘extra-label’. Many drugs are commonly prescribed for off label use in veterinary medicine. In these instances, follow your veterinarian’s directions and cautions very carefully as their directions may be significantly different from those on the label.

How is hydrocodone given?

Hydrocodone is given by mouth, with or without food, in the form of a tablet or liquid solution. If your pet vomits after receiving this medication on an empty stomach, give the next dose with a meal or a treat. Do not give the hydrocodone/acetaminophen combination to cats, or hydrocodone/ibuprofen combination to dogs or cats.

This medication will take effect quickly, in about 1 to 2 hours, and improvements in clinical signs should follow.

What if I miss giving my pet the medication?

If you miss a dose, give it when you remember, but if it is close to the time for the next dose, skip the dose you missed and give it at the next scheduled time, and return to the regular dosing schedule. Never give your pet two doses at once or give extra doses.

Are there any potential side effects?

Side effects of hydrocodone include sedation, constipation, vomiting, or other gastrointestinal disturbances. This short-acting medication should stop working within 24 hours, although effects can be longer in pets with liver or kidney disease.

Are there any risk factors for this medication?

This medication should not be used in pets that are allergic to narcotics or in pets that have diarrhea due to a toxin. Hydrocodone should be used with caution in pets with low thyroid levels, severe kidney disease, Addison’s disease, head injuries, sudden abdominal conditions, increased intracranial pressure, or in geriatric, pregnant, nursing, or debilitated pets.

It should be used with extreme caution in pets with respiratory disease accompanied by increased secretions or in pets receiving nebulization.

Are there any drug interactions I should be aware of?

The following medications should be used with caution when given with hydrocodone: acepromazine, anticholinergics, antidepressants (tricyclic and MOA inhibitors), CNS depressants, escitalopram, and quinidine.

Be sure to tell your veterinarian about any medications (including vitamins, supplements, or herbal therapies) that your pet is taking.

Is there any monitoring that needs to be done with this medication?

There is no specific monitoring that needs to be done while your pet is taking this medication. Your veterinarian may monitor your pet to be sure that the medication is working. Monitor for adverse effects such as a yellowing of the skin, persistent gastrointestinal upset, or bloody vomit or stool, and contact your veterinarian if these signs are noted.

How do I store hydrocodone?

Hydrocodone should be stored away from light and at room temperature.

What should I do in case of emergency?

If you suspect an overdose or an adverse reaction to the medication, call your veterinary office immediately. If they are not available, follow their directions in contacting an emergency facility.