Hydrocodone Bitartrate

By Lauren Forsythe, PharmD, DICVP; Rania Gollakner, BS, DVM, MPH

What is hydrocodone bitartrate?

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

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?

  • Give hydrocodone by mouth, with or without food, in the form of a tablet or liquid syrup.
  • 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.
  • Do not give the hydrocodone/ibuprofen combination to dogs or cats.

This medication takes 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. However, if it is close to the time for the next dose, skip the dose you missed, 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?

Do NOT use hydrocodone in pets that:

  • are allergic to narcotics
  • have diarrhea due to a toxin

Use hydrocodone with caution in pets that:

  • have low thyroid levels
  • have severe kidney disease
  • have Addison’s disease
  • have head injuries
  • have sudden abdominal conditions
  • have increased intracranial pressure
  • are geriatric, pregnant, nursing, or debilitated

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?

Certain medications should be used with caution when given with hydrocodone, including but not limited to:

  • acepromazine
  • some antidepressants
  • Central nervous system (CNS) depressants

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?

  • Store at room temperature.
  • Store protected from light.
  • Store in a locked cabinet or safe and monitor the amount of medication remaining.

Hydrocodone is a controlled substance, which means that it has been designated by the Drug Enforcement Administration (DEA) as having a potential for diversion to people other than the patient it was prescribed for.

Use of a controlled substance in any person or animal other than that for which it is prescribed is illegal. Therefore, this medication should be stored in a locked cabinet or safe that cannot be easily moved with access limited to only those that need to administer the medication. Monitor the amount of medication remaining to ensure the expected amount is present.

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.

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