hydrocodone / homatropine
Hycodan is a combination medication that contains hydrocodone (an opioid) and homatropine (an anticholinergic). It's used to help lower the urge to cough in adults. But Hycodan (hydrocodone / homatropine) isn't a first-choice cough medicine because it's a controlled substance and can cause serious side effects, such as trouble breathing. Hycodan (hydrocodone / homatropine) is taken by mouth, typically every 6 hours, as needed. Common side effects include sleepiness, dizziness, and constipation. This medication is available as a generic tablet and an oral solution.
What is Hycodan (hydrocodone / homatropine)?
What is Hycodan (hydrocodone / homatropine) used for?
Treatment of cough in adults
How Hycodan (hydrocodone / homatropine) works
Hycodan (hydrocodone / homatropine) is a combination of two medications:
Hydrocodone is an opioid. It eases cough by attaching to opioid receptors in the brain that control the urge to cough.
Homatropine is an anticholinergic medication. It blocks certain receptors in the body, which might relieve cough by affecting muscles in the airways. But it's also included in Hycodan to discourage people from taking too much medication.
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What are the risks and warnings for Hycodan (hydrocodone / homatropine)?
Hycodan (hydrocodone / homatropine) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Potential for misuse and addiction
Risk factors: Personal or family history of alcohol or substance use disorder | Personal or family history of mental health conditions
Hycodan contains an hydrocodone, which is an opioid medication that carries a risk of addiction or misuse, even at recommended doses. In serious cases, addiction and misuse of an opioid medication can lead to overdose and death.
Hycodan (hydrocodone / homatropine) is typically prescribed only when cough relief outweighs these serious risks. If absolutely necessary, your healthcare professional (HCP) will prescribe the lowest amount of medication for the shortest period of time needed to treat your symptoms. Contact your HCP to discuss other options if you've taken Hycodan (hydrocodone / homatropine) for 5 days and your cough hasn't gotten better.
Dangerously slow breathing (respiratory depression)
Risk factors: Older adults | Children younger than 18 years old | Taking medications that can cause slow breathing | Brain injury | Drinking alcohol | Having medical conditions that affect breathing | Taking higher doses of Hycodan (hydrocodone / homatropine) than prescribed
Hycodan (hydrocodone / homatropine) can cause dangerously slow breathing, which can be life-threatening. This can happen at any time, but you're at higher risk 1 to 3 days right after you start Hycodan (hydrocodone / homatropine). Drinking alcohol and taking other medications, like benzodiazepines, can also raise your risk for this dangerous side effect.
You're recommended to ask your prescriber about getting naloxone, a medication that can reverse slowed breathing from opioids. You should have naloxone before you start Hycodan (hydrocodone / homatropine) so that you can use it in case of an accidental overdose. Call 911 to get medical help right away if you or your loved one notices you have trouble breathing or have bluish-colored lips.
Difficulty concentrating and extreme sleepiness
Risk factors: Taking higher doses of Hycodan (hydrocodone / homatropine) | Age 65 years or older | Drinking alcohol | Taking other medications that can cause sleepiness
Hycodan (hydrocodone / homatropine) can cause extreme sleepiness and lower your ability to think, react, and focus. Your risk for these side effects is higher if you're taking other medications that can make you sleepy, such as benzodiazepines, muscle relaxants, and sleep medications.
Make sure you know how Hycodan (hydrocodone / homatropine) affects you before driving a car or doing activities that require your concentration. Talk to your HCP right away if you feel too sleepy from the medication.
Risk for overdose
Risk factors: History of opioid use disorder | Previous opioid overdose | Taking high doses of Hycodan (hydrocodone / homatropine) | Taking more opioids or antihistamines than prescribed | Drinking alcohol
Take Hycodan (hydrocodone / homatropine) exactly as prescribed. Taking too much medication or taking it more often than prescribed can lead to an overdose. When measuring out your dose of Hycodan (hydrocodone / homatropine), only use an oral syringe or a medication cup; don't use household spoons because they might not be accurate. Be sure to keep the opioid medication out of reach from children, pets, or visitors to prevent accidental exposure or overdose. Don't drink alcohol while taking Hycodan (hydrocodone / homatropine) because doing so raises the risk for overdose.
Symptoms of an opioid overdose include not responding to sound or touch, extremely slow breathing, extreme sleepiness, slow heartbeat, and cold or clammy skin. Be sure you and your loved ones know how to recognize an overdose. Your prescriber will probably write a prescription for naloxone (Narcan), a medication that can treat an opioid overdose. Carry naloxone with you at all times; use it and call 911 right away if an overdose happens.
Additionally, anticholinergic medications can be found in some over-the-counter products, such as diphenhydramine (Benadryl). Very rarely, taking too much anticholinergic medication can lead to side effects such as confusion, delirium, skin flushing, and fever. To prevent an accidental overdose, read package labels carefully. Ask your pharmacist if you're not sure whether a product has an anticholinergic in it.
Drug interactions
Hycodan (hydrocodone / homatropine) interacts with a lot of common medications. So it's important to tell your prescriber and pharmacist about the medications you're taking and planning to take with Hycodan (hydrocodone / homatropine). Your care team can check that your medications are safe to take together. Also talk to your care team first before making any changes to your medications because sudden dose adjustments can also lead to harm.
Some interactions can raise the level of hydrocodone in your body. This can raise your risk for serious side effects, including potentially life-threatening slowed breathing. Examples of medications that can lead to this type of interaction with Hycodan (hydrocodone / homatropine) include erythromycin, ketoconazole, and ritonavir (Norvir).
Other drug interactions can lower the levels of hydrocodone in your body. This can cause the opioid to work less well for you and possibly lead to withdrawal symptoms. These interactions include taking Hycodan (hydrocodone / homatropine) with rifampin (Rifadin) or carbamazepine (Tegretol).
Harm to newborn babies
Hycodan (hydrocodone / homatropine) can be transferred to your unborn baby if you take this medication during pregnancy. Long-term opioid use during pregnancy can cause your unborn baby to become dependent on the medication.
Once your baby is born, they can experience withdrawal symptoms, such as high-pitched crying, poor feeding and sucking behavior, trembling, irritability, abnormal sleep patterns, and seizures. This condition is called neonatal opioid withdrawal syndrome and can be life-threatening if not recognized and treated in time. Let your healthcare team know if you've used Hycodan (hydrocodone / homatropine) during pregnancy or if you notice these symptoms in your baby.
Low blood pressure
Hycodan (hydrocodone / homatropine) can cause extremely low blood pressure. Your blood pressure might drop when you stand from a sitting or lying down position. This can lead to dizziness and fainting. To avoid falling, get up slowly if you've been sitting or lying down. Talk to your HCP if any dizziness or lightheadedness doesn't go away.
Low adrenal hormone levels
Risk factors: Taking Hycodan (hydrocodone / homatropine) for longer than 1 month
Some people taking opioid medications like Hycodan (hydrocodone / homatropine) have had low adrenal hormone levels. This might be more likely to happen after taking opioids for longer than 1 month. Symptoms include tiredness, dizziness, weakness, not feeling hungry, nausea, and vomiting. Tell your HCP if you have these symptoms. If your adrenal hormone levels are too low, you might need to stop Hycodan (hydrocodone / homatropine) and be treated with corticosteroids.
Seizures
Risk factors: History of seizure conditions
Opioids such as hydrocodone can raise the risk of having seizures more often in people who have had seizures in the past. Hycodan (hydrocodone / homatropine) can also raise your risk of seizures in certain situations. Get medical help right away if you have a seizure while you're taking this medication.
Caution in people with gut-related conditions
Hycodan (hydrocodone / homatropine) can cause your gut movement to slow and can lead to constipation or bowel obstruction. This medication shouldn't be taken by people who already have bowel obstruction or conditions related to gut movement. To lower your risk of constipation, drink enough fluids and eat foods that are rich in fiber, such as broccoli, apples, almonds. Get medical attention right away if you experience symptoms related to bowel obstruction, such as serious stomach pains, bloating, or nausea.
What are the side effects of Hycodan (hydrocodone / homatropine)?
Common Side Effects
- Sleepiness
- Trouble thinking clearly
- Trouble walking or performing tasks
- Lightheadedness
- Dizziness
- Headache
- Dry mouth
- Nausea
- Vomiting
- Constipation
Other Side Effects
- Flushing
- Itching
- Rash
- Stomach pain
- Low appetite
Serious Side Effects
- Dangerously slow breathing: trouble breathing; bluish-colored lips, fingers, or toes
- Accidentally taking too much (overdose): not responding to sound or touch, slow breathing, extreme sleepiness, cold or clammy skin, slow or irregular heartbeat, confusion, seizure
- Opioid withdrawal (if suddenly stopped after long-term use): anxiety, suicidal thoughts, restlessness, runny nose, yawning, sweating, chills, wide pupils, irritability
- Excessive sleepiness or dizziness
- Seizures
Source: DailyMed
The following side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
- CNS depression—slow or shallow breathing, shortness of breath, feeling faint, dizziness, confusion, trouble staying awake
- Low adrenal gland function—nausea, vomiting, loss of appetite, unusual weakness or fatigue, dizziness
- Low blood pressure—dizziness, feeling faint or lightheaded, blurry vision
Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome):
- Confusion
- Constipation
- Dizziness
- Drowsiness
- Dry mouth
- Headache
- Nausea
- Vomiting
Pros and cons of Hycodan (hydrocodone / homatropine)
Pros
Available as a tablet and as a liquid
Can be used as needed for cough
Available as a lower-cost generic
Cons
Hasn't been studied in children
Can be habit-forming
Only provides relief for the cough, but doesn't help the actual cause of the cough
Pharmacist tips for Hycodan (hydrocodone / homatropine)
Take Hycodan (hydrocodone / homatropine) with or without food. If it's hurting your stomach, taking it with food might help.
Let your prescriber know if your cough doesn't get better after taking Hycodan (hydrocodone / homatropine) for 5 days. You might need to receive different treatment. Taking Hycodan (hydrocodone / homatropine) when it doesn't work well to treat a cough raises your risk for dependence and serious side effects, such as sleepiness and breathing problems.
Hycodan (hydrocodone / homatropine) can make you sleepy and dizzy, which can affect your ability to think, react, and focus. Don't drive or do activities where you need to focus until you know how this medication affects you.
You shouldn't drink alcohol while you're taking Hycodan (hydrocodone / homatropine). Doing so can make you very sleepy or dizzy and make it hard to think clearly. This can lead to accidental injuries.
Constipation is a common side effect of Hycodan (hydrocodone / homatropine). Drink enough water each day and add more foods with fiber to your diet. Speak to your care team if these lifestyle changes aren't enough to help with this side effect.
Tell your prescriber and pharmacist about all the medications you're taking to make sure Hycodan (hydrocodone / homatropine) is safe to take with them. Your care team should review your medication list to make sure your medications are safe to take together. Several medications can interact with Hycodan (hydrocodone / homatropine), which can be harmful.
Talk with your prescriber if you've been regularly taking Hycodan (hydrocodone / homatropine) for a long period of time and you want to stop. Your prescriber might lower your dose slowly over time before you can stop completely. This helps prevent opioid withdrawal symptoms, such as anxiety, sweating, chills, and irritability, which can happen after lowering your dose or stopping the medication too suddenly.
Let your prescriber know if you're pregnant. Hycodan (hydrocodone / homatropine) is generally not recommended during pregnancy. Doing so puts your baby at risk for neonatal opioid withdrawal syndrome at birth, and this condition can be life-threatening.
Tell your healthcare team if you're breastfeeding. It's typically recommended to avoid Hycodan (hydrocodone / homatropine) because hydrocodone can get into breast milk. This raises the risk for serious side effects to your baby (e.g., sleepiness, slowed breathing).
Store the Hycodan (hydrocodone / homatropine) liquid at room temperature. Only use the plastic dosing spoon, medication dosing cup, or oral syringe that the pharmacy gives you to measure out your dose. Never use household spoons because they aren't accurate.
Store Hycodan (hydrocodone / homatropine) out of reach from children, pets, or visitors. Contact a pharmacist about how to get rid of it safely if you don't need to take the medication anymore. This lowers the risk of accidental overdose and helps prevent medication misuse.
Frequently asked questions about Hycodan (hydrocodone / homatropine)
has several risks too, so it's not the best choice for everyone. People with certain medical conditions should ask a healthcare provider first if it's safe to take ibuprofen (Advil) with Hycodan (hydrocodone / homatropine), such as those with heart failure or kidney problems.
hydrocodone. Because of this risk, Hycodan (hydrocodone / homatropine) has a black box warning for risk of addiction and dependence and is a schedule II controlled substance, just like other opioids. To lower the risk for addiction and dependence, take Hycodan (hydrocodone / homatropine) exactly as prescribed to you. Your HCP will also prescribe the lowest dose for the shortest period of time needed to treat your condition.
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Hycodan (hydrocodone / homatropine) dosage forms
Typical dosing for Hycodan (hydrocodone / homatropine)
Hycodan (hydrocodone / homatropine) is available as a liquid and a tablet.
Each tablet contains 5 mg of hydrocodone and 1.5 mg of homatropine.
Each 5 mL of solution also contains 5 mg of hydrocodone and 1.5 mg of homatropine.
Adults: The typical starting dose is 1 tablet (or 5 mL of oral solution) by mouth every 6 hours as needed. Your primary care provider (PCP) will typically ask you to take the lowest dose for the shortest time needed to manage your cough.
How much does Hycodan (hydrocodone / homatropine) cost?
Hycodan (hydrocodone / homatropine) contraindications
Children younger than 6 years of age
Severe asthma or other medical conditions that cause severe, slow breathing
Medical conditions that cause blockage of the stomach passageway
Allergy to homatropine
Allergy to hydrocodone
What are alternatives to Hycodan (hydrocodone / homatropine)?
Hycodan (hydrocodone / homatropine) images
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References
Best studies we foundActavis Pharma, Inc. (2024). Hydromet- hydrocodone bitartrate and homatropine methylbromide solution [package insert]. DailyMed.
American College of Obstetricians and Gynecologists. (2017). Opioid use and opioid use disorder in pregnancy.
Centers for Disease Control and Prevention. (2024). About opioid use during pregnancy.
Cofano, S., et al. (2024). Hydrocodone. StatPearls.
Drugs and Lactation Database (LactMed®). (2023). Hydrocodone. National Institute of Child Health and Human Development.
Endocrine Society. (2022). Adrenal insufficiency.
Genus Lifesciences Inc. (2021). Hycodan- hydrocodone bitartrate and homatropine methylbromide tablet; Hycodan- hydrocodone bitartrate and homatropine methylbromide solution [package insert]. DailyMed.
Jansson, L. M., et al. (2019). Neonatal abstinence syndrome. Pediatric Clinics of North America.
National Institute of Diabetes and Digestive and Kidney Diseases. (2018). Symptoms and causes of adrenal insufficiency & Addison’s disease.
Obstetrics and Gynecology. (2021). Breastfeeding challenges: ACOG Committee Opinion, Number 820.
Patrick, S. W., et al. (2020). Neonatal opioid withdrawal syndrome. Pediatrics.
PubChem. (n.d.). Homatropine. National Library of Medicine.
Smith, H. S. (2009). Opioid metabolism. Mayo Clinic Proceedings.
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