hydrocodone / homatropine
Hydromet is a combination medication that contains hydrocodone (an opioid) and homatropine (an anticholinergic). It helps ease cough in adults by lowering the urge to cough. But Hydromet (hydrocodone / homatropine) isn't a first-choice option for this condition because it's a controlled substance and can cause serious side effects, such as trouble breathing. Hydromet (hydrocodone / homatropine) is taken by mouth, typically every 6 hours as needed. Some common side effects of this medication include sleepiness, trouble thinking clearly, and constipation. Hydromet (hydrocodone / homatropine) is available as a generic medication.
What is Hydromet (hydrocodone / homatropine)?
What is Hydromet (hydrocodone / homatropine) used for?
Treatment of cough in adults
How Hydromet (hydrocodone / homatropine) works
Hydromet (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 Hydromet to discourage people from taking too much medication.
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What are the risks and warnings for Hydromet (hydrocodone / homatropine)?
Hydromet (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
Hydromet contains an opioid medication (hydrocodone), which 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.
Hydromet (hydrocodone / homatropine) is typically prescribed only when cough relief outweigh 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 Hydromet (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 Hydromet (hydrocodone / homatropine) than prescribed
Hydromet (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 Hydromet (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 Hydromet (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 Hydromet (hydrocodone / homatropine) | Age 65 years or older | Drinking alcohol | Taking other medications that can cause sleepiness
Hydromet (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 Hydromet (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 Hydromet (hydrocodone / homatropine) | Taking more opioids or antihistamines than prescribed | Drinking alcohol
Take Hydromet (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 Hydromet (hydrocodone / homatropine), only use a 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 Hydromet (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
Hydromet (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 Hydromet (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 Hydromet (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 Hydromet (hydrocodone / homatropine) with rifampin (Rifadin) or carbamazepine (Tegretol).
Harm to newborn babies
Hydromet (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 Hydromet (hydrocodone / homatropine) during pregnancy or if you notice these symptoms in your baby.
Low blood pressure
Hydromet (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 Hydromet (hydrocodone / homatropine) for longer than 1 month
Some people taking opioid medications like Hydromet (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 Hydromet (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. Hydromet (hydrocodone / homatropine) can also raises 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
Hydromet (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 Hydromet (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:Â DailyMed
The following side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
Less common
Bladder pain
bloating or swelling of the face, arms, hands, lower legs, or feet
bloody or cloudy urine
body aches or pain
chills
difficult or labored breathing
difficult, burning, or painful urination
ear congestion
fear or nervousness
frequent urge to urinate
headache
loss of voice
lower back or side pain
rapid weight gain
tightness in the chest
tingling of the hands or feet
unusual tiredness or weakness
unusual weight gain or loss
Incidence not known
Agitation
darkening of the skin
difficulty swallowing
fast heartbeat
loss of appetite
mental depression
overactive reflexes
poor coordination
puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
restlessness
shivering
talking or acting with excitement you cannot control
trembling or shaking
twitching
vomiting
Get emergency help immediately if any of the following symptoms of overdose occur:
Symptoms of overdose
Blue lips and fingernails
blurred vision
change in consciousness
chest pain or discomfort
cold and clammy skin
confusion
constricted pupil (black part of the eye)
coughing that sometimes produces a pink frothy sputum
decreased awareness or responsiveness
dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
increased sweating
irregular, fast or slow, or shallow breathing
lightheadedness, dizziness, or fainting
pale skin
sleepiness or unusual drowsiness
slow or irregular heartbeat
weak muscle tone
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common
Difficulty having a bowel movement
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Pros and cons of Hydromet (hydrocodone / homatropine)
Pros
Liquid medication, so good option for people who've trouble swallowing tablets
Can be taken as needed for cough
Cons
Can be habit-forming
Can cause slowed or abnormal breathing, which can be dangerous
Only provides relief for the cough, but doesn't help the actual cause of the cough
Pharmacist tips for Hydromet (hydrocodone / homatropine)
Take Hydromet (hydrocodone / homatropine) with or without food. But taking the medication with food can help prevent or ease stomach upset.
Let your prescriber know if your cough doesn't get better after taking Hydromet (hydrocodone / homatropine) for 5 days. If this medication isn't helping your cough after 5 days, then your healthcare team will talk with you about other options. Continuing Hydromet when it isn't work well for you can raise your risk for dependence and serious side effects, such as sleepiness and breathing problems.
Store Hydromet (hydrocodone / homatropine) at room temperature. Make sure to use the plastic dosing spoon, medication dosing cup, or oral syringe that the pharmacy provides you to measure out your dose. Don't use household teaspoons; using them might cause you to take the wrong amount of medication.
Hydromet (hydrocodone / homatropine) causes dizziness, sleepiness, and trouble focusing or concentrating. Avoid activities that require you to be alert, like driving, until you know how the medication affects you.
Avoid drinking alcohol while taking Hydromet (hydrocodone / homatropine). Doing so can worsen side effects like sleepiness and dizziness. Both alcohol and Hydromet (hydrocodone / homatropine) can also cause you to have trouble thinking clearly and reacting quickly.
It's common to have constipation as a side effect while you're taking Hydromet (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 Hydromet (hydrocodone / homatropine) is safe to take with them. Several medications can interact with both hydrocodone and homatropine, and these interactions can be harmful.
Talk with your prescriber if you've been regularly taking Hydromet (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 before you start taking Hydromet (hydrocodone / homatropine) or if you become pregnant while you're taking this medication. Hydromet (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 Hydromet (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 Hydromet (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 Hydromet (hydrocodone / homatropine)
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Hydromet (hydrocodone / homatropine) dosage forms
| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 5mg/1.5mg/5ml | 120 ml | $14.67 | $0.12 |
Typical dosing for Hydromet (hydrocodone / homatropine)
Hydromet (hydrocodone / homatropine) liquid
Each 5 mL of solution contains 5 mg of hydrocodone and 1.5 mg of homatropine.
Adults: The typical starting dose is 5 mL 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.
Interactions between Hydromet (hydrocodone / homatropine) and other drugs
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
- Nalmefene
- Naltrexone
- Safinamide
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Abametapir
- Acepromazine
- Alfentanil
- Almotriptan
- Alprazolam
- Amifampridine
- Amineptine
- Amiodarone
- Amitriptyline
- Amitriptylinoxide
- Amobarbital
- Amoxapine
- Amphetamine
- Amprenavir
- Anileridine
- Aprepitant
- Aripiprazole
- Armodafinil
- Asenapine
- Atazanavir
- Baclofen
- Benperidol
- Benzphetamine
- Boceprevir
- Bosentan
- Bromazepam
- Bromopride
- Brompheniramine
- Buprenorphine
- Buspirone
- Butabarbital
- Butorphanol
- Calcium Oxybate
- Cannabidiol
- Carbamazepine
- Carbinoxamine
- Carisoprodol
- Carphenazine
- Ceritinib
- Cetirizine
- Chloral Hydrate
- Chlordiazepoxide
- Chlorpheniramine
- Chlorpromazine
- Chlorzoxazone
- Ciprofloxacin
- Citalopram
- Clarithromycin
- Clobazam
- Clomipramine
- Clonazepam
- Clopidogrel
- Clorazepate
- Clozapine
- Cobicistat
- Cocaine
- Codeine
- Conivaptan
- Crizotinib
- Cyclobenzaprine
- Cyclosporine
- Darunavir
- Dasabuvir
- Delavirdine
- Desipramine
- Desmopressin
- Desvenlafaxine
- Dexamethasone
- Dexmedetomidine
- Dextroamphetamine
- Dextromethorphan
- Dezocine
- Diazepam
- Dibenzepin
- Dichloralphenazone
- Difenoxin
- Dihydrocodeine
- Diltiazem
- Diphenhydramine
- Diphenoxylate
- Dolasetron
- Donepezil
- Doxepin
- Doxylamine
- Dronedarone
- Droperidol
- Duloxetine
- Efavirenz
- Eletriptan
- Enflurane
- Enzalutamide
- Erythromycin
- Escitalopram
- Esketamine
- Eslicarbazepine Acetate
- Estazolam
- Eszopiclone
- Ethchlorvynol
- Ethopropazine
- Ethylmorphine
- Etravirine
- Fenfluramine
- Fentanyl
- Flibanserin
- Fluconazole
- Fluoxetine
- Fluphenazine
- Flurazepam
- Fluspirilene
- Fluvoxamine
- Fosamprenavir
- Fosaprepitant
- Fosnetupitant
- Fosphenytoin
- Fospropofol
- Frovatriptan
- Furazolidone
- Gabapentin
- Gabapentin Enacarbil
- Granisetron
- Halazepam
- Haloperidol
- Halothane
- Hexobarbital
- Hydromorphone
- Hydroxytryptophan
- Hydroxyzine
- Idelalisib
- Imatinib
- Imipramine
- Indinavir
- Iproniazid
- Isocarboxazid
- Isoflurane
- Itraconazole
- Ivacaftor
- Ketamine
- Ketazolam
- Ketobemidone
- Ketoconazole
- Lasmiditan
- Lemborexant
- Levocetirizine
- Levomilnacipran
- Levorphanol
- Linezolid
- Lisdexamfetamine
- Lithium
- Lofepramine
- Lofexidine
- Lomitapide
- Lopinavir
- Lorazepam
- Lorcaserin
- Loxapine
- Lumacaftor
- Magnesium Oxybate
- Meclizine
- Melitracen
- Melperone
- Meperidine
- Mephobarbital
- Meprobamate
- Meptazinol
- Mesoridazine
- Metaxalone
- Methadone
- Methamphetamine
- Methdilazine
- Methocarbamol
- Methohexital
- Methotrimeprazine
- Methylene Blue
- Metoclopramide
- Mibefradil
- Midazolam
- Mifepristone
- Milnacipran
- Mirtazapine
- Mitotane
- Moclobemide
- Modafinil
- Molindone
- Moricizine
- Morphine
- Morphine Sulfate Liposome
- Nafcillin
- Nalbuphine
- Naratriptan
- Nefazodone
- Nelfinavir
- Netupitant
- Nevirapine
- Nialamide
- Nicomorphine
- Nilotinib
- Nitrazepam
- Nitrous Oxide
- Nortriptyline
- Olanzapine
- Ombitasvir
- Ondansetron
- Opipramol
- Opium
- Opium Alkaloids
- Orphenadrine
- Oxazepam
- Oxcarbazepine
- Oxycodone
- Oxymorphone
- Ozanimod
- Palbociclib
- Palonosetron
- Papaveretum
- Paregoric
- Paritaprevir
- Paroxetine
- Pentazocine
- Pentobarbital
- Perampanel
- Perazine
- Periciazine
- Perphenazine
- Phenelzine
- Phenobarbital
- Phenytoin
- Piperacetazine
- Pipotiazine
- Piritramide
- Posaconazole
- Potassium Oxybate
- Prazepam
- Prednisone
- Pregabalin
- Primidone
- Procarbazine
- Prochlorperazine
- Promazine
- Promethazine
- Propofol
- Protriptyline
- Quazepam
- Quetiapine
- Ramelteon
- Ranitidine
- Ranolazine
- Rasagiline
- Remifentanil
- Remimazolam
- Remoxipride
- Rifabutin
- Rifampin
- Rifapentine
- Ritonavir
- Rizatriptan
- Saquinavir
- Scopolamine
- Secobarbital
- Selegiline
- Sertindole
- Sertraline
- Sibutramine
- Sodium Oxybate
- St John's Wort
- Sufentanil
- Sulpiride
- Sumatriptan
- Suvorexant
- Tapentadol
- Telaprevir
- Telithromycin
- Temazepam
- Thiethylperazine
- Thiopental
- Thiopropazate
- Thioridazine
- Tianeptine
- Tilidine
- Tizanidine
- Tolonium Chloride
- Topiramate
- Tramadol
- Tranylcypromine
- Trazodone
- Triazolam
- Trifluoperazine
- Trifluperidol
- Triflupromazine
- Trimeprazine
- Trimipramine
- Tryptophan
- Venlafaxine
- Verapamil
- Vilazodone
- Voriconazole
- Vortioxetine
- Zaleplon
- Ziprasidone
- Zolmitriptan
- Zolpidem
- Zopiclone
- Zotepine
How much does Hydromet (hydrocodone / homatropine) cost?
Hydromet (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
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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.
American College of Obstetricians and Gynecologists. (2021). Breastfeeding challenges: ACOG Committee Opinion, number 820. Obstetrics & Gynecology.
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.
Jansson, L. M., et al. (2019). Neonatal abstinence syndrome. Pediatric Clinics of North America.
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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