Hydromet

Doctors prescribe Hydromet to soothe a dry cough.

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Other, off label uses for this medicine

Ingredients in Hydromet relieve pain, alleviate anxiety and cause sedation.
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Administration/Dosage

Actavis Mid Atlantic LLC offers Hydromet in a red colored, cherry flavored syrup form in one-pint containers. Hydromet is for oral use. Each 5 ml dose of Hydromet contains 5 mg of hydrocodone bitartrate and 1.5 mg of homatropine methylbromide.

The usual adult dosage is one 5 ml teaspoon every four to six hours as needed, not to exceed six teaspoons in a 24-hour period.

The typical dose for children aged six to twelve years is one-half a teaspoon every four to six hours as needed, not to exceed three teaspoons in one day. Researchers have not yet determined if Hydromet is safe and effective for children under the age of six years.

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Action

Hydrocodone soothes a nagging cough by depressing the cough reflex in the medulla, the breathing center of the brain. Respiratory effects of Hydromet are dose-dependent, meaning higher doses are more likely to cause more severe breathing problems.

Hydrocodone works with the central nervous system, or CNS, to relieve pain, calm anxiety and cause sedation. and a pleasant feeling of euphoria. This interaction with the CNS produces a pleasant feeling of euphoria.

Hydrocodone acts on smooth muscles, including intestinal muscles that push food through the digestive tract. Hydrocodone increases muscle tone, making these muscles stiff and less functional. Smooth muscles are found within the walls of blood vessels, in the bladder, skin and iris of the eye.

Homatropine methylbromide works against hydrocodone to discourage abuse.

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Warnings

Respiratory Depression

The hydrocodone in Hydromet acts directly on the medulla to cause the dangerous and potentially fatal breathing condition, respiratory depression. During respiratory depression, the lungs cannot adequately exchange oxygen for carbon dioxide and other toxins, causing oxygen starvation and buildup of toxic gases in body cells. Symptoms of respiratory depression include slow or shallow breathing, irregular respiratory patterns and a bluish tinge around the eyes, lips and fingertips. Emergency department physicians use naloxone to reverse respiratory depression.

Head Injury And Increased Intracranial Pressure

Along with respiratory depression, opioids including the hydrocodone in Hydromet can elevate pressure in the cerebrospinal fluid surrounding the brain and spinal cord. The presence of a head injury, brain tumor or pre-existing high pressure inside the skull may exaggerate these properties.

Hydrocodone causes side effects that may obscure the presence and progression of head injuries.

Acute Abdominal Conditions

Hydrocodone may obscure the presence and progression of acute abdominal conditions.

Pediatric Use

The brain’s respiratory center is sensitive to the depressant action of Hydromet, especially at high doses. Because of this, pediatricians should weigh the benefits and risks of using Hydromet to treat cough in young patients, especially in cases of croup.

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Precautions

Physicians should determine the cause of a patient’s cough before prescribing Hydromet to be sure suppressing the cough does not harm the patient. The doctor should also provide appropriate therapy for whatever condition caused the cough.

The hydrocodone in Hydromet may impair the consumer’s mental or physical abilities, interfering with his ability to drive a motor vehicle or operate other heavy machinery.

Special Risk Patients

People who are hypersensitive to hydrocodone or homatropine methylbromide should not use Hydromet. Elderly and debilitated individuals should use Hydromet with caution, as should those with serious kidney or liver dysfunction, Addison’s disease, asthma and certain types of prostate, thyroid, glaucoma or urinary problems.

Pregnancy and Breastfeeding

The FDA categorizes drugs according to the risk they pose to a pregnant woman and her unborn baby. The FDA ranks Hydromet as a Pregnancy Category C, meaning scientists do not know if this drug harms a woman’s ability to get pregnant or if taking Hydromet during pregnancy harms the unborn child. A woman should only take Hydromet during pregnancy when she clearly needs it.

Administering Hydromet during labor and delivery may result in respiratory depression in the newborn, especially at high doses.

A baby whose mother regularly takes Hydromet prior to delivery will be born physically dependent on hydrocodone and suffer withdrawal symptoms during the first few days of life. Babies born to mothers who have been taking opioids regularly prior to delivery will be physically dependent. These babies will seem irritable, cry excessively, breathe rapidly and experience tremors and hyperactive reflexes. Other neonatal withdrawal symptoms include increased stools, sneezing, yawning, vomiting and fever. The intensity of these symptoms does not always correlate with the dosage or duration of Hydromet use.

Research has not yet determined whether Hydromet is excreted into breast milk. Because many drugs pass into human milk, and because of the potential for adverse effects on a baby, a woman should only use Hydromet while breastfeeding if the benefit to the mother clearly outweighs the risk to the nursing baby.

Hydromet may be habit-forming. Using Hydromet continually for more than a few weeks may cause physical dependence resulting in withdrawal symptoms if the consumer stops taking Hydromet abruptly.

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Drug Interactions

Hydromet may interact with other medications in unsafe or undesirable ways. Other opioid drugs, antihistamines, antipsychotics, drugs to relieve anxiety or other CNS depressants, including alcohol, may enhance the way hydrocodone depresses the nervous system.

Taking Hydromet with certain types of antidepressants, including MAO inhibitors and tricyclic antidepressants, can increase the effects of either the antidepressant or the hydrocodone in Hydromet.

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Side effects

Hydromet may cause side effects in some consumers.

Because of the way hydrocodone works with the CNS, Hydromet may cause nervous system side effects, including sedation, dizziness, drowsiness, mental clouding and lethargy. The individual may suffer impaired mental and physical performance. Hydromet may cause psychiatric side effects including anxiety, fear, psychic dependence, mood changes and the emotional opposite of euphoria, dysphoria.

Hydromet’s action on smooth muscle groups may cause gastrointestinal side effects, including nausea and vomiting. These effects are more frequent in ambulatory consumers than in those confined to a wheelchair or bed. Long-term use of Hydromet may cause constipation.

Hydromet affects the smooth muscles in the urinary system, causing spasms and urinary retention. The hydrocodone in Hydromet may cause respiratory depression. Skin reactions include itching and rash.

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Overdose

It is possible to overdose on either the hydrocodone or the homatropine components of Hydromet. Taking large doses of Hydromet may cause homatropine intoxication.
Prescription painkiller overdose kill nearly 15,000 people every year in the United States.

Symptoms of hydrocodone overdose include respiratory depression, extreme sleepiness progressing to coma, flaccid muscles and cold, clammy skin. Sometimes the individual experiences a slow heartbeat and low blood pressure. In cases of severe hydrocodone overdose, stopped breathing, collapse of the circulatory system, cardiac arrest and death may occur.

Hydromet overdose requires immediate treatment. Emergency caregivers will establish an airway or put the patient on a ventilator. Physicians will administer naloxone to reverse respiratory depression. Nurses will pump excess Hydromet from the patient’s stomach.

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Abuse

The euphoric effects of Hydromet make it attractive to recreational users. Taking high doses of Hydromet, consuming this product for a long time or using it for non-medical reasons increases the risk for developing physical dependence and addiction to the hydrocodone in Hydromet.

Using a drug non-medically means to use it to get high or to treat a condition other than the one the doctor had intended to treat. Non-medical use of drugs like Hydromet is widespread in the United States: in 2010, 7 million Americans took drugs like Hydromet for non-medical reasons.

The DEA ranks drugs according to their potential for abuse as compared to other drugs. The DEA classifies Hydromet as a schedule III narcotic, meaning it poses the same relative risk for abuse as anabolic steroids.

Manufacturers add homatropine methylbromide to discourage abuse.

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Withdrawal

The body adapts to the presence of some substances, including hydrocodone. With time, the body begins to rely on a certain level of hydrocodone to feel “normal.” When hydrocodone levels drop radically, the opioid-dependent body struggles to maintain stability. Doctors refer to this as detoxification. The individual experiences detoxification through flulike withdrawal symptoms.

Withdrawal symptoms tend to arrive in two phases, with the first set beginning a few hours after the last dose of Hydromet. Hydromet withdrawal symptoms last five or more days, with the most severe symptoms appearing around the fourth day.
Early symptoms of withdrawal include:

  • Agitation
  • Anxiety
  • Muscle aches
  • Increased tearing
  • Insomnia
  • Runny nose
  • Sweating
  • Yawning

Late symptoms of withdrawal include:

  • Abdominal cramping
  • Diarrhea
  • Dilated pupils
  • Goose bumps
  • Nausea
  • Vomiting

Hydromet withdrawal also has psychological symptoms that can make the individual feel incapable or unworthy of recovery. Overpowering physical and psychological Hydromet withdrawal symptoms can cause relapse to drug abuse.

Various medications relieve individual withdrawal symptoms without disrupting the detoxification process, such as Imodium for diarrhea and vitamins for achy muscles. Taking more Hydromet halts withdrawal symptoms but reverses detoxification.
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Detox

Many institutions now offer detoxification services where physicians administer drugs to reduce hydrocodone along with drugs to ease withdrawal symptoms. While these procedures ease withdrawal symptoms somewhat, they do not shorten the duration of detoxification or address the psychological aspects of Hydromet withdrawal.
Rapid detox is the most humane and efficient method of detoxifying the body from opioid-dependence. Board-certified anesthesiologists receive advanced training that allows them to administer sedatives and anesthesia alongside the standard detoxification and anti-withdrawal drugs. As a result, the patient dozes in a comfortable “twilight sleep” during the detoxification process.
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Storage

Keep Hydromet in a tightly sealed container, away from light and at temperatures between 59 degrees Fahrenheit and 86 degrees Fahrenheit.

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Miscellaneous information

According to the DEA, the hydrocodone in Hydromet is the “most frequently prescribed opioid in the United States and is associated with more drug abuse and diversion than any other licit or illicit opioid.”

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Facts

  • Hydromet