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Hydrocodone ER (Hysingla ER) is a medication that carries several important safety concerns. It is crucial to follow your healthcare provider's guidance closely and be aware of the associated risks and necessary precautions.

• Risk of Addiction and Misuse: Hydrocodone ER is a controlled substance with a significant risk for addiction and misuse. Misuse can result in severe, life-threatening side effects, including dangerously slow breathing and overdose. Individuals with a personal or family history of substance use disorders or mental health conditions may be at higher risk.

• Respiratory Depression: This medication can cause dangerously slow breathing, which can be life-threatening. The risk is particularly high when starting the medication, increasing the dose, or when taken with alcohol or other drugs that depress the central nervous system.

• Opioid Overdose: Adhering strictly to the prescribed dosage is essential to prevent overdose. Symptoms of an overdose include extremely slow breathing, slow heartbeat, extreme sleepiness, and cold, clammy skin. In case of suspected overdose, administer naloxone (if available) and seek emergency medical assistance immediately.

• Interactions with Alcohol and Other Drugs: Mixing hydrocodone ER with alcohol, benzodiazepines, muscle relaxants, or sleep aids can intensify drowsiness and impair cognitive functions, raising the risk of severe side effects, including respiratory depression.

• Pregnancy and Newborns: Using this medication during pregnancy may lead to dependency in the unborn baby and withdrawal symptoms post-birth. It should be used during pregnancy only if necessary, and healthcare providers should be informed of its use.

• Physical Dependence and Withdrawal: Long-term use can lead to physical dependence. Sudden discontinuation may result in withdrawal symptoms, such as anxiety, irritability, and body aches. It is important to follow a healthcare provider's plan to taper the dosage gradually if discontinuation is necessary.

• Low Blood Pressure and Adrenal Hormone Levels: Hydrocodone ER may cause low blood pressure and, over extended use, potentially lower adrenal hormone levels. Symptoms may include dizziness, fainting, fatigue, muscle weakness, and nausea.

• Heart Rhythm Issues (QT Prolongation): Although rare, this can cause serious heart rhythm problems. Patients with a history of heart issues should inform their healthcare provider before starting this medication.

• Seizure Risk: Patients with a history of seizures should be cautious as opioids can increase seizure frequency. Immediate medical assistance is required if a seizure occurs while on this medication.

• Contraindications: Do not use hydrocodone ER if you have severely slowed breathing, severe asthma, stomach blockage, or an allergy to hydrocodone.

Always store this medication securely to prevent misuse and consult your healthcare provider for any concerns or before making changes to your medication regimen.

When taking this medication, you may encounter some common side effects, including nausea, constipation, vomiting, dizziness, headache, and sleepiness. These effects are often mild and may diminish as your body adjusts to the medication. To help manage constipation, consider increasing dietary fiber, staying hydrated, and exercising regularly. If dizziness or lightheadedness occurs, rise slowly from sitting or lying positions. While these side effects are typically manageable, consult your healthcare provider if they persist or worsen.

In some instances, more serious side effects can occur, though these are rare. Prompt medical attention is advised if you experience symptoms such as interrupted breathing during sleep, mental or mood changes like confusion or hallucinations, severe stomach pain, or difficulty urinating. Equally, be vigilant for signs of adrenal gland problems, including loss of appetite, unusual tiredness, or weight loss.

Seek immediate medical help if you experience very serious side effects like fainting, a fast or irregular heartbeat, severe dizziness, seizures, slow or shallow breathing, or difficulty waking up. Although a severe allergic reaction is rare, symptoms like rash, itching or swelling of the face, tongue, or throat, severe dizziness, or trouble breathing require urgent care. It's important to be aware of these potential reactions and to contact your healthcare provider with any concerns.

Hydrocodone, including its extended-release form Hysingla ER, can interact with various medications and substances, which may affect its efficacy or increase the risk of serious side effects. It is crucial to inform your healthcare provider about all medications, supplements, and over-the-counter products you use.

Certain pain medications, like mixed opioid agonist-antagonists (e.g., butorphanol, nalbuphine, pentazocine), and treatments for substance abuse, such as naltrexone and samidorphan, should be avoided as they may interfere with hydrocodone’s effectiveness. Alcohol, whether in beverages or medications such as cough syrups, can also interact negatively.

Some drugs can alter the way hydrocodone is metabolized, potentially diminishing its effectiveness or increasing side effects. This includes azole antifungals (like ketoconazole), macrolide antibiotics (such as erythromycin), certain HIV medications (e.g., tipranavir), rifamycins (like rifampin), and drugs used for seizures (such as carbamazepine and phenytoin).

Taking hydrocodone with other substances that cause drowsiness or respiratory issues can heighten the risk of severe side effects, including slow or shallow breathing and extreme drowsiness. These include other opioids (e.g., codeine, oxycodone), alcohol, marijuana, sleep and anxiety medications (such as alprazolam, lorazepam), muscle relaxants (e.g., carisoprodol, cyclobenzaprine), and antihistamines (like cetirizine, diphenhydramine).

It's essential to read labels on all medications you use, as many over-the-counter products, including allergy and cold remedies, may contain ingredients that cause drowsiness. Always discuss with your pharmacist how to use these products safely.

Lastly, hydrocodone may interfere with certain lab tests, potentially causing inaccurate results. Ensure all healthcare providers, including lab personnel, know if you are using this medication.