Hydrocodone
Hydrocodone is a phenanthrene-derivative **opiate agonist** used primarily in veterinary medicine as a potent **antitussive** (cough suppressant) for dogs. * **Primary Indications:** Management of harsh, dry, non-productive coughs associated with conditions like collapsing trachea, bronchitis, or canine infectious tracheobronchitis (kennel cough). * **Behavioral Use:** Occasionally used to treat opioid-related behavioral problems (e.g., lick granulomas, stereotypies) by providing an exogenous opioid source to reduce self-stimulating behaviors. * **Analgesia:** Combination products containing acetaminophen can be used for moderate oral analgesia in dogs. > **CRITICAL WARNING:** Combination products containing acetaminophen (e.g., Vicodin®, Lortab®) are **STRICTLY CONTRAINDICATED IN CATS** due to fatal acetaminophen toxicity.
Mecanismo: Hydrocodone acts primarily by binding to **mu-opioid receptors** in the central nervous system. * **Antitussive Effect:** Direct suppression of the cough reflex at the **cough center** in the **medulla oblongata**. * **Analgesic Effect:** Binds to pre- and post-synaptic **mu-receptors** in the brain and spinal cord → inhibits release of nociceptive neurotransmitters (like Substance P) → hyperpolarizes neurons → decreases excitability and pain transmission. * **Respiratory Effects:** Tends to have a drying effect on respiratory mucosa, increasing the viscosity of secretions. The addition of homatropine methylbromide (an anticholinergic) in some formulations enhances this drying effect.
Dosificación por especie
- For adjunctive treatment of opioid-related stereotypies · 1.25-5 mg per cat PO q12h · PO · q12h · Do NOT use any product that contains acetaminophen.
- For cough · 0.22 mg/kg PO q6-12h · PO · q6-12h · Goal is to suppress coughing without causing excessive sedation
- As an analgesic using fixed dose combination products with acetaminophen · 0.22-0.5 mg/kg of the hydrocodone component PO q8-12h · PO · q8-12h · Do not exceed 15 mg/kg of the acetaminophen component q8h.
- For cough using Hycodan (or equivalent) · ¼ to 1 tablet (5 mg) once to 4 times daily · PO · q6-24h · In small and medium sized dogs.
- For lick granulomas · 5-10 mg (1-2 tablets) per 20 kg of body weight PO three times daily · PO · TID
- For adjunctive treatment of opioid-related stereotypies, lick granuloma · 0.22-0.25 mg/kg PO q8-12h · PO · q8-12h · Supplies exogenous opioids to decrease the need for self-stimulation.
Las dosis son una referencia clínica para veterinarios colegiados. Confirme siempre con la ficha técnica vigente y el paciente individual.
Vías de administración
Contraindicaciones
- Hypersensitivity to narcotic analgesics
- Patients receiving monoamine oxidase inhibitors (MAOIs, e.g., selegiline)
- Diarrhea caused by toxic ingestion (until toxin is eliminated)
- Acetaminophen-containing products MUST NOT be used in cats
Efectos adversos
- Sedation
- Constipation (especially with chronic therapy)
- Vomiting
- Gastrointestinal disturbances
- Masking of clinical signs of underlying respiratory disease
Interacciones farmacológicas
- Acepromazine · May cause additive hypotension in dogs with collapsing trachea
- Anticholinergic Drugs · May cause additive anticholinergic effects
- Antidepressants (Tricyclic & MAOIs) · May potentiate the adverse effects associated with the antidepressant
- CNS Depressants (anesthetics, antihistamines, phenothiazines, barbiturates, tranquilizers) · May cause increased CNS or respiratory depression
Monitorización
- Clinical efficacy (reduction in cough frequency/severity, pain relief)
- Adverse effects (excessive sedation, constipation, respiratory depression)
Sobredosis
Massive overdose primarily causes **CNS, cardiovascular, and respiratory depression** secondary to opiate effects. * **Treatment:** If ingestion was recent, empty the gut using standard protocols. Administer **naloxone** to reverse opioid effects as necessary. * **Note on Homatropine:** The homatropine ingredient in some formulations may cause anticholinergic effects, but its relatively low toxicity usually does not require specific treatment.
La referencia de fármacos de VetSheet está destinada a veterinarios colegiados como apoyo a la decisión clínica, no sustituye el juicio profesional ni la ficha técnica vigente del fabricante.