The most common adverse effects of hydrocodone include frequent constipation and nausea. Additional adverse effects of hydrocodone include the following:
Respiratory: Severe respiratory depression, shortness of breath, respiratory tract infection
Cardiovascular: Hypotension, bradycardia, and peripheral edema
Neurologic: Headache, chills, anxiety, sedation, insomnia, dizziness, drowsiness, and fatigue
Dermatologic: Pruritus, diaphoresis, and rash
Gastrointestinal: Vomiting, dyspepsia, gastroenteritis, constipation, and abdominal pain Genitourinary: Urinary tract infection and urinary retention associated with prostatic hypertrophy
Otic: Tinnitus and sensorineural hearing loss (SNHL)
Endocrine: Secondary adrenal insufficiency
Drug-Drug Interactions
Concurrent use of hydrocodone with central nervous system depressants, such as alcohol, benzodiazepines, barbiturates, or other opioids, can result in profound sedation and respiratory depression; therefore, these combinations must be avoided.
Medications that induce (eg, rifampin, phenytoin, and carbamazepine) or inhibit (eg, cimetidine, fluoxetine, and ritonavir) cytochrome enzymes should be closely monitored. This can result in significant variations in hydrocodone plasma concentrations.
The combination of hydrocodone and acetaminophen poses a potential drug interaction with warfarin, causing an elevated international normalized ratio (INR) and an increased risk of bleeding.
Concurrent use of hydrocodone with CYP3A4 inhibitors or discontinuation of CYP3A4 inducers can result in a fatal overdose of hydrocodone. Consequently, it is crucial to avoid this combination.

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