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Hysingla ER
Hysingla ER is the brand name for hydrocodone bitartrate, an extended-release opioid analgesic used to manage severe pain in patients who require around-the-clock, long-term treatment. It is part of the opioid class of drugs and works by binding to opioid receptors in the brain and nervous system to reduce the perception of pain. Hysingla ER is typically reserved for patients who have not responded adequately to non-opioid treatments or other pain management options.
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Frequently Asked Questions
How long does Hysingla ER take to start working?
Hysingla ER begins to provide pain relief within about 6 hours, but its effects are extended over 24 hours due to its slow-release formulation.
Can Hysingla ER be used for short-term pain relief?
No, Hysingla ER is intended for long-term, around-the-clock management of severe pain. It is not appropriate for short-term or as-needed use.
What should I do if I miss a dose of Hysingla ER?
If you miss a dose, take it as soon as you remember, but if it's close to the next scheduled dose, skip the missed dose. Do not double up on doses to make up for a missed one.
Can I stop taking Hysingla ER suddenly?
No, stopping Hysingla ER suddenly can cause withdrawal symptoms. It’s important to work with your healthcare provider to taper off the medication gradually.
Is Hysingla ER safe for long-term use?
While Hysingla ER is used for long-term pain management, it carries risks of tolerance, dependence, and potential side effects. Regular monitoring by your healthcare provider is essential to ensure safe use over time.
Comprehensive Drug Guide
How Does Hysingla ER Work?
Hysingla ER works by binding to mu-opioid receptors in the brain and spinal cord, which alters the body’s response to pain by blocking pain signals. This action reduces the intensity of pain experienced by the patient and provides prolonged pain relief due to its extended-release formulation, allowing for once-daily dosing.
Common Dosages
- 20 mg, 30 mg, 40 mg, 60 mg, 80 mg, 100 mg, 120 mg (extended-release tablets)
Typical Dosing
- Adults: The typical starting dose for opioid-naive patients is 20 mg once daily, with gradual titration based on clinical response. Doses may be increased by 10 to 20 mg every 3 to 5 days as needed, with a maximum daily dose of 120 mg.
- For patients already on opioid therapy, the dose will be individualized based on the previous opioid dose.
Typical Dosing
FDA Approved Indications
- Management of severe pain that requires long-term, around-the-clock opioid treatment and cannot be managed by alternative, non-opioid medications.
Who Shouldn't Take Hysingla ER?
- Severe respiratory depression
- Acute or severe bronchial asthma in an unmonitored setting
- Known hypersensitivity to hydrocodone or any components of the formulation
- Paralytic ileus (a bowel condition that impairs movement of contents through the intestines)
Advice From The Pharmacist
- Hysingla ER should be taken once daily, swallowed whole with plenty of water. The tablet should not be crushed, broken, or chewed, as this could lead to a potentially fatal dose.
- Avoid alcohol while taking Hysingla ER, as it can increase the risk of severe side effects, including respiratory depression.
- Do not discontinue Hysingla ER abruptly, especially after prolonged use, as this could cause withdrawal symptoms. Your doctor will help taper the dose gradually.
- Store Hysingla ER in a secure location to prevent accidental ingestion or misuse.
- Be aware of signs of overdose, such as extreme drowsiness, slow breathing, or loss of consciousness, and seek emergency medical attention if these occur.
Side Effects of Hysingla ER
Common Side Effects
- Constipation
- Nausea
- Drowsiness
- Dizziness
- Dry mouth
Uncommon/Severe Side Effects
- Respiratory depression (slow or shallow breathing)
- Low blood pressure (hypotension)
- Severe allergic reactions
- Increased risk of opioid addiction, abuse, and misuse
Risks and Warnings of Hysingla ER
- Addiction, Abuse, and Misuse: Hysingla ER carries a high risk of addiction, even at recommended doses. Patients should be closely monitored for signs of misuse or abuse.
- Respiratory Depression: The most serious risk of opioids, including Hysingla ER, is life-threatening respiratory depression. This is especially dangerous in elderly patients, those with underlying respiratory conditions, or those who overdose.
- Accidental Ingestion: Ingestion of even one dose of Hysingla ER by children or non-opioid-tolerant individuals can result in a fatal overdose. The medication should be stored securely and out of reach of others.
- Neonatal Opioid Withdrawal Syndrome: Prolonged use of Hysingla ER during pregnancy can result in opioid withdrawal syndrome in newborns, which can be life-threatening if not treated properly.
Interactions with Hysingla ER
Common Drug Interactions
- Benzodiazepines: Taking Hysingla ER with benzodiazepines (such as alprazolam or diazepam) increases the risk of severe respiratory depression, sedation, and even death.
- Alcohol: Combining alcohol with Hysingla ER can result in dangerous interactions, leading to increased drowsiness, respiratory depression, or overdose.
- CYP3A4 inhibitors: Drugs that inhibit CYP3A4 (such as ketoconazole or clarithromycin) can increase the levels of hydrocodone in the blood, potentially leading to serious side effects or overdose.
- Muscle relaxants: Combining Hysingla ER with muscle relaxants may enhance the risk of respiratory depression or sedation.
Alternatives to Hysingla ER
- OxyContin (oxycodone ER): Another extended-release opioid analgesic used for long-term pain management.
- Morphine ER: An extended-release form of morphine used for severe chronic pain.
- Fentanyl patches: Transdermal patches that provide continuous pain relief for patients with opioid tolerance.
- Methadone: A long-acting opioid used for chronic pain and opioid addiction treatment.
