Hydrocodone is a synthetic opioid that belongs to the class of drugs called narcotic analgesics. It can help treat severe pain, especially in cases where non-opioid treatments don’t provide enough relief.
Hydrocodone works by activating mu-opioid receptors in the central nervous system, which are part of the body’s pain-regulating system. This inhibits the release of pain signals and reduces feelings of pain.
In the United States, you can purchase the brand-name hydrocodone products Hyslinga and Zohydro.
Hydrocodone is a Schedule II controlled substance, which means it has a high potential for misuse and addiction. Using it for longer periods increases the chance of dependency. Stopping hydrocodone suddenly may lead to withdrawal symptoms.
Hydrocodone also interacts with several other medications and alcohol and may cause the following side effects:
- Digestive: nausea, vomiting, constipation, dry mouth
- Energy and capability: drowsiness, dizziness, confusion, impaired coordination, headaches, insomnia
- Heart: low blood pressure, slow heart rate, edema (fluid retention)
- Lungs: slow or shallow breathing, shortness of breath, respiratory tract infection
- Skin: rash, itchiness, unusual sweating
- Other: urinary tract infection (UTI), tinnitus, hormonal issues
Side effects and the potential for dependency are some of the reasons why healthcare professionals may recommend alternative medications to hydrocodone.
Non-opioid drug alternatives to hydrocodone
Many hydrocodone alternatives exist that may help you manage pain. Here are just a few:
Anticonvulsants
Anticonvulsants are also called antiepileptics and can treat seizures. They do so by balancing the electrical activity in your brain and regulating the release of pain neurotransmitters.
Anticonvulsants can be especially effective at treating central pain syndrome. In this condition, your central nervous system reacts as if the body is receiving pain stimuli, even when it isn’t.
Anticonvulsants can also be suitable for long-term treatment of fibromyalgia or nerve pain, such as diabetic neuropathy.
Some of the common side effects of anticonvulsants are:
- dizziness
- blurred vision
- stomach upset
- tiredness
- nausea
- sexual dysfunction
- allergic reactions like a rash
- disrupted menstrual cycles (for females)
Some of the rare and serious side effects are:
- liver damage
- blood disorders
- coma
- suicidal thoughts
- seizures
It may not be safe to use anticonvulsants if you:
- have liver disease or failure
- have kidney disease
- are a child or an older adult
- are allergic to the medication
- have certain heart or blood diseases
- have narrow-angle glaucoma
Some of the anticonvulsants that offer pain relief are:
- pregabalin (Lyrica)
- gabapentin (Neurontin)
- carbamazepine (Carbatrol)
- lacosamide (Vimpat)
Antidepressants
Antidepressant medications are mainly used to treat depression and anxiety, but they can also help reduce chronic pain — especially related to fibromyalgia, nerve pain, and muscle pain.
Like anticonvulsants, they can also help manage severe central pain syndrome and can be suitable for long-term use.
Researchers believe they inhibit pain signals by elevating levels of serotonin and noradrenaline in the nervous system.
The side effects of antidepressants may depend on the type and brand. They may include:
- nausea
- insomnia
- irritability
- headaches
- dry mouth
- tremors
Rarer and more severe side effects may include:
- serotonin syndrome, a potentially life threatening condition
- suicidal thoughts
- liver damage
You should not take antidepressants if you:
- have allergies to any active or inactive ingredient
- take other medications or supplements that affect serotonin levels
- have heart disease
- experience seizures
- have liver injury
- have an eating disorder
Some of the antidepressants that healthcare professionals may prescribe for pain relief are:
- duloxetine (Cymbalta)
- venlafaxine (Effexor XR)
Milnacipran (Savella), a medication that belongs to the same drug class as other antidepressants but is rarely used for depression, is approved for fibromyalgia-related pain.
Nonsteroidal anti-inflammatory drugs (NSAIDs)
NSAIDs may improve inflammation, fever, and mild-to-moderate pain.
Some hydrocodone medications include NSAIDs for more effective pain relief. However, NSAIDs alone may not be effective for severe pain and may not be the best option as an alternative to hydrocodone for long-term pain management.
Some of the common side effects of NSAIDs include:
- stomach pain
- heartburn
- nausea
- loss of appetite
- diarrhea
Rarer and more serious side effects may include:
- kidney damage
- liver toxicity
- heart attack
- stroke
- stomach ulcers and bleeding
People with heart, kidney, or liver problems and those who take blood thinners should be cautious with NSAIDs.
Some NSAIDs that are available over-the-counter or by prescription are:
If you need help covering the cost of medications, the free Optum Perks Discount Card could help you save up to 80% on prescription drugs. Follow the links on drug names for savings on that medication, or search for a specific drug here.
