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What to know about hydrocodone in cough syrup

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BenefitsWhen will you need it?RisksOther cough medicationsDo I have an addiction?Getting helpSummary
Hydrocodone is a powerful opioid medication that is sometimes added to cough syrup to help treat severe, dry coughs. However, it is important to use it carefully as it can be addictive and cause side effects.
Medically reviewed by Philip Ngo, PharmD
Written by Charlotte Parker
Updated on

While hydrocodone primarily treats pain, it can also be an effective treatment for stubborn coughs.

However, as it is an opioid, it has a risk of addiction and misuse, so doctors must prescribe it carefully and monitor its use.

It’s important to use cough syrups containing hydrocodone exactly as a healthcare professional prescribes and for the shortest time possible to keep risks to a minimum.

Benefits of hydrocodone in cough syrup

Red cough syrup being pour into silver teaspoon
Image Source/Getty Images

Hydrocodone in cough syrup effectively calms the urge to cough, offering significant relief from persistent coughing.

Since hydrocodone can ease pain, it can make you feel more comfortable by reducing the discomfort you may be feeling through the strain of coughing.

When might a doctor prescribe it?

A doctor might prescribe cough syrups containing hydrocodone if you have a severe, ongoing cough that does not produce mucus and is affecting your daily life or sleep, especially if other treatments have not worked. Examples include hydrocodone bitartrate homatropine methylbromide (Hycodan, Hydromet) and hydrocodone chlorpheniramine polistirex.

This medication is usually saved for chronic bronchitis or after certain medical operations. Before prescribing cough syrup with hydrocodone, a doctor will carefully look at your medical history, consider any risk of addiction, and assess how severe your cough is.

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Risks associated with hydrocodone and other opioids

Using hydrocodone and similar opioid pain-relief medications can lead to dependency and misuse, especially if you use them for a long time.

You might experience side effects like feeling sleepy or confused, nausea, or constipation. More serious side effects can include life threatening breathing difficulties.

Additionally, if your hydrocodone cough syrup contains alcohol or sugar, the alcohol may increase drowsiness, while sugar contents can affect you if you have diabetes.

Those most at risk from the harmful effects of hydrocodone and other opioids include:

  • Children and adolescents: Cough syrups containing opiates are unsuitable for people under 18 years old due to the risk of severe side effects like breathing difficulties.
  • People with a history of substance misuse: There is a higher risk of opioid dependency or addiction if you have past substance misuse.
  • People with chronic health conditions: There is an increased risk of serious side effects for those with asthma, breathing difficulties, and liver or kidney disease.
  • Older adults: People over the age of 65 face a greater risk of falls, especially when using opioids, as they can affect sedation levels and cause dizziness and confusion.
  • People taking certain medications: There may be an increased danger of side effects for those taking opioids in combination with benzodiazepines, muscle relaxants, or other central nervous system depressants.
  • People living with mental health conditions: Those with untreated or mismanaged mental health conditions are more likely to misuse opioids.

It is important to take hydrocodone exactly how the doctor advises and to talk openly with them about any worries or side effects you notice.

Cough medications that may have lower risks

The following cough treatments may be safer than those containing hydrocodone:

  • Promethazine dextromethorphan (Promethazine DM): Promethazine dextromethorphan (Promethazine DM) is a prescription-only, nonaddictive cough suppressant that helps stop the coughing.
  • Dextromethorphan (Delsym, Robitussin): Dextromethorphan (Delsym, Robitussin) is also a cough suppressant available to buy over the counter.
  • Guaifenesin (Mucinex): Guaifenesin (Mucinex) is an expectorant that loosens mucus, making it easier to clear your lungs.
  • Honey: This may be effective for adults and children over 1 year as it soothes the throat and may reduce coughing.
  • Saline nasal sprays or drops: These may ease nasal congestion and coughs due to mucous dripping back down your throat from a runny nose.
  • Lozenges and hard candies: These can moisten the throat and help reduce coughing for older children and adults.

Always talk with a healthcare professional before starting any new medication.

Do I have an addiction to cough syrup?

The Drug Enforcement Administration (DEA) classifies all products containing hydrocodone as Schedule II controlled substances. This means they have a high potential for misuse and the possibility of severe psychological or physical dependence.

Therefore, refills are not available, and you will have to visit a doctor or prescribing healthcare professional to get another prescription.

To spot addiction to opioids in cough syrup like hydrocodone, watch for these signs:

  • Craving: You may strongly feel like you want the syrup, even if you don’t need it for a cough.
  • Tolerance: You may feel you need more syrup to get the same relief or find your original dosage less effective.
  • Withdrawal: You may feel uneasy, moody, sick, sweaty, or shaky without the syrup.
  • Ignoring harm: You may continue using the syrup even when it hurts your health, work, or social life.
  • Loss of control: You may find it difficult to use less or stop taking the cough medication even if you want to.

If these signs are familiar to you or someone else, it is important to seek help. Addiction is a treatable medical condition, and the proper support can make a big difference.

Learn more about hydrocodone addiction.

Help with substance misuse or addiction

If you are looking for help with substance misuse or addiction, getting support is a great first step toward getting better. Here are some places to find help:

  • Primary care physician or family doctor: A healthcare professional can check your situation and guide you toward the most suitable treatment.
  • Substance Abuse and Mental Health Services Administration (SAMHSA): This is a free, confidential service available 24/7 in English and Spanish for people facing mental health or addiction difficulties. You can reach SAMHSA at 800-662-4357.
  • Local rehabilitation centers: These centers can offer therapy, support groups, and sometimes medication.
  • Support groups: These groups, like Alcoholics Anonymous, Narcotics Anonymous, or SMART Recovery, offer support from people who know what you are going through.
  • Online tools and helplines: Here, you will find information, tools for finding help, and emergency helplines.
  • Health departments: Your local or state health department may have lists of services for addiction treatment and support.

For those with a risk of opioid dependency, healthcare professionals may prescribe naloxone — an opioid antagonist that can treat someone in the event of a life threatening opioid overdose.

In 2023, the FDA approved over-the-counter naloxone to increase access to this lifesaving medication.


Hydrocodone is a prescription-only, strong medication that may help with severe, stubborn coughs when other treatments have not been effective.

Although it works well, it is important to remember that it can be habit-forming and has some side effects. To keep risks low, use it exactly as a doctor instructs and only use it for as long as you need it.

Don’t hesitate to talk with a healthcare professional if you have concerns about your cough or the medication. Making informed decisions about your treatment, with professional guidance, is a positive step toward your overall well-being.

Download the free Optum Perks Discount Card to save up to 80% on some prescription medications.

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