Hydol

Hydol is an opioid analgesic used as an alternative or adjunct to codeine to treat moderate to severe pain, severe dyspnea, and cough. It is semi-synthetic, and was developed in Germany in 1908 during an international search to find a more effective antitussive agent to help reduce the spread of airborne infectious diseases such as tuburculosis. It was marketed in 1911. [Wikipedia]

Hydol is used for the treatment of moderate to severe pain, including post-operative and dental pain. It can also be used to treat chronic pain, breathlessness and coughing. In heroin addicts, Hydol has been used as a substitute drug, in doses up to 2500mg/day to treat addiction. [http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2014322/] (moderate Pain; severe Pain;)

Oral

Analgesia

Adult: As tartrate: 30 mg every 4-6 hr, up to 240 mg/day for severe pain. Modified-release prep may be given bid for chronic severe pain.

Child: >4 yr: As tartrate: 0.5-1 mg/kg every 4-6 hr.

Oral

Cough suppression

Adult: As tartrate: 10-30 mg tid.

Injection

Analgesia

Adult: As tartrate: Up to 50 mg every 4-6 hr deep SC or IM.

Child: As tartrate: >4 yr: 0.5-1 mg/kg (max: 30 mg) every 4-6 hr.

Hydol interactions

Hydol may increase the ototoxic potential of aminoglycoside antibiotics, especially in the presence of impaired renal function. Except in life-threatening situations, avoid this combination.

Hydol should not be used concomitantly with ethacrynic acid because of the possibility of ototoxicity. Patients receiving high doses of salicylates concomitantly with Hydol, as in rheumatic disease, may experience salicylate toxicity at lower doses because of competitive renal excretory sites.

Hydol has a tendency to antagonize the skeletal muscle relaxing effect of tubocurarine and may potentiate the action of succinylcholine.

Lithium generally should not be given with diuretics because they reduce lithiums renal clearance and add a high risk of lithium toxicity.

Hydol may add to or potentiate the therapeutic effect of other antihypertensive drugs. Potentiation occurs with ganglionic or peripheral adrenergic blocking drugs.

Hydol may decrease arterial responsiveness to norepinephrine. However, norepinephrine may still be used effectively.

Tablets

Simultaneous administration of sucralfate and Hydol tablets may reduce the natriuretic and antihypertensive effects of Hydol. Patients receiving both drugs should be observed closely to determine if the desired diuretic and/or antihypertensive effect of Hydol is achieved. The intake of Hydol and sucralfate should be separated by at least two hours.

Tablets, Injection, and

Oral Solution

One study in six subjects demonstrated that the combination of Hydol and acetylsalicylic acid temporarily reduced creatinine clearance in patients with chronic renal insufficiency. There are case reports of patients who developed increased BUN, serum creatinine and serum potassium levels, and weight gain when Hydol was used in conjunction with NSAIDs.

Literature reports indicate that coadministration of indomethacin may reduce the natriuretic and antihypertensive effects of Hydol in some patients by inhibiting prostaglandin synthesis. Indomethacin may also affect plasma renin levels, aldosterone excretion, and renin profile evaluation. Patients receiving both indomethacin and Hydol should be observed closely to determine if the desired diuretic and/or antihypertensive effect of Hydol is achieved.

Hydol side effects

Nausea, vomiting, constipation, drowsiness, confusion and other CNS effects. CV effects, sweating, hypothermia, restlessness, decreased libido, miosis, raised intracranial pressure, muscle rigidity.

Potentially Fatal: Pulmonary oedema. High doses may lead to resp depression and hypotension with circulatory failure and deepening coma.

Hydol contraindications

COUNTRA

Indications:

- Hypersensitivity to Hydol.

- Respiratory failure regardless of the degree of impairment because of the depressant effect of Hydol on the respiratory centers.

- Inadequate hepatocellular and / or renal impairment.

- Persons with asthma.

- Children under 1 year.

- Due to lack of information on the transition in breast milk in humans, avoid prescribing during lactation.

Association-cons indicated: MAOI.

NOT RECOMMENDED:

Concomitant use not recommended: agonist-antagonist opioids (buprenorphine, nalbuphine, pentazocine); alcohol.

Active ingredient matches for Hydol:

Dihydrocodeine

Furosemide