Details
| Stereochemistry | ABSOLUTE |
| Molecular Formula | C18H21NO3.ClH.2H2O |
| Molecular Weight | 371.856 |
| Optical Activity | UNSPECIFIED |
| Defined Stereocenters | 4 / 4 |
| E/Z Centers | 0 |
| Charge | 0 |
SHOW SMILES / InChI
SMILES
O.O.Cl.[H][C@@]12OC3=C4C(C[C@@]5([H])N(C)CC[C@@]14[C@@]5([H])CCC2=O)=CC=C3OC
InChI
InChIKey=HEUMIQUBXVWULP-GXTZACRKSA-N
InChI=1S/C18H21NO3.ClH.2H2O/c1-19-8-7-18-11-4-5-13(20)17(18)22-16-14(21-2)6-3-10(15(16)18)9-12(11)19;;;/h3,6,11-12,17H,4-5,7-9H2,1-2H3;1H;2*1H2/t11-,12+,17-,18-;;;/m0.../s1
| Molecular Formula | C18H21NO3 |
| Molecular Weight | 299.3642 |
| Charge | 0 |
| Count |
|
| Stereochemistry | ABSOLUTE |
| Additional Stereochemistry | No |
| Defined Stereocenters | 4 / 4 |
| E/Z Centers | 0 |
| Optical Activity | UNSPECIFIED |
| Molecular Formula | ClH |
| Molecular Weight | 36.461 |
| Charge | 0 |
| Count |
|
| Stereochemistry | ACHIRAL |
| Additional Stereochemistry | No |
| Defined Stereocenters | 0 / 0 |
| E/Z Centers | 0 |
| Optical Activity | NONE |
| Molecular Formula | H2O |
| Molecular Weight | 18.0153 |
| Charge | 0 |
| Count |
|
| Stereochemistry | ACHIRAL |
| Additional Stereochemistry | No |
| Defined Stereocenters | 0 / 0 |
| E/Z Centers | 0 |
| Optical Activity | NONE |
Benzhydrocodone is a prodrug of hydrocodone. Benzhydrocodone is formed by covalently bonding hydrocodone to benzoic acid. Benzhydrocodone itself is not pharmacologically active, but must be metabolized to hydrocodone by enzymes in the intestinal tract to optimally deliver its pharmacologic effects. Hydrocodone is a full agonist of the opioid receptors with a higher affinity for the mu-opioid receptor. Upon binding, hydrocodone produces an analgesic effect with no ceiling. APADAZ a combination of benzhydrocodone and acetaminophen is FDA approved and indicated for the short-term (no more than 14 days) management of acute pain severe enough to require an opioid analgesic and for which alternative treatments are inadequate. APADAZ, even when taken as recommended, can result in addiction, abuse, and misuse, which can lead to overdose and death.
Approval Year
Conditions
| Condition | Modality | Targets | Highest Phase | Product |
|---|---|---|---|---|
| Primary | ZOHYDRO ER Approved UseZOHYDRO ER is an opioid agonist indicated for the management of pain severe enough to require daily, around-the-clock, long-term opioid treatment and for which alternative treatment options are inadequate. Launch Date2013 |
|||
| Primary | APADAZ Approved UseAPADAZ is a combination of benzhydrocodone, a prodrug of the opioid agonist hydrocodone, and acetaminophen, and is indicated for the short-term (no more than 14 days) management of acute pain severe enough to require an opioid analgesic and for which alternative treatments are inadequate. Launch Date2019 |
Cmax
| Value | Dose | Co-administered | Analyte | Population |
|---|---|---|---|---|
10.1 ng/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/27138027/ |
15 mg single, oral dose: 15 mg route of administration: Oral experiment type: SINGLE co-administered: |
HYDROCODONE plasma | Homo sapiens population: UNHEALTHY age: ADULT sex: FEMALE / MALE food status: FASTED |
|
23.6 ng/mL |
10 mg single, oral dose: 10 mg route of administration: Oral experiment type: SINGLE co-administered: |
HYDROCODONE plasma | Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: FASTED |
AUC
| Value | Dose | Co-administered | Analyte | Population |
|---|---|---|---|---|
155 ng × h/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/27138027/ |
15 mg single, oral dose: 15 mg route of administration: Oral experiment type: SINGLE co-administered: |
HYDROCODONE plasma | Homo sapiens population: UNHEALTHY age: ADULT sex: FEMALE / MALE food status: FASTED |
T1/2
| Value | Dose | Co-administered | Analyte | Population |
|---|---|---|---|---|
10.2 h EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/27138027/ |
15 mg single, oral dose: 15 mg route of administration: Oral experiment type: SINGLE co-administered: |
HYDROCODONE plasma | Homo sapiens population: UNHEALTHY age: ADULT sex: FEMALE / MALE food status: FASTED |
|
4 h |
10 mg single, oral dose: 10 mg route of administration: Oral experiment type: SINGLE co-administered: |
HYDROCODONE plasma | Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: FASTED |
Funbound
| Value | Dose | Co-administered | Analyte | Population |
|---|---|---|---|---|
55% |
10 mg single, oral dose: 10 mg route of administration: Oral experiment type: SINGLE co-administered: |
HYDROCODONE plasma | Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: FASTED |
Doses
| Dose | Population | Adverse events |
|---|---|---|
30 mg multiple, oral (total) Overdose Dose: 30 mg Route: oral Route: multiple Dose: 30 mg Co-administed with:: clarithromycin Sources: valproic acid(250 mg, 2 times per day) |
unhealthy, 5 years n = 1 Health Status: unhealthy Condition: cold Age Group: 5 years Sex: F Population Size: 1 Sources: |
Other AEs: Adverse event... |
160 mg 1 times / day multiple, oral Highest studied dose Dose: 160 mg, 1 times / day Route: oral Route: multiple Dose: 160 mg, 1 times / day Sources: |
unhealthy, adult Health Status: unhealthy Age Group: adult Sources: |
Other AEs: Electrocardiogram QTc interval prolonged... Other AEs: Electrocardiogram QTc interval prolonged Sources: |
20 mg 1 times / day multiple, oral Recommended Dose: 20 mg, 1 times / day Route: oral Route: multiple Dose: 20 mg, 1 times / day Sources: |
pregnant, adult Health Status: pregnant Age Group: adult Sex: F Sources: |
Other AEs: Withdrawal syndrome neonatal... Other AEs: Withdrawal syndrome neonatal Sources: |
20 mg 1 times / day multiple, oral Recommended Dose: 20 mg, 1 times / day Route: oral Route: multiple Dose: 20 mg, 1 times / day Sources: |
unhealthy, adult Health Status: unhealthy Age Group: adult Sources: |
Other AEs: Respiratory depression, Addiction... Other AEs: Respiratory depression (grade 5) Sources: Addiction |
20 mg 1 times / day multiple, oral Dose: 20 mg, 1 times / day Route: oral Route: multiple Dose: 20 mg, 1 times / day Sources: Page: p. 115 |
unhealthy, adult n = 296 Health Status: unhealthy Age Group: adult Sex: M+F Population Size: 296 Sources: Page: p. 115 |
Disc. AE: Vomiting, Nausea... AEs leading to discontinuation/dose reduction: Vomiting (1%) Sources: Page: p. 115Nausea (1%) Headache (1%) Dizziness (1%) |
AEs
| AE | Significance | Dose | Population |
|---|---|---|---|
| Adverse event | grade 5 | 30 mg multiple, oral (total) Overdose Dose: 30 mg Route: oral Route: multiple Dose: 30 mg Co-administed with:: clarithromycin Sources: valproic acid(250 mg, 2 times per day) |
unhealthy, 5 years n = 1 Health Status: unhealthy Condition: cold Age Group: 5 years Sex: F Population Size: 1 Sources: |
| Electrocardiogram QTc interval prolonged | 160 mg 1 times / day multiple, oral Highest studied dose Dose: 160 mg, 1 times / day Route: oral Route: multiple Dose: 160 mg, 1 times / day Sources: |
unhealthy, adult Health Status: unhealthy Age Group: adult Sources: |
|
| Withdrawal syndrome neonatal | 20 mg 1 times / day multiple, oral Recommended Dose: 20 mg, 1 times / day Route: oral Route: multiple Dose: 20 mg, 1 times / day Sources: |
pregnant, adult Health Status: pregnant Age Group: adult Sex: F Sources: |
|
| Addiction | 20 mg 1 times / day multiple, oral Recommended Dose: 20 mg, 1 times / day Route: oral Route: multiple Dose: 20 mg, 1 times / day Sources: |
unhealthy, adult Health Status: unhealthy Age Group: adult Sources: |
|
| Respiratory depression | grade 5 | 20 mg 1 times / day multiple, oral Recommended Dose: 20 mg, 1 times / day Route: oral Route: multiple Dose: 20 mg, 1 times / day Sources: |
unhealthy, adult Health Status: unhealthy Age Group: adult Sources: |
| Dizziness | 1% Disc. AE |
20 mg 1 times / day multiple, oral Dose: 20 mg, 1 times / day Route: oral Route: multiple Dose: 20 mg, 1 times / day Sources: Page: p. 115 |
unhealthy, adult n = 296 Health Status: unhealthy Age Group: adult Sex: M+F Population Size: 296 Sources: Page: p. 115 |
| Headache | 1% Disc. AE |
20 mg 1 times / day multiple, oral Dose: 20 mg, 1 times / day Route: oral Route: multiple Dose: 20 mg, 1 times / day Sources: Page: p. 115 |
unhealthy, adult n = 296 Health Status: unhealthy Age Group: adult Sex: M+F Population Size: 296 Sources: Page: p. 115 |
| Nausea | 1% Disc. AE |
20 mg 1 times / day multiple, oral Dose: 20 mg, 1 times / day Route: oral Route: multiple Dose: 20 mg, 1 times / day Sources: Page: p. 115 |
unhealthy, adult n = 296 Health Status: unhealthy Age Group: adult Sex: M+F Population Size: 296 Sources: Page: p. 115 |
| Vomiting | 1% Disc. AE |
20 mg 1 times / day multiple, oral Dose: 20 mg, 1 times / day Route: oral Route: multiple Dose: 20 mg, 1 times / day Sources: Page: p. 115 |
unhealthy, adult n = 296 Health Status: unhealthy Age Group: adult Sex: M+F Population Size: 296 Sources: Page: p. 115 |
Overview
| CYP3A4 | CYP2C9 | CYP2D6 | hERG |
|---|---|---|---|
OverviewOther
| Other Inhibitor | Other Substrate | Other Inducer |
|---|---|---|
Drug as victim
| Target | Modality | Activity | Metabolite | Clinical evidence |
|---|---|---|---|---|
| minor | ||||
| minor | ||||
| yes | yes (co-administration study) Comment: The 90% confidence interval (CI) of the geometric means for hydrocodone AUCinf (98 to 115%), AUCt (98 to 115%), and Cmax (93 to 121%) values were within the range of 80 to 125% when a single dose of HYSINGLA ER 20 mg was co-administered with CYP2D6 inhibitor paroxetine |
|||
| yes | yes (co-administration study) Comment: Co-administration of HYSINGLA ER and CYP3A4 inhibitor ketoconazole increased mean hydrocodone AUC and Cmax by 135% and 78%, respectively; |
Tox targets
| Target | Modality | Activity | Metabolite | Clinical evidence |
|---|---|---|---|---|
PubMed
| Title | Date | PubMed |
|---|---|---|
| Profound hearing loss associated with hydrocodone/acetaminophen abuse. | 2000 Mar |
|
| Opioid formulations: tailoring to the needs in chronic pain. | 2001 |
|
| Harmonic Scalpel vs. electrocautery hemorrhoidectomy: a prospective evaluation. | 2001 Apr |
|
| Do gender and race affect decisions about pain management? | 2001 Apr |
|
| Efficacy and tolerability of celecoxib versus hydrocodone/acetaminophen in the treatment of pain after ambulatory orthopedic surgery in adults. | 2001 Feb |
|
| A retrospective study of the effect of postoperative indomethacin rectal suppositories on the need for narcotic analgesia in patients who had a cesarean delivery while they were under regional anesthesia. | 2001 Jun |
|
| Psychosis after ultrarapid opiate detoxification. | 2001 Jun |
|
| [Does the inhalation of a 1% L-menthol solution in the premedication of fiberoptic bronchoscopy affect coughing and the sensation of dyspnea?]. | 2001 Mar |
|
| Who's feeling no pain? | 2001 Mar 19 |
|
| Evaluation of urinary dihydrocodeine excretion in human by gas chromatography-mass spectrometry. | 2001 Mar 5 |
|
| Important drugs for cough in advanced cancer. | 2001 Nov |
|
| Cellulose granulomatosis presenting as centrilobular nodules: CT and histologic findings. | 2001 Nov |
|
| Acetaminophen, aspirin, or Ibuprofen in combination analgesic products. | 2001 Nov-Dec |
|
| Rofecoxib versus codeine/acetaminophen in postoperative dental pain: a double-blind, randomized, placebo- and active comparator-controlled clinical trial. | 2001 Sep |
|
| Engineering novel biocatalytic routes for production of semisynthetic opiate drugs. | 2001 Sep |
|
| The simultaneous determination of codeine, morphine, hydrocodone, hydromorphone, 6-acetylmorphine, and oxycodone in hair and oral fluid. | 2002 Apr |
|
| Synthesis and biological activity of 8beta-substituted hydrocodone indole and hydromorphone indole derivatives. | 2002 Jan 21 |
|
| A phase II study of hydrocodone for cough in advanced cancer. | 2002 Jan-Feb |
|
| Effect of narcotic pain reliever on pulp tests in women. | 2002 Jul |
|
| Gender differences in narcotic-induced emesis in the ED. | 2002 May |
|
| Exacerbation of panic disorder symptoms following Vicodin exposure. | 2002 Nov-Dec |
|
| Rational use of analgesic combinations. | 2002 Oct |
|
| Surveillance of drug identification calls: an overlooked poison center responsibility. | 2002 Oct |
|
| Senate committee fights hydrocodone abuse. | 2002 Sep |
|
| [Hypoxic brain damage in victims of fatal road traffic accident: prevalence, distribution and association with survival time and other head and extracranial injuries]. | 2002 Sep |
|
| Adverse drug reactions to oxycodone and hydrocodone in CYP2D6 ultrarapid metabolizers. | 2003 Aug |
|
| The synergistic analgesic interactions between hydrocodone and ibuprofen. | 2003 Dec |
|
| Quantification of the O- and N-demethylated metabolites of hydrocodone and oxycodone in human liver microsomes using liquid chromatography with ultraviolet absorbance detection. | 2003 Feb 25 |
|
| I am following a health care professional who, I think, has a drug problem. | 2003 Jan |
|
| Characterizing the subjective, psychomotor, and physiological effects of a hydrocodone combination product (Hycodan) in non-drug-abusing volunteers. | 2003 Jan |
|
| [Maternal and fetal morbidity in patients with premature rupture of the membrane after 27-week gestation. Causes and costs]. | 2003 Jul |
|
| Rapid communication: laparoscopic Anderson-Hynes dismembered pyeloplasty using the da Vinci robot: technical considerations. | 2003 Mar |
|
| Misuse of prescribed controlled substances defined by urinalysis. | 2003 Mar-Apr |
|
| Current concepts in acute pain management. | 2003 May |
|
| Withdrawal hyperalgesia after acute opioid physical dependence in nonaddicted humans: a preliminary study. | 2003 Nov |
|
| Evaluation of postoperative bupivacaine infusion for pain management after anterior cruciate ligament reconstruction. | 2003 Oct |
|
| 1000 office-based hysteroscopies prior to in vitro fertilization: feasibility and findings. | 2004 Apr-Jun |
|
| Effective treatment of laparoscopic cholecystectomy pain with intravenous followed by oral COX-2 specific inhibitor. | 2004 Feb |
|
| Office visits and analgesic prescriptions for musculoskeletal pain in US: 1980 vs. 2000. | 2004 Jun |
|
| Local anesthetic infusion pumps improve postoperative pain after inguinal hernia repair: a randomized trial. | 2004 Nov |
|
| 6-oxo-morphinane oximes: pharmacology, chemistry and analytical application. | 2004 Oct |
|
| Presurgical intravenous parecoxib sodium and follow-up oral valdecoxib for pain management after laparoscopic cholecystectomy surgery reduces opioid requirements and opioid-related adverse effects. | 2004 Oct |
|
| Metaxalone (Skelaxin)-related death. | 2004 Sep |
|
| Cough suppression during flexible bronchoscopy using combined sedation with midazolam and hydrocodone: a randomised, double blind, placebo controlled trial. | 2004 Sep |
|
| A 35-year-old physician with opioid dependence. | 2004 Sep 15 |
|
| Selective potentiation of opioid analgesia by nonsteroidal anti-inflammatory drugs. | 2005 Apr 8 |
|
| The GC-MS detection and characterization of neopine resulting from opium use and codeine metabolism and its potential as an opiate-product-use marker. | 2005 Jun |
Sample Use Guides
APADAZ Immediate-release tablets: 6.12 mg benzhydrocodone (equivalent to 6.67 mg benzhydrocodone hydrochloride) and 325 mg acetaminophen.
Initiate treatment with APADAZ at 1 or 2 tablets every 4 to 6 hours as needed for pain. Dosage should not exceed 12 tablets in a 24 hour period.
Route of Administration:
Oral
| Substance Class |
Chemical
Created
by
admin
on
Edited
Sat Dec 16 10:15:08 GMT 2023
by
admin
on
Sat Dec 16 10:15:08 GMT 2023
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| Record UNII |
PPK4BVC0DX
|
| Record Status |
Validated (UNII)
|
| Record Version |
|
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Download
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PPK4BVC0DX
Created by
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Created by
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| Related Record | Type | Details | ||
|---|---|---|---|---|
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ANHYDROUS->SOLVATE | |||
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PARENT -> SALT/SOLVATE |
APPROXIMATE PURE ANHYDROUS DRUG CONTENT (IN PERCENT)
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| Related Record | Type | Details | ||
|---|---|---|---|---|
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ACTIVE MOIETY |