Hysingla ER

1 What is Hysingla ER?

Brand: Hysingla ER, Zohydro ER

Generic: Hydrocodone

Hysingla ER belongs to a group of analgesics called narcotic analgesics. It is used to manage severe pain. It acts on the nerve receptors in the CNS to control the pain.

Hysingla ER can result in physical and mental dependence when used for a long time. Dependence is the habit-forming property of a drug. If the treatment is stopped abruptly, physical dependence can lead to withdrawal effects on the body.

This medicine is available only through a doctor's prescription.

This product is available in the following dosage forms:

  • Tablet, Extended Release
  • Capsule, Extended Release
  • Liquid
  • Tablet
  • Syrup

2 What To Know Before Using

Before using Hysingla ER, you must know all about the risks and complications associated with it. Your doctor will consider these risks before prescribing the drug and will inform you about them.

Following factors should be considered before taking this drug:


If you have had an allergic reaction to this drug in the past, inform your doctor. You should also tell your healthcare provider if you are allergic to any other drugs or food products.

Age-specific problems

The data regarding the effects of this medicine specific to the pediatric age group is not yet available. Its safety and efficacy have not been established in children.

The studies specific to the geriatric age group have not been carried out, therefore its safety and efficacy have not been established in older age group. However, geriatric population is more prone to having confusion, mental problems, kidney, liver and heart problems.


Regarding the safety of usage of this drug during pregnancy, it comes under “C” category, which means that clinical trials on animals have revealed harmful effects to the developing fetus or relevant studies have not been performed.

Drug Interactions

Certain drugs should not be used together because they can interact inside the body which can have a harmful effect. On the other hand, certain drugs are allowed to be used together.

So, you should tell your doctor about any other medications you are taking. If there is a chance of interaction between those two drugs, the doctor may change the dose or may prescribe an alternative drug.

This medication should be used cautiously with the following drugs:

  • Alfentanil
  • Acetophenazine
  • Alprazolam
  • Amobarbital
  • Aprepitant
  • Anileridine
  • Aripiprazole
  • Asenapine
  • Baclofen
  • Atazanavir
  • Boceprevir
  • Bromazepam
  • Bosentan
  • Brotizolam
  • Buspirone
  • Buprenorphine
  • Butabarbital
  • Butalbital
  • Carbamazepine
  • Butorphanol
  • Carbinoxamine
  • Ceritinib
  • Carisoprodol
  • Chlordiazepoxide
  • Chloral Hydrate
  • Chlorpromazine
  • Chlorzoxazone
  • Clarithromycin
  • Clobazam
  • Clonazepam
  • Clozapine
  • Clorazepate
  • Codeine
  • Conivaptan
  • Dantrolene
  • Cyclobenzaprine
  • Dexmedetomidine
  • Diacetylmorphine
  • Dezocine
  • Diazepam
  • Difenoxin
  • Dichloralphenazone
  • Dihydrocodeine
  • Diphenhydramine
  • Diltiazem
  • Diphenoxylate
  • Donepezil
  • Dixyrazine
  • Doxylamine
  • Dronedarone
  • Droperidol
  • Efavirenz
  • Enflurane
  • Erythromycin
  • Estazolam
  • Ethchlorvynol
  • Eszopiclone
  • Ethopropazine
  • Ethylmorphine
  • Flibanserin
  • Fentanyl
  • Fluconazole
  • Fluphenazine
  • Flunitrazepam
  • Flurazepam
  • Fosaprepitant
  • Fluspirilene
  • Fosphenytoin
  • Furazolidone
  • Fospropofol
  • Halazepam
  • Halothane
  • Haloperidol
  • Hexobarbital
  • Hydromorphone
  • Hydroxyzine
  • Idelalisib
  • Imatinib
  • Iloperidone
  • Indinavir
  • Isocarboxazid
  • Iproniazid
  • Isoflurane
  • Ketamine
  • Itraconazole
  • Ketazolam
  • Ketoconazole
  • Ketobemidone
  • Levorphanol
  • Lopinavir
  • Linezolid
  • Lorazepam
  • Loxapine
  • Lormetazepam
  • Lurasidone
  • Meclizine
  • Melperone
  • Medazepam
  • Mephenesin
  • Meperidine
  • Mephobarbital
  • Meprobamate
  • Meptazinol
  • Mesoridazine
  • Metaxalone
  • Methdilazine
  • Methadone
  • Methocarbamol
  • Methotrimeprazine
  • Methohexital
  • Methylene Blue
  • Metopimazine
  • Midazolam
  • Molindone
  • Moclobemide
  • Modafinil
  • Moricizine
  • Morphine
  • Morphine Sulfate Liposome
  • Nalbuphine
  • Nefazodone
  • Nicomorphine
  • Nelfinavir
  • Nilotinib
  • Nitrazepam
  • Opium
  • Olanzapine
  • Opium Alkaloids
  • Orphenadrine
  • Oxycodone
  • Oxazepam
  • Oxymorphone
  • Papaveretum
  • Paliperidone
  • Paregoric
  • Pentobarbital
  • Pentazocine
  • Perampanel
  • Periciazine
  • Perazine
  • Perphenazine
  • Phenobarbital
  • Phenelzine
  • Phenytoin
  • Pipotiazine
  • Pimozide
  • Piritramide
  • Prazepam
  • Posaconazole
  • Primidone
  • Prochlorperazine
  • Procarbazine
  • Promazine
  • Promethazine
  • Propofol
  • Propiomazine
  • Quazepam
  • Ramelteon
  • Quetiapine
  • Rasagiline
  • Remoxipride
  • Remifentanil
  • Rifampin
  • Ritonavir
  • Risperidone
  • Saquinavir
  • Selegiline
  • Secobarbital
  • Sertindole
  • St John's Wort
  • Sodium Oxybate
  • Sulpiride
  • Sufentanil
  • Tapentadol
  • Suvorexant
  • Telaprevir
  • Telithromycin
  • Temazepam
  • Thiopental
  • Thiethylperazine
  • Thiopropazate
  • Thioridazine
  • Thioproperazine
  • Thiothixene
  • Tizanidine
  • Tilidine
  • Tolonium Chloride
  • Tramadol
  • Topiramate
  • Tranylcypromine
  • Trifluperidol
  • Triazolam
  • Triflupromazine
  • Verapamil
  • Trimeprazine
  • Voriconazole
  • Ziprasidone
  • Zaleplon
  • Zolpidem
  • Zotepine
  • Zopiclone

Furthermore, certain medications should not be taken with alcohol or tobacco, which may also result in harmful interactions. Ask your doctor about the concurrent use of this drug along with alcohol or tobacco.

You should also inform your doctor about any other medical condition you may be suffering from, especially:

  • Breathing problems (eg, chronic obstructive pulmonary disease [COPD], cor pulmonale, hypoxia)
  • Alcohol abuse
  • Depression
  • Congestive heart failure
  • Drug dependence, especially with narcotics
  • Gallbladder problems
  • Electrolyte imbalance
  • Heart rhythm problems (eg, congenital long QT syndrome, slow heartbeat) 
  • Mental illness
  • Stomach or bowel problems (eg, blockage) 
  • Pancreatitis (inflammation or swelling of the pancreas) 
  • Trouble swallowing 
  • Asthma
  • Weakened immune system—Use with caution. May increase risk for more serious side effects
  • Breathing problems, severe (eg, hypercarbia) 
  • Respiratory depression (very slow breathing)—Should not be used in patients with these conditions
  • Paralytic ileus (intestine stops working and may be blocked), known or suspected 
  • Head injuries
  • Brain tumor
  • Hypotension (low blood pressure)
  • Increased pressure in the head
  • Seizures
  • Liver disease
  • Kidney disease

3 Proper Usage

To use Hysingla ER properly, you must follow all instructions given by your doctor. Hysingla ER has a tendency to cause dependence (habit-forming). So, it is important that you only take the recommended dose.

This drug should be used exactly as prescribed by your doctor in order to avoid adverse effects. Do not overuse or misuse this drug and do not use it longer than the recommended time. Read all the instructions mentioned in the medication guide. 

Swallow the tablet or capsule as a whole. Avoid chewing, breaking and crushing the tablet. Take the medication at the same time each day. The dose of this drug varies according to the condition of each person.

The number of doses per day, the time interval between the doses and the length of time you have to take the medicine depends on your condition individually and all these factors should only be determined by your healthcare provider. Follow each and every instruction of your doctor and also read the label carefully.

In case you miss one dose of this drug, take it as soon as you can. If it is almost time for your subsequent dose, you can then skip the missed dose and continue with your regular dosing schedule. Do not take two doses at once.

This medicine should be stored at room temperature within a closed container, away from heat, direct light, and moisture. Keep this drug out of the reach of children. Do not store expired or outdated medicines or the medicine no longer needed.

4 Precautions To Take

Before using Hysingla ER, there are some precautions you must take. Your doctor will monitor the response to this medicine and look for any side effects.

Therefore, regular follow-up is necessary during and after the treatment. Contact your doctor if your symptoms have not improved even after taking the full course of treatment. 

Hydrocodone will enhance the effects of alcohol or any other CNS depressants like benzodiazepines. So avoid taking them concurrently.

Hydrocodone can cause severe constipation. It can also lead to dizziness, drowsiness and loss of attention.

The overdose of Hydrocodone can also cause serious symptoms and needs urgent medical help. This medicine can cause serious types of allergic reactions including anaphylaxis. It is a serious condition and needs emergency medical attention.

Avoid taking any other medicine unless thoroughly discussed with your doctor. Always ask your doctor before using any prescription, non-prescription or herbal medicine.

5 Potential Side Effects

As with many medications, there are several potential side effects associated with Hysingla ER. Although these side effects may occur only in a handful of patients, but if they do occur, contact your physician immediately.

This medication is associated with the following side effects:

  • Body aches or pain
  • Bloating or swelling of the face, arms, hands, lower legs, or feet
  • Chills
  • Depression
  • Cough
  • Difficult or labored breathing
  • Ear congestion
  • Fever
  • Fear or nervousness
  • Headache
  • Nasal congestion
  • Loss of voice
  • Rapid weight gain
  • Sneezing
  • Runny nose
  • Sore throat
  • Tingling of the hands or feet
  • Tightness in the chest
  • Unusual weight gains or loss
  • Unusual tiredness or weakness
  • Symptoms of overdose
  • Blurred vision
  • Blue lips and fingernails
  • Change in consciousness
  • Cold and clammy skin
  • Chest pain or discomfort
  • Confusion
  • Coughing that sometimes produces a pink frothy sputum
  • Constricted pupil (black part of the eye)
  • Decreased awareness or responsiveness
  • Dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
  • Difficult, fast, noisy breathing, sometimes with wheezing
  • Increased sweating
  • Lightheadedness, dizziness, or fainting
  • Irregular, fast or slow, or shallow breathing
  • Loss of consciousness
  • Pale skin
  • No muscle tone or movement
  • Severe sleepiness
  • Slow or irregular heartbeat
  • Sleepiness or unusual drowsiness

Seek medical help instantly, if you experience any of these symptoms while on this drug. Also contact your health care professional immediately, if you have overdosed on this drug. If any of these side effects becomes more bothersome or does not go away, contact your doctor.