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Mini Review ARTICLE Provisionally accepted The full-text will be published soon. Notify me

Front. Pharmacol. | doi: 10.3389/fphar.2018.01122

Pre-clinical and clinical pharmacology of hydrocodone for chronic pain: a mini review

 Luigi Cardia1,  Gioacchino Calapai2*, Domenico Quattrone3, Cristina Mondello2,  Vincenzo Arcoraci4,  Fabrizio Calapai5,  Carmen Mannucci2 and Epifanio Mondello1
  • 1Department, Dipartimento di Patologia umana dell'adulto e dell'età evolutiva Gaetano Barresi, Universita' degli Studi di Messina, Italy
  • 2Dipartimento di Scienze Biomediche, Odontoiatriche e delle Immagini Morfologiche e Funzionali, Universita' degli Studi di Messina, Italy
  • 3ASP Messina, Italy
  • 4Dipartimento di Medicina Clinica e Sperimentale, Universita' degli Studi di Messina, Italy
  • 5Università degli Studi di Messina, Italy

Hydrocodone is one of the most prescribed oral analgesic drugs and it is one of the most abused drugs in general population. It is a mu-opioid agonist predominantly metabolized to the O-demethylated product hydromorphone and to the N-demethylated product norhydrocodone. The purpose of the study is to summarise the preclinical and clinical characteristics of hydrocodone. Pharmacokinetic aspect (terminal half-life, maximum serum concentration, and time to maximum serum concentration) of hydrocodone and the influence of metabolic genetic polymorphism in analgesic response to hydrocodone are also illustrated and commented. Literature on experimental preclinical pharmacology investigating analgesic activity in laboratory animals is furtherly discussed. Moreover, the authors discuss and comment on the updated data regarding safety profile and effectiveness of hydrocodone in the treatment of chronic pain. A bibliographic research was carried out (from 01 February 2018 until 28 August 2018) independently by two researchers (blinded to the authors and initially on results) in the major scientific databases and research engines of peer-reviewed literature on life sciences and biomedical topics, starting from January 1990 to August 2018. Analysis of results of clinical studies suggests that abuse-deterrent extended-release (ER) hydrocodone formulations can be effective and they are well tolerated in the treatment of chronic low back pain. Weaker is the evidence of the analgesic effectiveness of ER hydrocodone on other chronic pain syndromes and non-cancer non-neuropathic chronic pain. In these conditions, hydrocodone showed to have positive effects in non-controlled open studies and needs to be further studied to assess the real strength of results.

Keywords: Chronic Pain, Opioids, Pain, Analgesics, Hidrocodone

Received: 19 Jun 2018; Accepted: 13 Sep 2018.

Edited by:

Francesco P. Busardò, Università degli Studi di Roma La Sapienza, Italy

Reviewed by:

Maria Antonietta De Luca, Università degli studi di Cagliari, Italy
Mariana Spetea, Universität Innsbruck, Austria  

Copyright: © 2018 Cardia, Calapai, Quattrone, Mondello, Arcoraci, Calapai, Mannucci and Mondello. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Prof. Gioacchino Calapai, Dipartimento di Scienze Biomediche, Odontoiatriche e delle Immagini Morfologiche e Funzionali, Universita' degli Studi di Messina, Messina, 98122, Italy,