Is It Safe To Take Hydrocodone During Pregnancy?
This drug poses no known health risks yet should only be used under prescription.
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In This Article
If you are pregnant, you may discover that suffering from pains and minor aches is part of the process. However, if you are experiencing chronic pain, your doctor may prescribe opioid analgesics such as hydrocodone while pregnant. It is used to treat intense pains that are unmanageable with other methods. Also, it requires ongoing, longtime treatment (1). However, taking opioids during pregnancy may pose certain risks to the fetus; hence, you must be extremely cautious. Read on as we discuss the safety, side effects, and other important details of taking hydrocodone when pregnant.
Is It Safe To Take Hydrocodone During Pregnancy?
According to the US Food and Drug Administration (FDA), hydrocodone belongs to Pregnancy Category C (D, when used long-term). It means animal studies showed adverse effects on the fetus, but there are no well-controlled studies on pregnant women to determine its safety during pregnancy (2). So, your doctor would only prescribe hydrocodone when other alternatives fail to work and when the potential benefits outweigh the risks. Long-term usage during pregnancy may increase the risk of neonatal opioid withdrawal syndrome (1).
The American College of Obstetricians and Gynecologists (ACOG) states that if you need to take hydrocodone while pregnant, then discuss with your doctor the available treatments to treat neonatal withdrawal syndrome in the newborn. It is also necessary to monitor your and your baby’s health throughout the pregnancy and after delivery (3).
What Is The Right Dosage Of Hydrocodone While Pregnant?
The dosage of hydrocodone during pregnancy is usually decided by the physician depending on the intensity of pain and pregnancy risk factors. Hydrocodone is available as a single entity or in combination with other non-opioid analgesic drugs such as acetaminophen or ibuprofen.
Hydrocodone immediate-release combination products may contain 2.5 mg to 10 mg. Hydrocodone present singly is only available in extended-release formulations that may contain 10, 15, 20, 30, 40, and 50mg of the drug (1) (4).
If you have to take an opioid such as hydrocodone during pregnancy, you should work with your healthcare provider to try to minimize possible risks. This may be done by (5):
- Taking opioids for the shortest possible duration
- Using the lowest dose required to address your pain
- Strictly adhering to your doctor’s instructions for taking such medicines
- Reporting side effects immediately to your doctor
- Not missing your follow-up appointments and other prenatal check-ups
How Long Does It Take To Feel The Effects Of Hydrocodone?
Immediate-release hydrocodone is available in combination with other painkillers and may take about 10 to 30 minutes to start its pain-reducing action. The effect usually peaks after an hour and remains for about four to six hours (a next dose may be then required) (6).
Are There Risks Of Taking Hydrocodone While Pregnant?
The US FDA warns against prolonged usage of hydrocodone during pregnancy as it can lead to neonatal opioid withdrawal syndrome, also known as neonatal abstinence syndrome (NAS), shortly after birth. NAS is characterized by the following symptoms (1).
- Poor feeding
- Diarrhea
- Irritability
- Tremors
- Rigidity
- Seizures
Other risks from opioid analgesics such as hydrocodone during pregnancy may include (1) (5) (7):
- Increased risk of congenital anomalies (birth defects) such as neural tube defects, congenital heart defects, and gastroschisis (hole in the abdominal wall)
- Increased risk of pregnancy loss (miscarriage) or a stillbirth
- More likelihood of preterm birth before 37 weeks
- Poor fetal growth
- More likelihood of re-hospitalization within 30 days of being born
- If used before labor, it can prolong labor by reducing the strength, duration, and frequency of uterine contractions
Can Hydrocodone Cause Other Pregnancy Complications?
Along with the possible fetal defects, opioids have certain side effects that can lead to complications during pregnancy. Some of the side effects of hydrocodone are (8):
- Sedation
- Respiratory depression
- Mental clouding
- Euphoria
- Agitation
- Constipation
- Diarrhea
- Abdominal bloating
- Nausea
- Vomiting
- Headache and dizziness
The complications could be serious in the case of an overdose, which must be avoided.
What Happens If You Overdose On Hydrocodone When Pregnant?
Hydrocodone must be taken only in the prescribed dosage for the recommended duration. Abusing opioids can lead to several serious complications. If you overdose on opioids, you might pass out, or your breathing might slow down or stop.
You may develop an opioid addiction, which can make it difficult for you to take care of yourself and your baby. Also, overuse of opioids during pregnancy may cause fetal growth problems, preterm birth, and stillbirth (3).
What Precautions To Take While Having Hydrocodone During Pregnancy?
Some precautionary measures may be useful in ensuring fetal and maternal safety while using opioids during pregnancy (1).
- Pregnant women should never exceed the prescribed dose. Call your doctor if the prescribed dose does not seem sufficient to reduce your pain.
- If you are taking hydrocodone and find out you are pregnant, do not stop it abruptly, as it can cause withdrawal effects on your body. Consult your doctor to know how to stop taking hydrocodone without triggering complications.
- Hydrocodone may cause severe drowsiness, so activities that require constant alertness, such as driving a car, are not advisable when on the drug.
- Your doctor should be informed if you have pre-existing asthma or other respiratory problems. Hydrocodone is usually not suitable in such conditions.
- Tell your healthcare provider if you have any problems related to thyroid, gallbladder, liver, or kidney and about all medications that you are currently taking.
- If you are taking hydrocodone tablets, you should swallow them whole and not cut, break, chew, or crush them.
- Seek immediate medical attention if you observe symptoms of allergic reactions such as difficulty breathing, increased heart rate, and swelling in the face, tongue, or throat.
Frequently Asked Questions
1. How long does hydrocodone last in the body?
Hydrocodone and its metabolites are primarily eliminated through the kidneys. Detectable levels of hydrocodone have been found in urine for about 98 hours (about four days) after a single 10mg dose of the drug (9). However, a hair test may show the presence of hydrocodone for up to 90 days (10). The time taken for the drug to leave the body depends on several factors, including a person’s kidney functions and age.
2. Is hydrocodone the same as oxycodone?
Oxycodone and hydrocodone are different drugs with similar chemical structures and belong to the same category of opioid analgesics (11).
Hydrocodone is an opioid analgesic that can relieve pain and aches. You may receive a prescription for hydrocodone while pregnant when other alternatives prove ineffective. The doctor will prescribe a dosage based on the intensity of the pain and your and your baby’s overall health. On the other hand, if you are taking medicine and get pregnant, don’t stop using it abruptly as it may expose you to the risk of withdrawal effects. Since opioids fall under strict US FDA regulations for prescription during pregnancy, you might have to see a pain specialist and obstetricians specializing in opioid-related pain management.
Key Pointers
- Hydrocodone is an opioid analgesic that may be prescribed during pregnancy for chronic pain refractory to other treatments.
- The medication may have several side effects and should be used in the lowest dose for the least duration.
- An overdose may have serious fetal and maternal consequences, so no changes in dose, frequency, or duration should be made without discussing it with your doctor.
This post is for informational purposes only and is not a replacement for a doctor’s consultation. Do not use any medication without talking to your doctor.
References
- Prescribing Information- Zohydro.
https://www.accessdata.fda.gov/drugsatfda_docs/label/2016/202880s009s010lbl.pdf - Dana G. Carroll; Drugs In Pregnancy.
https://jfmo.cchs.ua.edu/files/2013/09/Drugs_Pregnancy.pdf - Opioid Use Disorder and Pregnancy.
https://www.acog.org/womens-health/faqs/opioid-use-disorder-and-pregnancy - Hydrocodone.
https://www.ncbi.nlm.nih.gov/books/NBK537288/ - Pregnancy and opioids.
https://medlineplus.gov/pregnancyandopioids.html - Onset peak and duration of common pain medications.
https://www.hhs.texas.gov/sites/default/files/documents/doing-business-with-hhs/provider-portal/QMP/PainMedicationTable.pdf - About Opioid Use During Pregnancy.
https://www.cdc.gov/pregnancy/opioids/basics.html - Drug Record- Hydrocodone.
https://www.ncbi.nlm.nih.gov/books/NBK548700/ - Sandra Valtier and Vikhyat S. Bebarta; Excretion Profile of Hydrocodone Hydromorphone and Norhydrocodone in Urine Following Single Dose Administration of Hydrocodone to Healthy Volunteers.
https://academic.oup.com/jat/article/36/7/507/829318 - How Long Do Opioids Stay In Your System?
https://americanaddictioncenters.org/prescription-drugs/how-long-in-system - Opiates or Opioids — What’s the difference?
https://www.oregon.gov/adpc/pages/opiate-opioid.aspx
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