Hydromet dosage, forms, and strengths

Hydromet is a brand-name prescription cough suppressant. It contains a narcotic (hydrocodone) and a low dose of an anticholinergic drug (homatropine). Hydrocodone works on the central nervous system to suppress the cough reflex. The second drug is added to discourage overdosage. Doses are taken every four to six hours for the shortest possible period.

Hydromet forms and strengths

Hydromet comes in only one dosage form: a liquid oral solution. 

• Oral solution: 5 mg hydrocodone/1.5 mg homatropine per 5 mL

Hydromet dosage for adults

The FDA has approved Hydromet for cough relief in adults. It can only be purchased with a prescription and filled at a pharmacy.

Because it contains an opioid, Hydromet is never prescribed to children younger than 6 years of age or to people who have:

• Significantly slow or shallow breathing (respiratory depression)

• Active or severe bronchial asthma

• Gastrointestinal blockage, including paralysis of the colon (paralytic ileus)

• Known allergies to hydrocodone or homatropine

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Hydromet dosage for cough

Coughing is one of our most common experiences. We do it several times a day simply to clear airway passages. It is also a common symptom of a wide variety of medical conditions. 

Most people treat their cough with nonprescription remedies, including throat lozenges, natural remedies, or cough medicines like dextromethorphan. In some cases, people seek medical advice or help. A doctor tries to discover and treat the cause but may also prescribe a more powerful cough medication than can be purchased off a store shelf. Doctors are more likely to use prescription cough medications when the cough is severe, very bothersome to the patient, or long-lasting.

Coughing is a reflex, so the nervous system is what makes us cough. It starts with nerves responding to irritation, sending the irritation signals to the “cough center” in the brain, and the brain then triggers a cough. Most drugs that treat coughing affect the nervous system in one way or another. They either block the sensations or the cough trigger. Healthcare professionals are generally discouraged from using drugs like these since coughing is a useful defense rather than an illness.

Hydromet contains hydrocodone, an opioid derived from codeine, another common cough medication. Like all opioids, hydrocodone slows down nerves but primarily affects the part of the brain responsible for the cough reflex, preventing the “cough center” from triggering a cough in response to irritation in the throat or lungs.

Homatropine is a muscarinic antagonist (or anticholinergic) similar to atropine, but the dose level is too small to have a clinical benefit. Instead, homatropine counters the effects of hydrocodone. It’s combined with hydrocodone to discourage abuse or overdose. 

Together, these two medications help people with chronic or severe cough who may be at risk of overdosing or abusing the drug. Doses are taken every four to six hours.

• Standard Hydromet dosage for cough: 5 mL taken orally every four to six hours

• Maximum Hydromet dosage for cough: No more than 30 mL every 24 hours

Hydromet dosage for children

Hydromet is not FDA-approved for use in pediatric patients. It should never be given to children younger than 6 years of age.

Hydromet dosage restrictions

Hydromet does not require dosage reductions in people with kidney problems or liver impairment. However, healthcare professionals use the drug cautiously in people with severe liver or kidney disease. 

Hydromet dosage for pets

Veterinarians use hydrocodone-homatropine in dogs with persistent coughs due to collapsing trachea, bronchitis, or kennel cough. They are more likely to use hydrocodone alone, but the combination drug can also be used. The homatropine in the drug counters the effects of overdosage or discourages human abuse.

Pet caregivers can give their dogs brand-name Hydromet, Hycodan, or generic hydrocodone-homatropine. Dosage forms include an oral solution, syrup, or pills. Doses are usually given four times daily with or without food.

How to take Hydromet

Hydromet contains a potentially hazardous opioid. Here are some tips for taking this drug safely:

• Follow all the doctor’s instructions.

• Do not take more Hydromet than prescribed. Do not take doses more frequently than prescribed.

• Hydromet can be taken with or without food.

• Only take this medicine by mouth.

• Use an oral dosing syringe or other measuring device that measures the liquid in milliliters. Never use kitchen measuring devices like a household teaspoon because of the risk of overdose.

• Do not overfill the oral syringe or milliliter measuring device.

• Rinse the measuring device with water after each use.

• Call the prescriber if the cough doesn’t improve after five days.

• Store Hydromet in a child-proof closed container at room temperature in a dry, cool location. Keep the container away from heat and direct sunlight.

• Keep Hydromet out of the reach of children.

Hydromet dosage FAQs

How long does it take Hydromet to work?

Hydromet should start working in one to two hours. The hydrocodone in Hydromet hits its peak concentrations about one hour after taking a dose. If Hydromet doesn’t work after the first dose, keep taking it for a few days. If the cough doesn’t improve after five days, talk to the prescriber.

How long does Hydromet stay in your system?

With a half-life of four hours, hydrocodone takes about 20 hours to be completely cleared from the system. The dose of homatropine is a subclinical dose, but it, too, has a half-life of around four hours.

What happens if I miss a dose of Hydromet?

Ask the prescriber how to handle a missed dose. Always follow the prescription instructions when spacing doses unless the prescribing clinician instructs otherwise. That means that if a missed dose is taken, the next dose should be taken at least four hours later. Never take extra Hydromet to make up for a missed dose.

How long can you take Hydromet?

Because of the risk of abuse, physical dependence, and overdose, Hydromet should be used for the shortest possible time. If it doesn’t work after five days, the prescriber will advise the patient to discontinue the medication even if there is more medication in the bottle that was dispensed by the pharmacy. 

When it’s time for a refill, the prescribing clinician will re-evaluate the need for the medication and consider switching to a non-opioid cough medicine.

How do I stop taking Hydromet?

Stop taking Hydromet when instructed by the prescriber. If Hydromet is only prescribed for a few days, then stop taking the drug unless you get a refill from the doctor. 

If Hydromet has been taken for several weeks, do not stop taking the drug without talking to the prescriber. The dose may need to be gradually reduced to prevent opioid withdrawal. Symptoms of opioid withdrawal include restlessness, sweating, insomnia, irritability, anxiety, high blood pressure, racing heartbeats, vomiting, muscle pain, dilated pupils, and abdominal cramps.

If it becomes necessary to stop Hydromet and coughing is still a problem, healthcare professionals can prescribe dextromethorphan, benzonatate, or codeine.

What is the maximum dosage for Hydromet?

Do not take more than 30 milliliters of Hydromet in a single day.

Can you overdose on Hydromet?

An overdose of hydrocodone can be fatal. If too much hydrocodone is taken by anyone (the patient or a child or another member of the household), get emergency medical care. A hydrocodone overdose can be suspected by symptoms such as excessive sleepiness, shallow breathing, stupor, loss of muscle tone, cold skin, blue skin, low blood pressure, and slow heart rate. An overdose can result in life-threatening respiratory depression, heart attack, or death.

What interacts with Hydromet?

To prevent possible hazardous drug interactions, tell the prescribing healthcare provider about all the prescription drugs, over-the-counter medications, and supplements being taken, particularly:

• Other CNS depressants, including other opioids, sedatives, benzodiazepines, antihistamines, cough suppressants, and similar drugs

• Drugs that treat mood or mental health problems such as antidepressants, anxiety medications, or antipsychotics

• Muscle relaxants

• Monoamine oxidase inhibitors (MAOIs)

• Blood pressure medications

• Drugs that make you urinate (diuretics)

• Drugs called anticholinergics that treat asthma, COPD, stomach problems, or overactive bladder

• Macrolide antibiotics such as erythromycin

• Oral azole drugs that treat fungal infections such as ketoconazole

• Antiviral drugs called protease inhibitors

• Carbamazepine, Paxlovid, phenytoin, rifampin

What happens when you mix Hydromet and alcohol?

It is not safe to drink alcohol when taking Hydromet. The combination can cause excessive sedation and slow down breathing.

Is it safe to take Hydromet during pregnancy?

Women who are pregnant should not take Hydromet. If they do, Hydromet should only be used for a short period. Taking Hydromet during a pregnancy may cause potentially life-threatening withdrawal symptoms in a newborn baby, a condition called neonatal opioid withdrawal syndrome.

Is it safe to take Hydromet while breastfeeding?

Women who are breastfeeding should not take Hydromet. Hydrocodone is present in breast milk and may cause serious adverse reactions in a nursing infant including excessive sleepiness, respiratory depression, and death. The homatropine in Hydromet may affect lactation, but that’s a less serious concern.

What should I tell the doctor before taking Hydromet?

Tell the prescriber about all your medical conditions, particularly:

• Lung or breathing problems

• Glaucoma

• Pancreas or bile duct problems

• Recent head injury

• Brain tumor

• Kidney problems

• Liver problems

• Adrenal gland problems

• Stomach pain

• Low blood pressure (hypotension)

• Constipation or intestinal problems

• A history of seizures

• A current or past drug addiction

Tell the prescriber about any plans to have surgery.

What are the most common side effects of Hydromet?

The most common side effects of Hydromet are:

• Drowsiness

• Dizziness

• Lightheadedness

• Confusion

• Brain fog

• Constipation

• Coordination problems

• Dry mouth

• Low energy

• Nausea and vomiting

What are the serious side effects of Hydromet?

The most serious adverse effects of Hydromet include:

• Increased pressure inside the head

• Severe constipation

• Slow heart rate

• Low blood pressure (hypotension)

• Adrenal gland insufficiency

• Infertility

• Severe allergic reactions

Sources

• Hycodan hydrocodone bitartrate and homatropine methylbromide tablets and oral solution prescribing information, Food and Drug Administration (FDA)

• Hydrocodone, StatPearls

• Hydrocodone + homatropine oral, VCA Animal Hospitals

• Hydromet hydrocodone bitartrate and homatropine methylbromide oral solution prescribing information, DailyMed (NIH National Library of Medicine)

• Plumb’s Veterinary Drug Handbook 7th ed.