Hydrocodone: clinical applications and considerations for palliative care

Hydrocodone is one of the most commonly prescribed opioids for the management of moderate pain in the United States of America. This paper explores its pharmacological properties, clinical applications and safety considerations, particularly in palliative care settings. Hydrocodone acts as a full mu-opioid receptor agonist, that can have enhanced effectiveness through the attached acetaminophen com­ponent, which also acts as the reason for its ceiling effect of dose limitations. Although hydrocodone is not widely available in Europe, understanding its risks and benefits is important for clinicians in international discussions on pain management and opioid stewardship.