Which extended release hydrocodone formulations have lower abuse potential?

Access to the full content of this site is available only to registered healthcare professionals. Access to the full content of this site is available only to registered healthcare professionals.

Takeaway

  • Intranasal hydrocodone extended release (ER) has a low abuse potential compared with hydrocodone powder and hydrocodone bitartrate ER capsules (Zohydro ER).

Why this matters

  • Prior studies have found that abuse-deterrent formulations reduce the overdoses of those specific formulations, but do not appear to affect illicit drug use.
  • ER opioid formulations are more likely to be manipulated for illicit use, particularly for intranasal use.

Study design

  • A single-dose, randomized, double-blind, quadruple-dummy, active- and placebo-controlled crossover study identified 170 healthy adults to assess the abuse potential of hydrocodone formulations.
  • Funding: Teva Branded Pharmaceutical Products R&D, Inc.

 Key results

  • Mean efficacy of drug liking “at the moment” was significantly lower for intranasal hydrocodone ER (Maximum effect [Emax], 72.8) vs hydrocodone powder (Emax, 80.2; P=.004) and bitartrate ER capsules (Emax, 83.2; P<.001>
  • Overall drug liking, 24 h after administration was significantly lower with intranasal hydrocodone ER (Emax, 68.5) compared with hydrocodone powder (Emax, 77.1; P=.004) and bitartrate ER capsules (Emax, 79.8; P<.001>
  • Overall adverse events with placebo, intranasal hydrocodone powder, intranasal hydrocodone ER tablets and bitartrate ER capsules were 18%, 53%, 52%, and 61%, respectively.
  •  Most adverse events were mild and resolved.

  Limitations

  • Single-center study.

Coauthored with Anand Ramanathan, PharmD