Hydrocodone chemical structure
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Tussionex

Hydrocodone or dihydrocodeinone (marketed as Vicodin, Anexsia, Dicodid, Hycodan, Hycomine, Lorcet, Lortab, Norco, Tussionex, Vicoprofen) is an opioid derived from either of the naturally occurring opiates codeine or thebaine. Hydrocodone is an orally active narcotic analgesic and antitussive. The typical therapeutic dose of 5 to 10 mg is pharmacologically equivalent to 30 to 60 mg of oral codeine. Sales and production of this drug have increased significantly in recent years, as have diversion and illicit use. more...

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Hydrocodone is commonly available in tablet, capsule and syrup form.

As a narcotic, hydrocodone relieves pain by binding to opioid receptors in the brain and spinal cord. It may be taken with or without food, but should never be combined with alcohol. It may interact with monoamine oxidase inhibitors, as well as other drugs that cause drowsiness. It is in FDA pregnancy category C: its effect on an unborn embryo or fetus is not clearly known and pregnant women should consult their physicians before taking it. Common side effects include dizziness, lightheadedness, nausea, drowsiness, euphoria, vomiting, and constipation. Some less common side effects are allergic reaction, blood disorders, changes in mood, mental fogginess, anxiety, lethargy, difficulty urinating, spasm of the ureter, irregular or depressed respiration and rash.

Hydrocodone can be habit-forming, and can lead to physical and psychological addiction. In the U.S., pure hydrocodone and forms containing more than 15 mg per dosage unit are considered Schedule II drugs. Those containing less than 15 mg per dosage unit are Schedule III drugs. Hydrocodone is typically found in combination with other drugs such as paracetamol (acetaminophen), aspirin and homatropine methylbromide. In the UK it is listed as a Class A drug under the Misuse of Drugs Act 1971.

The presence of acetaminophen in hydrocodone-containing products deters many drug users from taking excessive amounts. However, some users will get around this by extracting a portion of the acetaminophen using hot/cold water, taking advantage of the water-soluble element of the drug. It is not uncommon for addicts to have liver problems from taking excessive amounts of acetaminophen over a long period of time--taking 10–15 grams of acetaminophen in a period of 24 hours typically results in severe hepatotoxicity. It is this factor that leads many addicts to use only single entity opiates such as OxyContin.

Symptoms of hydrocodone overdosage include respiratory depression, extreme somnolence, coma, stupor, cold/clammy skin, sometimes bradycardia, and hypotension. A severe overdose may involve circulatory collapse, cardiac arrest and/or death.

Notes

  1. ^  Tarascon Pocket Pharmacopoeia.

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Xyrem(R) is Launched in Germany for the Treatment of Cataplexy in Adults with Narcolepsy
From Market Wire, 12/8/05

Brussels, Belgium - December 8, 2005: UCB announced today that Xyrem® (sodium oxybate) oral solution is now available in Germany for the treatment of cataplexy in adult patients with narcolepsy. Launch in this first major European market follows the recent European Commission (EC) marketing approval of Xyrem® in this orphan indication, with pan-European commercialisation expected over 2006.

"Xyrem® provides physicians and patients in Europe with the first and only EMEA approved medication for the treatment of cataplexy in patients with narcolepsy. We are delighted to serve European physicians and sleep centres with a product that can help fulfil the unmet medical need in patients with this serious sleep disorder." said Emmanuel Caeymaex, Vice-President, Marketing CNS, UCB.

Narcolepsy is a debilitating, life-long neurological disorder that is characterised by excessive daytime sleepiness and sleep attacks[1]. Cataplexy is a typical symptom of narcolepsy and is present in 65-70% of patients with narcolepsy. It involves a sudden reversible loss of muscle tone, usually triggered by emotional stimuli such as laughter, excitement, surprise and anger, with contributing factors including physical fatigue, stress or sleepiness[2]. Commenting on the marketing approval Adrian Williams MD of Sleep Centre, St. Thomas Hospital, London, UK said "Patients and physicians in the EU should be encouraged by the body of clinical research supporting Xyrem®. In Europe, the approval of Xyrem® for the treatment of cataplexy in patients with narcolepsy provides a welcome addition to the pharmacological armamentarium."

Notes to Editor

1. UCB acquired the licence to distribute Xyrem® in Europe from Orphan Medical recently acquired by Jazz Pharmaceuticals). Xyrem® is marketed in the U.S. by Jazz Pharmaceuticals and has been available in the U.S. since 2002.

2. Orphan medicinal product designation

Xyrem® was designated as an orphan medicinal product on February 3, 2003. Orphan medicinal products are used to diagnose, prevent or treat life-threatening or very serious conditions that are rare, with a prevalence of less than five per 10,000 of the EU population. European orphan drug designation enables recipient sponsors to receive regulatory guidance in the drug development process and allows for up to 10 years of European market exclusivity for the designated indication upon approval of the market application.

3. Clinical trials

The European marketing approval of Xyrem® was mainly based on a prospective, multicentre, randomized, double-blind, placebo-controlled trial that examined the safety and efficacy of Xyrem® (3 g, 6 g and 9 g) for the treatment of narcolepsy symptoms. Xyrem® was taken in divided nightly doses immediately before bed-time and repeated 2oe-4 hours later. Results of this four-week study showed that in comparison to placebo, Xyrem® demonstrated clinical improvements in the reported number of weekly cataplexy attacks and daytime sleepiness. Investigators assessed changes in disease severity using the Clinical Global Impression of change (CGI-c) measure, and Xyrem® (9 g) was found to significantly decrease the frequency of cataplexy attacks compared to placebo[1].

A follow-up, 12-month open-label study showed that Xyrem® (3-9 g) was well-tolerated and produced significant and long-term clinical improvement in the frequency of cataplexy attacks and diminished day-time sleepiness[3].

About UCB

UCB (www.ucb-group.com) is a global biopharmaceutical leader with headquarters in Brussels, Belgium, specialising in the fields of central nervous system disorders, inflammatory diseases, and oncology. UCB key products are Keppra® (antiepileptic), Xyzal® and Zyrtec® (antiallergics), Nootropil® (cerebral function regulator), Tussionex® (antitussive) and Metadate(TM) / Equasym XL(TM) (attention deficit/hyperactivity disorder). UCB employs over 8,500 people operating in over 40 countries. UCB is listed on Euronext Brussels (UCB / UCBBt.BR / UCB BB).

[1] The U.S. Xyrem® Multicenter Study Group A randomized, double-blind, placebo controlled multi-centre trial comparing the effects of three doses of orally administered sodium oxybate with placebo for the treatment of narcolepsy Sleep 2002: 25 (1), 42-49

[2] http://www.sleepfoundation.org/sleeptionary/index.php?id=12&subsection=symptomsaccessed November 6, 2005

[3] The U.S. Xyrem® Multicenter Study Group A 12-month, Open-Label, Multicenter Extension Trial of Orally Administered Sodium Oxybate for the Treatment of Narcolepsy Sleep 2003: 26 (1), 31-35

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