Hydrocodone Bitartrate side effects: what 43,191 FDA adverse event reports show
Drug class
Not stated in label
Who reports
43,191 reports · 87% serious · 21,422 with death outcome · 52% female
Used for
Hydrocodone bitartrate extended-release tablets are indicated for the management of severe and persistent pain that requires an opioid analgesic and that cannot be adequately treated with alternative options, including immediate-release opioids. Limita.
What it is
Hydrocodone bitartrate extended-release tablets are supplied in 20 mg, 30 mg, 40 mg, 60 mg, 80 mg, 100 mg and 120 mg film-coated tablets for oral administration. The tablet strengths describe the amount of hydrocodone per tablet as the bitartrate salt. Hydrocodone bitartrate is an opioid agonist.
Boxed warning
SERIOUS AND LIFE-THREATENING RISKS FROM USE OF HYDROCODONE BITARTRATE EXTENDED-RELEASE TABLETS Addiction, Abuse, and Misuse Because the use of hydrocodone bitartrate extended-release tablets exposes patients and othe.
Causality screen of the 40 strongest signals
What the badges mean
- Labeled adverse reaction The exact term appears in the label's warnings or adverse-reactions sections: a known, expected effect. The FAERS signal confirms the label rather than discovering anything.
- Labeled (related wording) The label describes this effect under different wording (e.g. 'neutropenia' for 'neutrophil count decreased'). Treated as known.
- Likely indication confounding The term appears in the label's indications: reports probably describe the disease being treated (or its progression), not a drug effect. Classic confounding by indication.
- Reporting / coding artifact An administrative, monitoring or exposure term (product issue, off-label use, 'test normal', overdose...). Not a biological reaction; a high PRR here reflects how reports are coded.
- Outcome field, not a reaction Death is a report outcome, not a reaction term. It is dominated by the underlying illness; see the seriousness profile and the boxed warning instead.
- Not in label — unassessed Not found in the label text, not an artifact pattern. This is a genuine candidate for a formal causality assessment (Bradford Hill / WHO-UMC); it has NOT had one here.
Strongest disproportionality signals
Flagged terms (PRR ≥ 2, χ² ≥ 4, n ≥ 10), ranked by PRR; infinite PRRs (no comparator reports) excluded. The EBGM column is a second, shrinkage-based estimate (MGPS) with its 5th percentile EB05 and the BCPNN IC025; a pair flagged by PRR alone is marked PRR-only and should be read as fragile. The strata column recomputes the PRR on serious reports only (and, for the 300 most-reported drugs, adjusted for age band), and flags pairs whose reports are unusually skewed by sex or come mostly from consumers. Each row also shows the PRR against the other drugs of the same FDA class, which removes most confounding by the condition being treated, and a calibrated p-value: on validation, known non-causes average an ROR of about 2, so significance is judged against that empirical null (✓ = p < 0.05 after calibration). 1,071 further terms are in the interactive explorer. Reaction links open the term's cross-drug page.
| Reaction | Reports | PRR 95% CI · ROR · χ²/p | EBGM EB05 · IC025 | Label screen | Serious-only & strata | Trial cross-check |
|---|---|---|---|---|---|---|
| Drug diversion | 510 | 47.4 43.3–51.9ROR 48.0 · calibrated p 2e-5 ✓ | 43.2 EB05 40.1 · IC025 +5.2 3/3 methods agree | Reporting / coding artifact | serious n=206 · ♀ 30% (drug 52%) · 99% consumer | no trial arm names this drug |
| Multiple drug overdose accidental | 41 | 47.0 34.1–64.8ROR 47.1 · calibrated p 3e-5 ✓ | 42.1 EB05 32.4 · IC025 +4.3 3/3 methods agree | Labeled (related wording) related wording | serious n=41 · ♀ 30% (drug 52%) | no trial arm names this drug |
| Drug withdrawal syndrome neonatal | 1,290 | 45.8 43.3–48.4ROR 47.2 · calibrated p 2e-5 ✓ | 41.8 EB05 40.0 · IC025 +5.3 3/3 methods agree | Labeled (related wording) related wording | serious PRR 27.8 · 100% consumer | no trial arm names this drug |
| Vision abnormal neonatal | 30 | 37.0 25.5–53.6ROR 37.0 · calibrated p 1e-4 ✓ | 33.7 EB05 24.8 · IC025 +3.9 3/3 methods agree | Not in label — unassessed | serious n=30 · 100% consumer | no trial arm names this drug |
| Drug dependence | 10,364 | 33.0 32.4–33.6ROR 43.1 · calibrated p 3e-5 ✓ | 30.9 EB05 30.4 · IC025 +4.9 3/3 methods agree | Reporting / coding artifact | serious PRR 20.9 · 97% consumer | no trial arm names this drug |
| Learning disability | 341 | 32.7 29.3–36.5ROR 33.0 · calibrated p 2e-4 ✓ | 30.6 EB05 28.0 · IC025 +4.7 3/3 methods agree | Not in label — unassessed | serious n=341 · 100% consumer | no trial arm names this drug |
| Drug withdrawal syndrome | 5,578 | 32.5 31.7–33.4ROR 37.2 · calibrated p 8e-5 ✓ | 30.5 EB05 29.9 · IC025 +4.9 3/3 methods agree | Labeled adverse reaction exact term | serious PRR 25.0 · 93% consumer | no trial arm names this drug |
| Neonatal hypoacusis | 14 | 30.7 17.9–52.7ROR 30.7 · calibrated p 6e-4 ✓ | 27.9 EB05 17.6 · IC025 +3.0 3/3 methods agree | Not in label — unassessed | serious n=14 | no trial arm names this drug |
| Toxicity to various agents | 9,510 | 29.1 28.6–29.7ROR 37.1 · calibrated p 8e-5 ✓ | 27.5 EB05 27.0 · IC025 +4.7 3/3 methods agree | Not in label — unassessed | serious PRR 18.7 | no trial arm names this drug |
| Emotional distress | 6,721 | 28.4 27.8–29.0ROR 33.4 · calibrated p 1e-4 ✓ | 26.9 EB05 26.3 · IC025 +4.7 3/3 methods agree | Not in label — unassessed | serious PRR 19.2 · 86% consumer | no trial arm names this drug |
| Overdose | 9,662 | 22.6 22.2–23.0ROR 28.9 · calibrated p 3e-4 ✓ | 21.7 EB05 21.3 · IC025 +4.4 3/3 methods agree | Reporting / coding artifact | serious PRR 18.1 · 96% consumer | no trial arm names this drug |
| Spina bifida | 78 | 18.7 14.9–23.4ROR 18.7 · calibrated p 0.003 ✓ | 17.9 EB05 14.8 · IC025 +3.6 3/3 methods agree | Not in label — unassessed | serious n=78 · 100% consumer | no trial arm names this drug |
| Developmental delay | 320 | 17.7 15.8–19.7ROR 17.8 · calibrated p 0.003 ✓ | 17.1 EB05 15.5 · IC025 +3.9 3/3 methods agree | Not in label — unassessed | serious PRR 11.4 · 100% consumer | no trial arm names this drug |
| Polysubstance abuse | 21 | 16.3 10.6–25.2ROR 16.3 · calibrated p 0.007 ✓ | 15.4 EB05 10.2 · IC025 +2.8 3/3 methods agree | Reporting / coding artifact | serious n=21 | no trial arm names this drug |
| Inadequate analgesia | 278 | 16.2 14.4–18.3ROR 16.3 · calibrated p 0.005 ✓ | 15.7 EB05 14.2 · IC025 +3.7 3/3 methods agree | Reporting / coding artifact | serious n=44 · 86% consumer | no trial arm names this drug |
| Multiple drug overdose | 136 | 13.5 11.3–15.9ROR 13.5 · calibrated p 0.011 ✓ | 13.0 EB05 11.3 · IC025 +3.4 3/3 methods agree | Labeled (related wording) related wording | serious n=136 · ♀ 32% (drug 52%) · 92% clinician | no trial arm names this drug |
| Coronary artery atherosclerosis | 11 | 12.7 7.0–23.1ROR 12.7 · calibrated p 0.023 ✓ | 10.6 EB05 5.6 · IC025 +2.0 3/3 methods agree | Not in label — unassessed | serious n=11 | no trial arm names this drug |
| Victim of homicide | 13 | 11.4 6.6–19.8ROR 11.4 · calibrated p 0.030 ✓ | 9.6 EB05 5.4 · IC025 +2.1 3/3 methods agree | Not in label — unassessed | serious n=13 | no trial arm names this drug |
| Gallbladder cholesterolosis | 10 | 10.7 5.7–20.1ROR 10.7 · calibrated p 0.040 ✓ | 8.4 EB05 4.5 · IC025 +1.8 3/3 methods agree | Not in label — unassessed | serious n=10 | no trial arm names this drug |
| Drug abuse | 1,776 | 10.5 10.0–11.0ROR 10.9 · calibrated p 0.024 ✓ | 10.3 EB05 9.9 · IC025 +3.3 3/3 methods agree | Reporting / coding artifact | serious PRR 6.9 · 84% consumer | no trial arm names this drug |
| Accidental overdose | 754 | 10.2 9.5–11.0ROR 10.4 · calibrated p 0.029 ✓ | 10.0 EB05 9.4 · IC025 +3.2 3/3 methods agree | Reporting / coding artifact | serious PRR 10.9 · ♀ 25% (drug 52%) · 84% consumer | no trial arm names this drug |
| Self esteem decreased | 46 | 9.3 7.0–12.5ROR 9.3 · calibrated p 0.045 ✓ | 8.7 EB05 6.7 · IC025 +2.6 3/3 methods agree | Not in label — unassessed | serious n=46 | no trial arm names this drug |
| Homicide | 32 | 8.7 6.2–12.4ROR 8.7 · calibrated p 0.057 | 8.0 EB05 5.8 · IC025 +2.4 3/3 methods agree | Not in label — unassessed | serious n=21 · ♀ 23% (drug 52%) · 100% consumer | no trial arm names this drug |
| Multiple congenital abnormalities | 25 | 8.5 5.7–12.6ROR 8.5 · calibrated p 0.065 | 7.5 EB05 5.3 · IC025 +2.2 3/3 methods agree | Labeled (related wording) related wording | serious n=25 · 100% consumer | no trial arm names this drug |
| Gun shot wound | 31 | 8.0 5.6–11.5ROR 8.0 · calibrated p 0.074 | 7.3 EB05 5.3 · IC025 +2.2 3/3 methods agree | Not in label — unassessed | serious n=31 · ♀ 0% (drug 52%) | no trial arm names this drug |
| Drug effect increased | 52 | 8.0 6.1–10.5ROR 8.0 · calibrated p 0.072 | 7.5 EB05 5.9 · IC025 +2.4 3/3 methods agree | Reporting / coding artifact | 87% consumer | no trial arm names this drug |
| Death | 11,932 | 6.8 6.7–6.9ROR 9.0 · calibrated p 0.045 ✓ | 6.7 EB05 6.6 · IC025 +2.7 3/3 methods agree | Outcome field, not a reaction boxed warning mentions mortality | serious PRR 4.5 · 94% consumer | no trial arm names this drug |
| Hepatitis c | 169 | 6.8 5.8–7.9ROR 6.8 · calibrated p 0.108 | 6.6 EB05 5.8 · IC025 +2.5 3/3 methods agree | Not in label — unassessed | serious PRR 4.7 · 81% consumer | no trial arm names this drug |
| Colonic polyp | 22 | 6.4 4.2–9.8ROR 6.4 · calibrated p 0.140 | 5.7 EB05 3.9 · IC025 +1.8 3/3 methods agree | Not in label — unassessed | serious n=21 | no trial arm names this drug |
| Cholecystitis chronic | 89 | 6.4 5.2–7.9ROR 6.5 · calibrated p 0.128 | 6.2 EB05 5.2 · IC025 +2.3 3/3 methods agree | Not in label — unassessed | serious PRR 4.2 · ♀ 100% (drug 52%) | no trial arm names this drug |
| Shoulder pain | 13 | 6.4 3.7–11.1ROR 6.4 · calibrated p 0.152 | 5.3 EB05 3.3 · IC025 +1.5 3/3 methods agree | Not in label — unassessed | serious n=11 | no trial arm names this drug |
| Congenital anomaly | 97 | 6.1 5.0–7.5ROR 6.1 · calibrated p 0.147 | 5.9 EB05 5.0 · IC025 +2.2 3/3 methods agree | Labeled (related wording) related wording | serious PRR 4.0 · 100% consumer | no trial arm names this drug |
| Substance use disorder | 38 | 6.1 4.4–8.3ROR 6.1 · calibrated p 0.156 | 5.6 EB05 4.3 · IC025 +2.0 3/3 methods agree | Labeled adverse reaction exact term | serious n=38 · 100% consumer | no trial arm names this drug |
| Pain | 7,320 | 5.8 5.7–6.0ROR 6.8 · calibrated p 0.106 | 5.8 EB05 5.7 · IC025 +2.5 3/3 methods agree | Likely indication confounding term in indications; also in warnings | serious PRR 5.6 · 75% consumer | no trial arm names this drug |
| Breakthrough pain | 27 | 5.7 3.9–8.3ROR 5.7 · calibrated p 0.187 | 5.2 EB05 3.7 · IC025 +1.7 3/3 methods agree | Not in label — unassessed | serious n=8 · 85% consumer | no trial arm names this drug |
| Imprisonment | 20 | 5.5 3.5–8.5ROR 5.5 · calibrated p 0.210 | 4.9 EB05 3.3 · IC025 +1.5 3/3 methods agree | Not in label — unassessed | serious n=20 | no trial arm names this drug |
| Biliary dyskinesia | 19 | 5.4 3.5–8.5ROR 5.4 · calibrated p 0.214 | 4.8 EB05 3.3 · IC025 +1.5 3/3 methods agree | Not in label — unassessed | serious n=19 | no trial arm names this drug |
| Disability | 215 | 5.3 4.7–6.1ROR 5.3 · calibrated p 0.202 | 5.2 EB05 4.7 · IC025 +2.2 3/3 methods agree | Not in label — unassessed | serious PRR 3.6 · 94% consumer | no trial arm names this drug |
| Impaired driving ability | 118 | 5.1 4.2–6.1ROR 5.1 · calibrated p 0.229 | 4.9 EB05 4.2 · IC025 +2.0 3/3 methods agree | Labeled (related wording) related wording | serious PRR 4.3 · 100% consumer | no trial arm names this drug |
| Meniscus lesion | 14 | 4.9 2.9–8.2ROR 4.9 · calibrated p 0.281 | 4.2 EB05 2.7 · IC025 +1.2 3/3 methods agree | Not in label — unassessed | serious n=13 | no trial arm names this drug |
Trial evidence (ClinicalTrials.gov)
Most frequently reported reactions
By raw co-report count, regardless of disproportionality. Common terms here are often the illness itself or generic outcomes.
| Reaction | Reports | PRR 95% CI · ROR · χ²/p | EBGM EB05 · IC025 | Label screen | Serious-only & strata | Trial cross-check |
|---|---|---|---|---|---|---|
| Death | 11,932 | 6.8 6.7–6.9ROR 9.0 · calibrated p 0.045 ✓ | 6.7 EB05 6.6 · IC025 +2.7 3/3 methods agree | Outcome field, not a reaction boxed warning mentions mortality | serious PRR 4.5 · 94% consumer | no trial arm names this drug |
| Drug dependence | 10,364 | 33.0 32.4–33.6ROR 43.1 · calibrated p 3e-5 ✓ | 30.9 EB05 30.4 · IC025 +4.9 3/3 methods agree | Reporting / coding artifact | serious PRR 20.9 · 97% consumer | no trial arm names this drug |
| Overdose | 9,662 | 22.6 22.2–23.0ROR 28.9 · calibrated p 3e-4 ✓ | 21.7 EB05 21.3 · IC025 +4.4 3/3 methods agree | Reporting / coding artifact | serious PRR 18.1 · 96% consumer | no trial arm names this drug |
| Toxicity to various agents | 9,510 | 29.1 28.6–29.7ROR 37.1 · calibrated p 8e-5 ✓ | 27.5 EB05 27.0 · IC025 +4.7 3/3 methods agree | Not in label — unassessed | serious PRR 18.7 | no trial arm names this drug |
| Pain | 7,320 | 5.8 5.7–6.0ROR 6.8 · calibrated p 0.106 | 5.8 EB05 5.7 · IC025 +2.5 3/3 methods agree | Likely indication confounding term in indications; also in warnings | serious PRR 5.6 · 75% consumer | no trial arm names this drug |
| Emotional distress | 6,721 | 28.4 27.8–29.0ROR 33.4 · calibrated p 1e-4 ✓ | 26.9 EB05 26.3 · IC025 +4.7 3/3 methods agree | Not in label — unassessed | serious PRR 19.2 · 86% consumer | no trial arm names this drug |
| Drug withdrawal syndrome | 5,578 | 32.5 31.7–33.4ROR 37.2 · calibrated p 8e-5 ✓ | 30.5 EB05 29.9 · IC025 +4.9 3/3 methods agree | Labeled adverse reaction exact term | serious PRR 25.0 · 93% consumer | no trial arm names this drug |
| Drug abuse | 1,776 | 10.5 10.0–11.0ROR 10.9 · calibrated p 0.024 ✓ | 10.3 EB05 9.9 · IC025 +3.3 3/3 methods agree | Reporting / coding artifact | serious PRR 6.9 · 84% consumer | no trial arm names this drug |
| Drug withdrawal syndrome neonatal | 1,290 | 45.8 43.3–48.4ROR 47.2 · calibrated p 2e-5 ✓ | 41.8 EB05 40.0 · IC025 +5.3 3/3 methods agree | Labeled (related wording) related wording | serious PRR 27.8 · 100% consumer | no trial arm names this drug |
| Nausea | 1,062 | 0.7 0.6–0.7ROR 0.6 · calibrated p 0.104 | 0.7 EB05 0.6 · IC025 -0.7 PRR-only: not supported by EBGM or IC | Labeled adverse reaction exact term | serious PRR 0.4 · 73% consumer | no trial arm names this drug |
| Anxiety | 974 | 1.7 1.6–1.8ROR 1.7 · calibrated p 0.754 | 1.7 EB05 1.6 · IC025 +0.6 | Labeled adverse reaction exact term | serious PRR 1.2 | no trial arm names this drug |
| Drug ineffective (drug did not work) | 913 | 0.3 0.3–0.4ROR 0.3 · calibrated p 0.010 ✓ | 0.3 EB05 0.3 · IC025 -1.7 PRR-only: not supported by EBGM or IC | Reporting / coding artifact | serious PRR 0.2 · 82% consumer | no trial arm names this drug |
| Accidental overdose | 754 | 10.2 9.5–11.0ROR 10.4 · calibrated p 0.029 ✓ | 10.0 EB05 9.4 · IC025 +3.2 3/3 methods agree | Reporting / coding artifact | serious PRR 10.9 · ♀ 25% (drug 52%) · 84% consumer | no trial arm names this drug |
| Depression | 750 | 1.6 1.5–1.7ROR 1.6 · calibrated p 0.710 | 1.6 EB05 1.5 · IC025 +0.6 | Labeled — boxed warning exact term | serious PRR 1.4 | no trial arm names this drug |
| Headache | 602 | 0.5 0.4–0.5ROR 0.5 · calibrated p 0.037 ✓ | 0.5 EB05 0.4 · IC025 -1.2 PRR-only: not supported by EBGM or IC | Labeled adverse reaction exact term | serious PRR 0.3 · 74% consumer | no trial arm names this drug |
Unlabeled candidate signals
These flagged terms were not found in the FDA label text and do not match an artifact pattern. They are the pairs that would merit a structured assessment (temporality, dose-response, biological plausibility, consistency across databases, trial or cohort evidence). The screen has not done that; string-matching misses label wording, and a strong PRR can still be stimulated reporting, co-medication, or the disease itself.
- Vision abnormal neonatal — n=30, PRR 37.0
- Learning disability — n=341, PRR 32.7
- Toxicity to various agents — n=9,510, PRR 29.1
- Emotional distress — n=6,721, PRR 28.4
- Spina bifida — n=78, PRR 18.7
- Developmental delay — n=320, PRR 17.7
- Self esteem decreased — n=46, PRR 9.3
- Homicide — n=32, PRR 8.7
- Gun shot wound — n=31, PRR 8.0
- Hepatitis c — n=169, PRR 6.8
✓ A hand-written Bradford Hill causality assessment exists for this drug: Hydrocodone Bitartrate And Acetaminophen ↔ Drug Dependence.
Want to assess one of these properly? The runbook describes the Bradford Hill / trial-evidence workflow used on the assessment page, and handoff_top1000_signals.csv lists the strongest unassessed pairs across all drugs.
Common questions
What are the most reported side effects of Hydrocodone Bitartrate?
In FDA FAERS, the most frequently co-reported reaction terms for Hydrocodone Bitartrate are toxicity to various agents, pain, emotional distress, drug withdrawal syndrome, drug withdrawal syndrome neonatal, nausea. These are report counts, not rates: FAERS has no denominator, reporting is voluntary and uneven, and a term can be reported because of the illness being treated rather than the drug.
Does Hydrocodone Bitartrate have an FDA boxed warning?
Yes. The current FDA label carries a boxed warning: SERIOUS AND LIFE-THREATENING RISKS FROM USE OF HYDROCODONE BITARTRATE EXTENDED-RELEASE TABLETS Addiction, Abuse, and Misuse Because the use of hydrocodone bitartrate extended-release tablets exposes patients and othe.
Do FAERS signals prove that Hydrocodone Bitartrate causes these side effects?
No. A disproportionality signal (PRR, ROR) means a reaction is reported more often with this drug than with others in the database. That can reflect a real effect, but also the disease being treated, stimulated reporting after news or litigation, co-medications, or how reports are coded. Causality needs temporality, dose-response, biological plausibility, consistency across data sources and, ideally, trial or cohort evidence. This page screens each term against the FDA label and ClinicalTrials.gov results; it does not establish causation.
Sources & methods
- FDA label via openFDA (set ID f7b55d14-0980-b680-8ceb-7489ff65455e, effective 20251007; matched on
openfda.generic_name.exact:"HYDROCODONE BITARTRATE") - Bayesian shrinkage measures computed offline over all 1,317,300 cached pairs: BCPNN information component (IC, with Norén closed-form IC025) and MGPS empirical-Bayes geometric mean (EBGM, EB05) with a two-component gamma prior fitted by maximum marginal likelihood (α₁=0.57, β₁=0.02, α₂=1.42, β₂=0.70, w=0.17); unstratified
- FAERS pair statistics from the OpenPV build of 2026-09-14 (openFDA
count=aggregation, fieldpatient.drug.openfda.generic_name.exact, 1,111 reaction terms, min 3 co-reports); PRR/ROR with 95% CI, chi-square with Yates correction - Serious-only and stratified counts (serious:1, patient.patientsex, primarysource.qualification) from openFDA count queries; serious-only PRR uses the drug serious report total and the term global serious total (N_serious=11,882,979); strata shown only when n ≥ 20
- Seriousness and sex counts from openFDA
count=serious,patient.patientsex,seriousnessdeath - ClinicalTrials.gov API v2 (query
HYDROCODONE BITARTRATE, results-bearing studies sorted by enrollment)
Page generated 2026-10-14. Label and PubChem text are retrieved automatically and may lag the current label; always check the current prescribing information. OpenPV is a beta research tool of the Open Source Medicine Foundation.