Recent Newspaper & Online Columns by Kate Scannell MD

Zohydro: The pained debate over approval of a new painkiller

March 23, 2014

Tags: Zohydro, hydrocodone, palliative care, pain treatment, opiate abuse, debate, Amy Haddad, Robert V. Brody

By Dr. Kate Scannell, Syndicated columnist
First Published in Print: 03/23/2014

For a powerful new pill that's supposed to ease pain, Zohydro is causing major headaches for an increasingly vocal group of critics.

Zohydro is a potent extended-release formulation of hydrocodone, an opiate painkiller that's been in use for decades and the primary analgesic ingredient in drugs like Vicodin. However, unlike other formulations of hydrocodone, Zohydro is uniquely free of added medications like aspirin (as in Azdone and Lortab ASA), ibuprofen (Vicoprofen), or acetaminophen (Vicodin and Norco). That means that Zohydro can be prescribed as stand-alone hydrocodone -- free from worry about aspirin allergy and side effects, ibuprofen kidney and GI toxicities or acetaminophen overdose and liver damage.

This improved patient safety profile is what makes Zohydro an appealing alternative to traditional hydrocodone-combination drugs. Additionally, because Zohydro is engineered in an extended-release form, it need be given only twice a day -- a convenience for patients requiring chronic opiate therapy.

And yet these same selling points are cited by critics in advancing arguments against Zohydro's release. That's because with Zohydro, if you're not forced to take a dose of acetaminophen or aspirin every time you swallow a hydrocodone tablet, the amount of hydrocodone you can take is no longer limited by side effects from acetaminophen or aspirin. Critics insist that will encourage excess intake of hydrocodone, worsen the epidemic of opiate-drug abuse, and lead to higher death rates from overdose. They've petitioned the FDA to withdraw its approval of Zohydro, and bills have been filed in the House and Senate to remove Zohydro from the market. (more…)

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