Dosage should be adjusted according to the severity of the pain and the response of the patient. However, it should be kept in mind that tolerance to hydrocodone can develop with continued use and that the incidence of untoward effects is dose related.
The usual adult dosage is one tablespoonful (15 mL) every four to six hours as needed for pain. The total daily dosage should not exceed 6 tablespoonfuls.
The usual dosages for children are given by the table below, and are to be given every 4 to 6 hours as needed for pain. These dosages correspond to an average individual dose of 0.20 mL/kg of hydrocodone bitartrate and acetaminophen oral solution (providing 0.135 mg/kg of hydrocodone bitartrate and 4.38 mg/kg of acetaminophen). Dosing should be based on weight whenever possible.
BODY WEIGHT
APPROXIMATE AGE
DOSE
every 4 to 6 hours
MAXIMUM TOTAL DAILY DOSE
(6 doses per day)
12 to 15 kg
(27 to 34 lbs)
2 to 3 years
2.8 mL (approx.
½ teaspoonful)
16.8 mL (approx.
3¼ teaspoonfuls)
16 to 22 kg
(35 to 50 lbs)
4 to 6 years
3.75 mL (approx.
¾ teaspoonful)
22.5 mL (approx.
4½ teaspoonfuls)
23 to 31 kg
(51 to 69 lbs)
7 to 9 years
5.6 mL (approx.
1 teaspoonful)
33.6 mL (approx.
6½ teaspoonfuls)
32 to 45 kg
(70 to 100 lbs)
10 to 13 years
7.5 mL (approx.
1½ teaspoonfuls)
45 mL (approx.
9 teaspoonfuls)
46 kg and up
(101 lbs and up)
14 years to adult
11.25 mL (approx.
2¼ teaspoonfuls)
67.5 mL (approx.
13½ teaspoonfuls)
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Adult
15 mL
(1 Tablespoonful)
90 mL
(6 Tablespoonfuls)
The total daily dosage for children should not exceed 6 doses per day. It is of utmost importance that the dose of hydrocodone bitartrate and acetaminophen oral solution be administered accurately. A household teaspoon or tablespoon is not an adequate measuring device, especially when one-half or three-fourths of a teaspoonful is to be measured. Given the inexactitude of the household spoon measure and the possibility of using a tablespoon instead of a teaspoon, which could lead to overdosage, it is strongly recommended that caregivers obtain and use a calibrated measuring device. Health care providers should recommend a dropper that can measure and deliver the prescribed dose accurately, and instruct caregivers to use extreme caution in measuring the dosage.