In patients with chronic obstructive pulmonary disease (COPD), cor pulmonale, decreased respiratory reserve, hypoxia, hypercapnia, respiratory insufficiency, upper airway obstruction, or preexisting respiratory depression, it is recommended that non-opioid analgesics be considered as alternatives to hydrocodone, as even usual therapeutic doses of hydrocodone may decrease respiratory drive and cause apnea in these patient populations. Monitor patients closely for signs or symptoms of respiratory depression or sedation. Reserve concomitant prescribing for use in patients for whom alternative treatment options are inadequate if concurrent use is necessary, use the lowest effective doses and minimum treatment durations needed to achieve the desired clinical effect. Additionally, avoid coadministration with other CNS depressants when possible, as this significantly increases the risk for profound sedation, respiratory depression, coma, and death. Receipt of moderate hydrocodone doses in these patients may significantly decrease pulmonary ventilation. Asthma, chronic obstructive pulmonary disease (COPD), coadministration with other CNS depressants, coma, cor pulmonale, hypoxemia, obesity, pulmonary disease, respiratory depression, respiratory insufficiency, scoliosis, sleep apnea, status asthmaticusДЄcetaminophen hydrocodone is contraindicated for use in patients with significant respiratory depression and in patients with acute or severe asthma (e.g., status asthmaticus) in unmonitored care settings or in the absence of resuscitative equipment.

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