Taking Hycodan With Estradiol And Spironolactone

In our latest question and answer, the pharmacist discusses whether or not there is an interaction between Hycodan, estradiol and spironolactone.

Mar 15, 2018

Ripley asked

I am transgender MTF and take 2mg estradiol twice a day And 100 mg spironolatane twice a day. I have a cold and the doc prescribed me hycodan. Is this safe to take with my current meds?

Answer

Hycodan is a combination prescription medication that contains:

  • Hydrocodone
  • Homatropine

Hydrocodone is a opioid agonist that is used in this medication for its antitussive (i.e. cough suppressant) effects. Homatropine, an anticholinergic agent is included in Hycodan purely to discourage abuse and overdosing. When taken as directed, the amount of homatropine in Hycodan is considered sub-therapeutic, and does not have any appreciable effects. However, if taken in large quantities, unpleasant side effects may occur such as dry mouth, poor coordination, fast heart rate and confusion.

Hycodan has a mild interaction with spironolactone. The two are generally considered to be safe to take together but the hydrocodone in Hycodan may potentiate symptoms of orthostatic hypotension, so care must be taken when going from a laying down position to a standing position quickly.

Hycodan does not interact with estradiol. It should be noted however that all opioid agonists, including hydrocodone, are associated with wide ranging effects on the endocrine system, although effects are thought to be minimal for most people. Various studies have shown that long term use of hydrocodone could potentially inhibit the secretion of the following hormones:

  • Adrenocorticotropic hormone (ACTH)
  • Cortisol
  • Luteinizing hormone (LH)

Alterations of these hormones could theoretically cause the following side effects:

  • Altered hormone levels
  • Libido decrease
  • Sexual dysfunction

As mentioned above, the effect of opioids on the endocrine system is thought to be minimal, but are good to be aware of if taking hormone therapy.

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