Author: Lisa Conatser, LPC

Yes, hydrocodone can make you itch. It is just one of many side effects of taking hydrocodone. While this itching can be irritating, it isn’t typically dangerous or worrisome, except in the case of hives caused by an allergic reaction. If you are taking hydrocodone for pain relief and are experiencing itching, there are some things you can try to gain some relief.

Does Hydrocodone Make You Itch?

One of the most common side effects reported from patients using opioid medications like hydrocodone is itching.
Hydrocodone is a prescription drug in the opioid family. It is prescribed to relieve severe, around-the-clock pain that cannot be managed with other non-opioid medications or treatments.¹

If your pain can be managed by a medicine that is taken on an “as-needed” basis, physicians will most likely recommend that treatment before prescribing hydrocodone. This is partly because hydrocodone is in a class of medications called opioid (narcotic) analgesics, which work by changing the way the brain and nervous system respond to pain.¹

Why Does Hydrocodone Make You Itch?

Many experts have assumed for a while that the itching associated with hydrocodone was just a common side effect of opioids and, therefore, unavoidable for anyone taking the drug. New research, however, has recently offered more insights into what may actually be causing you to itch when you take hydrocodone.

Your brain has four main types of receptors that respond to opioids. A recent study found that one of these receptors has a protein on the surface of the mast cells that can trigger immune system responses in your body that leads to itching.² Mast cells are part of the immune system, and they respond to certain signals from opioids. The response causes a release of inflammatory factors like histamine.² This is similar to the response your body has to allergies—which can also lead to itchiness. The studies do show that the itching response to hydrocodone is not from an actual allergy to the medicine even though the response to the medicine mimics allergy responses.²

How to Stop Hydrocodone Itch

Several studies have been conducted to assess the effectiveness of varying treatments for itching that coincides with hydrocodone use. These studies looked at the effects of diphenhydramine, naloxone, Propofol, and nalbuphine. The findings across these studies indicate that nalbuphine is superior in treating opioid-induced itching when compared with the other treatments listed.³ Therefore, nalbuphine should be used as a first-line treatment of opioid-induced itching.³

Nalbuphine is only available as an injectable drug. If you are wanting to treat a minor itch at home without a prescription or hospital intervention, you can also try one of these options commonly used to ease itching caused by various sources:⁴

• Applying cold compresses
• Using moisturizing lotions
• Taking lukewarm or oatmeal baths
• Using over-the-counter hydrocortisone cream
• Avoiding scratching, wearing irritating fabrics, and exposure to high heat and humidity

Other Side Effects of Hydrocodone Use

Hydrocodone has several other unwanted side effects aside from just the itching. Some of those side effects include:¹

• Stomach and back pain
• Dry mouth
• Sleep difficulties
• Fatigue
• Headache
• Muscle cramps
• Painful urination
• Ringing in the ears
• Foot, leg, or ankle swelling
• Tremors or shaking

Some of the side effects of hydrocodone can be serious. If you experience any of these symptoms, call your doctor immediately or get emergency medical treatment:¹

• Chest pain
• Rapid heart rate
• Problems breathing or swallowing
• Fever
• Hallucinations or agitation
• Confusion
• Loss of coordination
• Nausea, vomiting
• Swelling of your eyes, face, lips, tongue, or throat
• Hives

Risks of Hydrocodone Misuse

As with all opioids, you can build up a tolerance to hydrocodone, leading you to take larger doses to experience the same desired effects. This can lead you to become dependent on the substance and experience withdrawal symptoms when you suddenly quit taking it.⁵

Hydrocodone is a DEA Schedule II controlled substance and therefore has a potential for misuse and addiction.⁵ If you find yourself misusing hydrocodone, it could lead to overdose. Signs of a hydrocodone overdose include:⁶

• Blue-ish lips and fingernails
• Pale, clammy face
• Slowed or stopped breathing
• Slow or stopped heartbeat
• Limp body
• Vomiting or gurgling noises

If you suspect your or someone else has overdosed on hydrocodone or any other opioid, call 911 immediately. Stay by the person’s side and administer naloxone if it is available.

Due to the risks of becoming dependent on hydrocodone, you should take this opioid exactly as directed by your doctor and avoid making any changes to the frequency or dosage on your own. Discuss your pain treatment goals with your healthcare provider, and they will decide how long you need this treatment and if there are other options besides hydrocodone.¹

If you think you or someone you love is addicted to hydrocodone, please call 800-934-1582(Who Answers?) to learn more about recovery options.

Resources

1. National Library of Medicine. (2021.) Hydrocodone: Drug Information.
2. Lansu, K., Karpiak, J., Liu, J., Huang, X., McCorvy, J.D., Kroeze, W.K., Che, T., Nagase, H. Carroll, F.I., Jin, J., Scoichet, B.K. Roth, B.L. (2017). In silico design of novel probes for the atypical opioid receptor MRGPRX2. Nature Chemical Biology, 13(5), 529-536.
3. National Library of Medicine. (2016). Nalbuphine for treatment of opioid-induced pruritus: a systematic review of literature.
4. National Institute of Health. Itching.
5. National Center for Biotechnology Information. (2021). Hydrocodone and acetaminophen.
6. S. National Library of Medicine. (2021). Opioid Overdose.