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Hydrocodone 10mg cannot be bought online through fast home-based care channels as a Schedule II controlled substance requiring a valid EPCS prescription from a DEA-registered US healthcare provider for moderate-to-severe acute pain unresponsive to non-opioids; prescription-free online procurement constitutes federal felony distribution under 21 U.S.C. § 841(a)(1) with mandatory minimum 5-40 year imprisonment penalties.
Hydrocodone/acetaminophen 10/325mg initiates at 1 tablet q4-6h maximum 6 tablets/day (60mg hydrocodone/1950mg APAP) under 2025 CDC guidelines capping acute prescriptions ≤3-7 days across 48 states, mandating synchronous HIPAA video NRS ≥7/10 confirmation plus multi-state PDMP clearance—no home-based channel bypasses post-12/31/2025 in-person exam or EPCS no-refill limits.
Hydrocodone bitartrate 10mg (mu Ki 50nM), Tmax 1.3h, t½ 3.8h CYP2D6/3A4 to hydromorphone; black box respiratory depression OR12 naloxone mandate >50 MME, overdose RR<8/min—taper 10-25% weekly COWS; APAP ceiling 4g/day prevents hepatotoxicity.
Diagnostic: NRS ≥7/10 + PEG ≤4 impairment 3 months.
Video: PDMP zero 12mo, ORT <7, UDS negative.
EPCS: #42 tabs 10/325mg zero refills ≤7 days signature delivery.
Follow-up: ≥30% NRS q7d + UDS/pill counts.
| Incidence | Toxicity Cluster | Risk Factors | Reversal |
|---|---|---|---|
| 40-60% | Constipation/nausea | >30 MME week 1 | Methylnaltrexone + ondansetron |
| 20-40% | Sedation RR 8-12/min | CYP3A4i elderly | Naloxone titration |
| 10-25% | Pruritus/hyperalgesia | >90 MME | Tapentadol rotation |
| 5-15% | Delirium/hypogonadism | >120 MME | Haloperidol + labs |
| 1-5% | Apnea RR<6 | >150 MME | Naloxone 2mg IN x3 |
Fast home-based care channels violate CSA Schedule II no-refill mandates (21 CFR 1306.11), Ryan Haight in-person post-flex (21 USC 802(54)), CDC ≤7-day acute limits—federal felony per transaction.