- Side Effects
- Drug Interactions
- What Else I Should Know
Brand Name: Vicodin, Vicodin ES, Vicodin HP, Lortab, Lorcet, Lorcet Plus, Norco, Zydone, Hycet, Maxidone, Stagesic, Verdrocet, Xodol, Zamicet, Zolvit and Anexsia (discontinued brand)
Drug Class: Analgesics, Opioid Combos
What is hydrocodone/acetaminophen, and what is it used for?
Acetaminophen is a non-narcotic analgesic (pain reliever) and antipyretic (fever reducer). Acetaminophen works by elevating the threshold to pain, that is, in order for pain to be felt, greater stimulation of the nerves responsible for the sensation of pain is necessary. It reduces fever through its action on the temperature-regulating center of the brain.
- Frequently, hydrocodone and acetaminophen are combined to achieve pain relief, as in Vicodin and Lortab. The FDA approved Vicodin in January 1983.
- Get emergency help right away if you take too much hydrocodone/acetaminophen (overdose). When you first start taking hydrocodone/acetaminophen, when your dose is changed, or if you take too much (overdose), serious or life-threatening breathing problems that can lead to death may occur.
- Taking hydrocodone/acetaminophen with other opioid medicines, benzodiazepines, alcohol, or other central nervous system depressants (including street drugs) can cause severe drowsiness, decreased awareness, breathing problems, coma, and death.
- Never give anyone else your hydrocodone/acetaminophen. They could die from taking it. Store hydrocodone/acetaminophen away from children and in a safe place to prevent stealing or abuse. Selling or giving away hydrocodone/acetaminophen is against the law.
Do not take hydrocodone/acetaminophen if you have:
What are the side effects of hydrocodone/acetaminophen?
Common side effects of hydrocodone/acetaminophen include:
Serious side effects of hydrocodone/acetaminophen include:
- difficulty breathing,
- swelling of the face, lips, tongue, or throat,
- breathing that slows with a long pause,
- blue colored lips,
- difficult to wake up,
- skin redness or a rash that spreads and causes blistering and peeling,
- noisy breathing,
- shallow breathing that stops,
- upper stomach pain,
- loss of appetite,
- dark urine,
- clay-colored stools,
- yellowing of the skin or eyes,
- loss of appetite,
- worsening tiredness,
- fast heart rate,
- muscle stiffness,
- loss of coordination,
- diarrhea, and
- spasm of the ureter, which can lead to difficulty in urinating.
Hydrocodone can impair thinking and the physical abilities required for driving or operating machinery. Hydrocodone can depress breathing and should be used with caution in elderly, debilitated patients and in patients with serious lung disease.
Hydrocodone may be habit-forming. Mental and physical dependence can occur but are unlikely when used for short-term pain relief.
This is not a complete list of all side effects or adverse reactions that may occur from the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may also report side effects or health problems to the FDA at 1-800-FDA-1088.
What are the dosages for hydrocodone/acetaminophen?
- The usual dose for adults is 1 to 2 tablets or capsules (hydrocodone 2.5 to 10 mg; acetaminophen 300 to 750 mg) every 4 to 6 hours, or
- 15 mL of liquid every 4 to 6 hours as needed.
- Acute overdose with hydrocodone bitartrate and acetaminophen tablets can be manifested by respiratory depression, somnolence progressing to stupor or coma, skeletal muscle flaccidity, cold and clammy skin, constricted pupils, and, in some cases, pulmonary edema, bradycardia, hypotension, partial or complete airway obstruction, atypical snoring, and death. Marked mydriasis rather than miosis may be seen with hypoxia in overdose situations.
- Dose-dependent, potentially fatal hepatic necrosis is the most serious adverse effect of acetaminophen overdose. Renal tubular necrosis, hypoglycemic coma, and coagulation defects may also occur.
- Early symptoms following a potentially hepatotoxic overdose may include nausea, vomiting, diaphoresis, and general malaise. Clinical and laboratory evidence of hepatic toxicity may not be apparent until 48 to 72 hours post-ingestion.
What drugs interact with hydrocodone/acetaminophen?
Inform your doctor of all medications you are currently taking, who can advise you on any possible drug interactions. Never begin taking, suddenly discontinue, or change the dosage of any medication without your doctor's recommendation.
- Patients receiving other narcotics, antihistamines, antipsychotics, antianxiety agents, or other CNS depressants (including alcohol) concomitantly with NORCO may exhibit an additive CNS depression. When combined therapy is contemplated, the dose of one or both agents should be reduced.
- The use of MAO inhibitors or tricyclic antidepressants with hydrocodone preparations may increase the effect of either the antidepressant or hydrocodone.
- Acetaminophen may produce false-positive test results for urinary 5-hydroxyindoleacetic acid.
Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider, or pharmacist first. Here are the drug interactions or adverse effects.
- Hydrocodone/Acetaminophen has severe interactions with the following other drugs:
- Hydrocodone/Acetaminophen has serious interactions with at least 94 other drugs.
- Hydrocodone/Acetaminophen has moderate interactions with at least 156 other drugs.
- Hydrocodone/Acetaminophen has minor interactions with at least 51 other drugs.
The drug interactions listed above are not all of the possible interactions or adverse effects. For more information on drug interactions, visit the RxList Drug Interaction Checker.
It is important to always tell your doctor, pharmacist, or health care provider of all prescription and over-the-counter medications you use, as well as the dosage for each, and keep a list of the information. Check with your doctor or health care provider if you have any questions about the medication.
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What else should I know about hydrocodone/acetaminophen?
What preparations of hydrocodone/acetaminophen are available?
Tablets, capsules, and liquid. Among the many brands, the dose of acetaminophen ranges between 300 and 750 mg, and the dose of hydrocodone ranges between 2.5 and 10 mg.
Vicodin was recently reformulated, and the acetaminophen component was reduced to 300 mg in all preparations, however, generic formulations may still contain 500 and 750 mg of acetaminophen.
How should I keep hydrocodone/acetaminophen stored?
Hydrocodone/acetaminophen should be stored at room temperature, between 15 C to 30 C (59 F to 86 F).
Hydrocodone/acetaminophen is a narcotic pain reliever and cough suppressant. Hydrocodone/acetaminophen is prescribed for moderate to moderately severe pain. Side effects include lightheadedness, dizziness, sedation, nausea, and vomiting. There is a risk of acute overdose with hydrocodone bitartrate and acetaminophen tablets.
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Related Disease Conditions
Liver disease can be cause by a variety of things including infection (hepatitis), diseases, for example, gallstones, high cholesterol or triglycerides, blood flow obstruction to the liver, and toxins (medications and chemicals). Symptoms of liver disease depends upon the cause and may include nausea, vomiting, upper right abdominal pain, and jaundice. Treatment depends upon the cause of the liver disease.
Acute injuries, medical conditions, and chronic use conditions are causes of knee pain. Symptoms and signs that accompany knee pain include redness, swelling, difficulty walking, and locking of the knee. To diagnose knee pain, a physician will perform a physical exam and also may order X-rays, arthrocentesis, blood tests, or a CT scan or MRI. Treatment of knee pain depends upon the cause of the pain.
Lower Back Pain (Lumbar Spine Pain)
There are many causes of back pain. Pain in the low back can relate to the bony lumbar spine, discs between the vertebrae, ligaments around the spine and discs, spinal cord and nerves, muscles of the low back, internal organs of the pelvis, and abdomen, and the skin covering the lumbar area.
Tylenol Liver Damage
Tylenol liver damage (acetaminophen) can occur from accidentally ingesting too much acetaminophen, or intentionally. Signs and symptoms of acetaminophen-induced liver damage may include: nauseau, vomiting, kidney failure, bleeding disorders, coma, and death. Acetaminophen is a drug contained in over 200 OTC and prescription medications from NyQuil to Vicodin. Avoiding unintentional overdoses include reading medication labels, write down the dosages of medications you are taking, do not drink excessive alcohol while taking acetaminophen. In severe cases, a liver transplant may be necessary.
Tailbone Pain (Coccydynia)
Coccydynia is an inflammation of the bony area (tailbone or coccyx) located between the buttocks. Coccydynia is associated with pain and tenderness at the tip of the tailbone between the buttocks. Pain is often worsened by sitting. There are many causes of tailbone pain that can mimic coccydynia including fracture, pilonidal cysts, infection, and sciatica. Treatment methods include medication and rest.
Restless Leg Syndrome
Restless leg syndrome (RLS) is a common cause for painful legs that typically eases with motion, and becomes worse and more noticeable at rest. This characteristic nighttime worsening can frequently lead to insomnia. Treatment of the symptoms of restless leg syndrome is generally with medication as well as treating any underlying condition causing restless leg syndrome.
A broken bone is a fracture. There are different types of fractures, such as: compressed, open, stress, greenstick, spiral, vertebral compression, compound, and comminuted. Symptoms of a broken bone include pain at the site of injury, swelling, and bruising around the area of injury. Treatment of a fracture depends on the type and location of the injury.
Pain management and treatment can be simple or complex, according to its cause. There are two basic types of pain, nociceptive pain and neuropathic pain. Some causes of neuropathic pain include: complex regional pain syndrome, interstitial cystitis, and irritable bowel syndrome. There are a variety of methods to treat chronic pain, which are dependant on the type of pain experienced.
Neck Pain (Cervical Pain)
Neck pain (cervical pain, cervicalgia) may be caused by any number of disorders and diseases. Tenderness is another symptom of neck pain. Though treatment for neck pain really depends upon the cause, treatment typically may involve heat/ice application, traction, physical therapy, cortisone injection, topical anesthetic creams, and muscle relaxants.
Chronic pain is pain (an unpleasant sense of discomfort) that persists or progresses over a long period of time. In contrast to acute pain that arises suddenly in response to a specific injury and is usually treatable, chronic pain persists over time and is often resistant to medical treatments.
Rotator Cuff Tear and Injury
Rotator cuff injury is damage to any of the four tendons that stabilize the shoulder joint. Shoulder pain and tenderness are common symptoms. Rotator cuff disease treatment depends on the severity of the shoulder injury.
Whiplash is a common injury to a person's neck following a car accident (in most cases). Symptoms include headache, neck pain, neck and shoulder stiffness, shoulder pain, fatigue, dizziness, jaw pain, arm pain, weakness of the arm(s), visual disturbances, and tinnitus. Diagnosis is generally with a physical exam, X-rays, or possibly an MRI. Treatment generally includes physical therapy and time.
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Treatment & Diagnosis
- Buttock Pain
- Lower Back Pain
- Neck Pain (Cervicalgia)
- Coccydynia (Tailbone Pain)
- Kidney Stone
- Chronic Pain
- Chronic Pain: Implantable Pain Control Devices
- Torn ACL (Anterior Cruciate Ligament Tear)
- Pain Management
- Doctor: Checklist to Take To Your Doctor's Appointment
- Complex Regional Pain Syndrome (CRPS)
- Pain Management: Dealing with Back Pain
- Impacted Wisdom Tooth
- Pain Awareness and Management
- Chronic Pain: Dealing With Back and Neck Pain
- Chronic Pain and Fatigue - What You Can Do
- Pain Management: Painkiller Addiction
- Meditation for Stress and Pain with Karen Eastman, Ph.D., Lobsang Rapgay, Ph.D., and Lonnie Zeltz
- Chronic Pain Treatments for Mind and Body
- Pain Management: Routes to Relief
- Mind-Body-Pain Connection: How Does It Work?
- Pain: Managing the Pains and Aches of Office Life
- Headaches FAQs
- Back Pain FAQs
- Pain FAQs
- Pain Management: OTC NSAIDs - Doctors Dialogue
- Pain Management Over-The-Counter
- Drug Interactions: Know Ingredients, Consult Your Physician
- How To Reduce Your Medication Costs
- Pharmacy Visit, How To Get The Most Out of Your Visit
- Indications for Drugs: Approved vs. Non-approved
- Pain (Acute and Chronic)
- Painful Periods Related to Stress
- Drugs: Buying Prescription Drugs Online Safely
- Pain and Stress: Endorphins: Natural Pain and Stress Fighters
- Drugs: The Most Common Medication Errors
- Medication Disposal
- Dangers of Mixing Medications
- Doctors Answer Pain Questions
- Does Pain Medication Affect Men and Women Differently?
- What Is Breakthrough Pain?
- Pain Relievers and High Blood Pressure
- Generic Drugs, Are They as Good as Brand-Names?
Medications & Supplements
- Oxycodone vs. Tramadol for Pain
- acetaminophen (Tylenol, Tylenol Arthritis Pain, Tylenol Ext, Little Fevers Children's Fever/Pain)
- Drugs: Questions to Ask Your Doctor or Pharmacist about Your Drugs
- Drug Interactions
- Cyclobenzaprine vs. Norco (hydrocodone acetaminophen)
- Hydrocodone vs. Hydromorphone (Differences between Side Effects)
- Oxycodone vs. Hydrocodone
- Oxycodone for Pain (OxyContin, Roxicodone, Oxecta, Oxaydo, Xtampza ER, Roxybond)
- Percocet vs. Lortab
- codeine (for Pain)
- Acetaminophen vs. Ibuprofen for Pain (Differences in Side Effects and Dosage)
- Lyrica (pregabalin) vs. Norco (hydrocodone and acetaminophen)
- OTC Pain Relievers and Fever Reducers
- Side Effects of Vicodin (hydrocodone/acetaminophen)
- Pain Medications (Narcotics)
- Tussigon (hydrocodone)
- Zohydro ER (hydrocodone)
Prevention & Wellness
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You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.
Content for drug interaction section courtesy of U.S. Food and Drug Administration