Hydrocodone / acetaminophen for pain management


Hydrocodone / Acetaminophen (common to Vicodin, Lortab, Norco) is a narcotic pain reliever used to treat pain. The drug received renewed attention after Darvon and Darvocet were discontinued on November 19, 2010. As pain relievers are withdrawn from the market, there are fewer options for treating chronic pain .

Vicodin, which has been discontinued in the US market, has been a popular alternative for some Darvocet users. Vicodin, which was available as an oral (oral) tablet, contained 5 milligrams (mg) of hydrocodone bitartrate and 500 mg of acetaminophen . There was also Vicodin-ES (7.5 mg hydrocodone bitartrate / 750 mg acetaminophen) and Vicodin-HP (10 mg hydrocodone bitartrate / 660 mg acetaminophen).

In 2014, the Food and Drug Administration (FDA) imposed stricter restrictions on hydrocodone-containing products to improve safety and address abuse of prescription pain relievers.

The FDA has limited the amount of acetaminophen to 325 mg per tablet in hydrocodone-containing products and other acetaminophen-containing prescription drug combinations to prevent acetaminophen overdose. The FDA has also changed hydrocodone-containing products from Schedule III to Schedule II, which affects how the drugs can be prescribed and obtained.


Hydrocodone / Acetaminophen is prescribed for moderate to moderately severe pain. Researchers believe that hydrocodone relieves pain by altering the way the brain and nervous system respond to painful stimuli.


The hydrocodone / acetaminophen dose should be adjusted under the close supervision of your prescribing physician, not to exceed the total acceptable daily dose. With continued use, tolerance to hydrocodone may develop, and with increasing dosage, side effects may occur.

Common side effects

Some of the common side effects that may be associated with hydrocodone / acetaminophen include :

  • Daze
  • Dizziness
  • Sedation
  • Nausea
  • Threw up

There are also side effects associated with the central nervous system, gastrointestinal tract, genitourinary system, respiratory system, sensory organs, and dermatology :

  • Central nervous system: drowsiness, lethargy, blurred thinking, decreased physical and mental performance, anxiety, fear, dysphoria, mood swings, and mental dependence.
  • Gastrointestinal tract: constipation with prolonged use.
  • From the genitourinary system: spasm of the ureter, spasm of the bladder sphincter, urinary retention.
  • Respiratory: respiratory depression and death (dose dependent)
  • Special senses: hearing impairment or hearing loss associated with a chronic overdose.
  • Dermatology: rash, itchy skin.

Precautions and contraindications.

People who have previously shown hypersensitivity to hydrocodone or acetaminophen should not take medications with these active ingredients.

Hydrocodone / acetaminophen should be used with caution in elderly and debilitated patients, as well as in patients with severe liver or kidney damage, hypothyroidism, Addison's disease, prostatic hypertrophy, or urethral stricture. It should always be remembered that there is a possibility of respiratory depression, and that the drug suppresses the mechanism of coughing.

Patients should exercise caution when driving and operating machinery while taking hydrocodone / acetaminophen.

The drug can be addictive. If you need more and more drugs to achieve the same therapeutic effect, talk to your doctor.

Special instructions for pregnant women.

Hydrocodone / Acetaminophen should be used with caution in pregnant women. Its use during pregnancy can cause physical dependence or respiratory problems in the newborn. Breastfeeding mothers should not use hydrocodone / acetaminophen as it is excreted in breast milk .

Drug interactions

There may be drug interactions with narcotic pain relievers and antihistamines, antipsychotics, sedatives, or other central nervous system depressants, including alcohol and sedatives. Your doctor may need to adjust your hydrocodone / acetaminophen dose if you are taking any of these medications.

Signs of overdose.

Signs and symptoms of overdose include respiratory depression, extreme drowsiness that progresses to coma, skeletal muscle laxity (lethargy), cold or clammy skin, bradycardia (slow heartbeat), and hypotension ( low blood pressure ). In the event of a very severe overdose, apnea, circulatory disturbances, cardiac arrest, and death can occur. Some acetaminophen can cause fatal liver necrosis, renal tubular necrosis, hypoglycemic coma, and thrombocytopenia (low platelet count).

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