Tuesday, October 25, 2016

acetaminophen and hydrocodone



Generic Name: acetaminophen and hydrocodone (a SEET a MIN oh fen and hye droe KOE done)

Brand names: Anexsia, Co-Gesic, Hycet, Liquicet, Lorcet 10/650, Lorcet Plus, Lortab 10/500, Lortab 2.5/500, Lortab 5/500, Lortab 7.5/500, Lortab Elixir, Maxidone, Norco, Polygesic, Stagesic, Vicodin, Vicodin ES, Vicodin HP, Xodol, Zamicet, Zolvit, Zydone, ...show all 34 brand names.


What is acetaminophen and hydrocodone?

Hydrocodone is in a group of drugs called narcotic pain relievers.


Acetaminophen is a less potent pain reliever that increases the effects of hydrocodone.


The combination of acetaminophen and hydrocodone is used to relieve moderate to severe pain.


Acetaminophen and hydrocodone may also be used for purposes not listed in this medication guide.


What is the most important information I should know about acetaminophen and hydrocodone?


Tell your doctor if you have ever had alcoholic liver disease (cirrhosis) or if you drink more than 3 alcoholic beverages per day. You may not be able to take medicine that contains acetaminophen. Do not take more of this medication than is recommended. An overdose of acetaminophen can damage your liver or cause death. Tell your doctor if the medicine seems to stop working as well in relieving your pain. Hydrocodone may be habit-forming and should be used only by the person it was prescribed for. Keep the medication in a secure place where others cannot get to it. Ask a doctor or pharmacist before using any other cold, allergy, pain, or sleep medication. Acetaminophen (sometimes abbreviated as APAP) is contained in many combination medicines. Taking certain products together can cause you to get too much acetaminophen which can lead to a fatal overdose. Check the label to see if a medicine contains acetaminophen or APAP. This medication may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert. Avoid drinking alcohol. It may increase your risk of liver damage while taking acetaminophen.

What should I discuss with my healthcare provider before taking acetaminophen and hydrocodone?


Do not use this medication if you are allergic to acetaminophen (Tylenol) or hydrocodone. Tell your doctor if you have ever had alcoholic liver disease (cirrhosis) or if you drink more than 3 alcoholic beverages per day. You may not be able to take medicine that contains acetaminophen.

To make sure you can safely take acetaminophen and hydrocodone, tell your doctor if you have any of these other conditions:



  • asthma, COPD, sleep apnea, or other breathing disorders;




  • liver or kidney disease;




  • a history of head injury or brain tumor;




  • low blood pressure;




  • a stomach or intestinal disorder;




  • underactive thyroid;




  • Addison's disease or other adrenal gland disorder;




  • curvature of the spine;




  • mental illness; or




  • a history of drug or alcohol addiction.




Hydrocodone may be habit forming and should be used only by the person it was prescribed for. Never share acetaminophen and hydrocodone with another person, especially someone with a history of drug abuse or addiction. Keep the medication in a place where others cannot get to it. FDA pregnancy category C. It is not known whether this medication is harmful to an unborn baby, but it could cause breathing problems or addiction/withdrawal symptoms in a newborn. Tell your doctor if you are pregnant or plan to become pregnant while using this medication. Acetaminophen and hydrocodone can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

How should I take acetaminophen and hydrocodone?


Take exactly as prescribed. Never take acetaminophen and hydrocodone in larger amounts, or for longer than recommended by your doctor. An overdose of acetaminophen can damage your liver or cause death.

One acetaminophen and hydrocodone tablet may contain up to 750 mg of acetaminophen. Know the amount of acetaminophen in the specific product you are taking.


Follow the directions on your prescription label. Tell your doctor if the medicine seems to stop working as well in relieving your pain.


Measure liquid medicine with a special dose-measuring spoon or medicine cup, not with a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist for one.


Drink 6 to 8 full glasses of water daily to help prevent constipation while you are taking acetaminophen and hydrocodone. Ask your doctor about ways to increase the fiber in your diet. Do not use a stool softener (laxative) without first asking your doctor. Do not stop using this medicine suddenly after long-term use, or you could have unpleasant withdrawal symptoms. Ask your doctor how to avoid withdrawal symptoms when you stop using acetaminophen and hydrocodone.

Acetaminophen can cause false results with certain lab tests for glucose (sugar) in the urine. Talk to your doctor if you are diabetic and you notice changes in your glucose levels during treatment.


If you need surgery, tell the surgeon ahead of time that you are using acetaminophen and hydrocodone. You may need to stop using the medicine for a short time.


Store at room temperature away from moisture and heat.

Keep track of the amount of medicine used from each new bottle. Oxycodone is a drug of abuse and you should be aware if anyone is using your medicine improperly or without a prescription.


Always check your bottle to make sure you have received the correct pills (same brand and type) of medicine prescribed by your doctor. Ask the pharmacist if you have any questions about the medicine you receive at the pharmacy.


See also: Acetaminophen and hydrocodone dosage (in more detail)

What happens if I miss a dose?


Since acetaminophen and hydrocodone is taken as needed, you may not be on a dosing schedule. If you are taking the medication regularly, take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not use extra medicine to make up the missed dose.


What happens if I overdose?


Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose of acetaminophen and hydrocodone can be fatal.

The first signs of an acetaminophen overdose include loss of appetite, nausea, vomiting, stomach pain, sweating, and confusion or weakness. Later symptoms may include pain in your upper stomach, dark urine, and yellowing of your skin or the whites of your eyes.


Overdose symptoms may also include extreme drowsiness, pinpoint pupils, cold and clammy skin, muscle weakness, fainting, weak pulse, slow heart rate, coma, blue lips, shallow breathing, or no breathing


What should I avoid while taking acetaminophen and hydrocodone?


This medication may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert. Ask a doctor or pharmacist before using any other cold, allergy, pain, or sleep medication. Acetaminophen (sometimes abbreviated as APAP) is contained in many combination medicines. Taking certain products together can cause you to get too much acetaminophen which can lead to a fatal overdose. Check the label to see if a medicine contains acetaminophen or APAP. Avoid drinking alcohol. It may increase your risk of liver damage while taking acetaminophen.

Acetaminophen and hydrocodone side effects


Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Call your doctor at once if you have any of these serious side effects:

  • shallow breathing, slow heartbeat;




  • feeling light-headed, fainting;




  • confusion, fear, unusual thoughts or behavior;




  • seizure (convulsions);




  • problems with urination; or




  • nausea, upper stomach pain, itching, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).



Less serious side effects may include:



  • anxiety, dizziness, drowsiness;




  • mild nausea, vomiting, upset stomach, constipation;




  • headache, mood changes;




  • blurred vision;




  • ringing in your ears; or




  • dry mouth.



This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.


Acetaminophen and hydrocodone Dosing Information


Usual Adult Dose for Pain:

Initial dose:
1 tablet (acetaminophen/hydrocodone 500 mg-5 mg) orally every 6 hours as needed or
10 mL (acetaminophen/hydrocodone 333 mg-5 mg) oral elixir every 6 hours as needed or
15 mL (acetaminophen/hydrocodone 325 mg-10 mg) oral solution every 4 to 6 hours as needed or
15 mL (acetaminophen/hydrocodone 500 mg-10 mg) oral elixir every 4 to 6 hours as needed.
11.25 mL (acetaminophen/hydrocodone 300 mg-10 mg) oral elixir every 4 to 6 hours as needed.

Many different combination dosage forms of acetaminophen-hydrocodone are commercially available. In general, combinations with 5 mg of hydrocodone are given 1 to 2 doses every 4 to 6 hours, up to 8 doses per day. Combinations containing 7.5 or 10 mg of hydrocodone are given once every 4 to 6 hours, up to 5 or 6 doses per day (depending on how much acetaminophen they contain).

Usual Geriatric Dose for Pain:

Initial dose: 1 tablet (acetaminophen/hydrocodone 500 mg-2.5 mg) orally every 6 hours as needed or 5 mL (acetaminophen/hydrocodone 167 mg-2.5 mg) oral elixir every 6 hours as needed.

Usual Pediatric Dose for Cough:

Antitussive (doses based on hydrocodone):
Children: 0.6 mg/kg/day or 20 mg/m2/day divided in 3 to 4 doses/day
Less than 2 years: Do not exceed 1.25 mg/single dose
2 to 12 years: Do not exceed 5 mg/single dose
Greater than 12 years: Do not exceed 10 mg/single dose

Analgesic: Children: Dose has not been well established:
Opioid-naive patients (dose based on hydrocodone):
Children and Adults less than 50 kg: Usual initial dose: 0.1 to 0.2 mg/kg every 3 to 4 hours
Children and Adults greater than or equal to 50 kg: Usual initial dose: 5 to 10 mg every 3 to 4 hours

Usual Pediatric Dose for Pain:

Antitussive (doses based on hydrocodone):
Children: 0.6 mg/kg/day or 20 mg/m2/day divided in 3 to 4 doses/day
Less than 2 years: Do not exceed 1.25 mg/single dose
2 to 12 years: Do not exceed 5 mg/single dose
Greater than 12 years: Do not exceed 10 mg/single dose

Analgesic: Children: Dose has not been well established:
Opioid-naive patients (dose based on hydrocodone):
Children and Adults less than 50 kg: Usual initial dose: 0.1 to 0.2 mg/kg every 3 to 4 hours
Children and Adults greater than or equal to 50 kg: Usual initial dose: 5 to 10 mg every 3 to 4 hours


What other drugs will affect acetaminophen and hydrocodone?


Do not take acetaminophen and hydrocodone with any other narcotic pain medications, sedatives, tranquilizers, sleeping pills, muscle relaxers, or other medicines that can make you sleepy or slow your breathing. Dangerous side effects may result.

Tell your doctor about all other medicines you use, especially:



  • an antidepressant such as amitriptyline (Elavil, Vanatrip, Limbitrol), doxepin (Sinequan), nortriptyline (Pamelor), and others;




  • an MAO inhibitor such as furazolidone (Furoxone), isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam, Zelapar), or tranylcypromine (Parnate);




  • atropine (Donnatal, and others), benztropine (Cogentin), dimenhydrinate (Dramamine), glycopyrrolate (Robinul), mepenzolate (Cantil), methscopolamine (Pamine), or scopolamine (Transderm-Scop);




  • bladder or urinary medications such as darifenacin (Enablex), flavoxate (Urispas), oxybutynin (Ditropan, Oxytrol), tolterodine (Detrol), or solifenacin (Vesicare);




  • a bronchodilator such as ipratropium (Atrovent) or tiotropium (Spiriva); or




  • irritable bowel medications such as dicyclomine (Bentyl), hyoscyamine (Anaspaz, Cystospaz, Levsin, and others), or propantheline (Pro-Banthine).



This list is not complete and other drugs may interact with acetaminophen and hydrocodone. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.



More acetaminophen and hydrocodone resources


  • Acetaminophen and hydrocodone Side Effects (in more detail)
  • Acetaminophen and hydrocodone Dosage
  • Acetaminophen and hydrocodone Use in Pregnancy & Breastfeeding
  • Drug Images
  • Acetaminophen and hydrocodone Drug Interactions
  • Acetaminophen and hydrocodone Support Group
  • 370 Reviews for Acetaminophen and hydrocodone - Add your own review/rating


Compare acetaminophen and hydrocodone with other medications


  • Back Pain
  • Cough
  • Pain
  • Rheumatoid Arthritis


Where can I get more information?


  • Your pharmacist can provide more information about acetaminophen and hydrocodone.

See also: acetaminophen and hydrocodone side effects (in more detail)


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