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Hydrocodone and Acetaminophen

Generic Name: hydrocodone and acetaminophen (a SEET a MIN oh fen and hye droe KOE done)
Brand names: Anexsia, Dolorex Forte, 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, Xodol 5, Zydone

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What is hydrocodone and acetaminophen?
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 HYDROCODONE and acetaminophen is used to relieve moderate to severe pain.
This medicine may also be used for purposes other than those listed in this guide.
Important information about hydrocodone and acetaminophen
Tell your doctor if you drink more than three alcoholic beverages per day or if you have ever had alcoholic liver disease (cirrhosis). You may not be able to take medication that contains acetaminophen.
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. Hydrocodone can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.

Tell your doctor if the medicine seems to stop working as well in relieving your pain.
Before taking hydrocodone and acetaminophen
Do not use this medication if you are allergic to acetaminophen (Tylenol) or hydrocodone. Hydrocodone may be habit-forming and should be used only by the person it was prescribed for. Hydrocodone and acetaminophen should never be given to another person, especially someone who has a history of drug abuse or addiction. Keep the medication in a secure place where others cannot get to it.

Before using HYDROCODONE and acetaminophen, tell your doctor if you are allergic to any drugs, or if you have:

* 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.

FDA pregnancy category C. This medication may be harmful to an unborn baby, and could cause breathing problems or addiction/withdrawal symptoms in a newborn. Tell your doctor if you are pregnant or plan to become pregnant during treatment. hydrocodone and acetaminophen 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 hydrocodone and acetaminophen exactly as it was prescribed for you. Do not take it in larger amounts, or use it for longer than recommended by your doctor. Follow the directions on your prescription label. Tell your doctor if the medicine seems to stop working as well in relieving your pain.
An overdose of acetaminophen can cause serious harm to your liver. The maximum amount of acetaminophen for adults is 1 gram (1000 mg) per dose and 4 grams (4000 mg) per day. One hydrocodone and acetaminophen tablet may contain up to 750 mg of acetaminophen. Know the amount of acetaminophen in the specific product you are taking.

Measure the liquid form of hydrocodone and acetaminophen with a special dose-measuring spoon or cup, not a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist where you can get one.
Drink 6 to 8 full glasses of water daily to help prevent constipation while you are taking hydrocodone and acetaminophen. Ask your doctor about ways to increase the fiber in your diet. Do not use a stool softener (laxative) without first asking your doctor. You may have withdrawal symptoms when you stop using hydrocodone and acetaminophen after using it over a long period of time. Do not stop using HYDROCODONE and acetaminophen suddenly without first talking to your doctor. You may need to use less and less before you stop the medication completely.

This medication can cause you to have unusual results with certain urine tests. Tell any doctor who treats you that you are using hydrocodone and acetaminophen.

If you need to have any type of surgery, tell the surgeon ahead of time that you are using hydrocodone and acetaminophen. You may need to stop using the medicine for a short time.
Store hydrocodone and acetaminophen at room temperature away from moisture and heat.

Keep track of how many tablets have been used from each new bottle of this medicine. Hydrocodone is a drug of abuse and you should be aware if any person in the household is using this medicine improperly or without a prescription.
What happens if I miss a dose?

Since HYDROCODONE and acetaminophen 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. If it is almost time for the next dose, skip the missed dose and wait until your next regularly scheduled dose. Do not use extra medicine to make up the missed dose.
What happens if I overdose?
Seek emergency medical attention if you think you have used too much of this medicine. An overdose of hydrocodone and acetaminophen can be fatal.

Overdose symptoms may include extreme drowsiness, sweating, pinpoint pupils, nausea, vomiting, dark urine, jaundice (yellowing of the skin or eyes), confusion, 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 hydrocodone and acetaminophen?
Hydrocodone and acetaminophen can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert. Do not use any other over-the-counter cough, cold, allergy, or pain medication without first asking your doctor or pharmacist. Acetaminophen is contained in many medicines available over the counter. If you take certain products together you may accidentally take too much acetaminophen. Read the label of any other medicine you are using to see if it contains acetaminophen. Avoid drinking alcohol while taking hydrocodone and acetaminophen. Alcohol may increase your risk of liver damage while taking acetaminophen. Cold or allergy medicine, narcotic pain medicine, sleeping pills, muscle relaxers, antidepressants, or seizure medication can add to sleepiness caused by hydrocodone, or could slow your breathing. Tell your doctor if you need to use any of these other medicines while you are taking hydrocodone and acetaminophen.
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Hydrocodone and acetaminophen 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, stomach pain, loss of appetite, itching, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).

Less serious hydrocodone and acetaminophen side effects may include:

* feeling anxious, dizzy, or drowsy;
* 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. Tell your doctor about any unusual or bothersome side effect.

See also: Hydrocodone side effects (in more detail)
What other drugs will affect hydrocodone and acetaminophen?

Before taking hydrocodone and acetaminophen, tell your doctor if you are using any of the following drugs:

* antidepressants such as amitriptyline (Elavil, Etrafon), clomipramine (Anafranil), imipramine (Janimine, Tofranil), and others;
* an MAO inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), 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 there may be other drugs that can interact with hydrocodone and acetaminophen. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.


Hydrocodone [4,5?-epoxy-3-methoxy-17-methyl-morphinan-6-one tartrate (1:1) hydrate (2:5), dihydrocodeinone] is a semi-synthetic opioid most closely related to codeine in structure and morphine in producing opiate-like effects. The first report, that hydrocodone produces euphoria and habituation symptoms, was published in 1923. The first report of hydrocodone dependence and addiction was published in 1961.

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