Hydrocodone and Acetaminophen (Oral)

Overview

Hydrocodone and Acetaminophen is a combination of drugs that is given to patients who are suffering from pain that is moderate to moderately severe.

Acetaminophen has the dual effects of relieving pain and reducing fevers. It is particularly useful because, compared to other, similar drugs, it does not lead to habit-forming if taken for extended periods. However, if taken in large doses, it does have the potential to cause other unwanted effects, such as liver damage.

Hydrocodone is known in the medical world as a narcotic analgesic, otherwise called pain medicines. It works directly on the patient's central nervous system in order to relieve pain. It can also help prevent or stop lingering coughs.

Unlike to Acetaminophen, Hydrocodone can lead to habit-forming if it is used for a long period of time. This can, therefore, lead to either physical or mental dependence on the drug. However, it is worth noting that fear of dependence should not stop patients from using narcotics to relieve pain.

If the drug is used solely for the intended purpose of relieving pain, then mental dependence (or addiction) is not likely to occur. If treatment is stopped suddenly, some degree of physical dependence may be triggered. This, in turn, will lead to withdrawal side effects. To prevent these, patients should gradually reduce the dose they receive of this medicine over a period of time, as opposed to stopping quickly and completely.

Due to the nature of this drug combination and its specific uses, it is only available via a doctor's prescription.

Conditions Treated

  • Moderate to moderately severe pain

Type Of Medicine

  • Elixir

Side Effects

As well as helping to relieve pain, it is possible that Hydrocodone and Acetaminophen combination will cause other unwanted side effects to arise. Directly below is a list of the more serious side effects that may occur. If you experience any of these, you should contact your doctor immediately.

More common

  • Lightheadedness

Incidence not known

  • Unusual bruising or bleeding

Listed below are the symptoms of overdosing on Hydrocodone and Acetaminophen combination. Seek emergency medical assistance if you experience any of the following:

  • Not breathing

As well as these more serious side effects, it is possible that you will experience less serious ones. Directly below is a list of such side effects. You may find that, as your body adjusts to the medicine, these side effects will pass. However, if you find them bothersome or they linger, then you may still seek your doctor's assistance. They may be able to help relieve the side effects, such as by altering your doses.

More common

  • Sleepiness

Incidence not known

  • Nervousness or fear

Though these lists are extensive, they are not necessarily all inclusive. This means you may experience other side effects that are not listed here. If that is the case and you are worried by the effects, then you can still contact your doctor and ask for advice.

Dosage

Below, you can find the typical doses of Hydrocodone and Acetaminophen combination that are prescribed to patients suffering from moderate to moderately severe pain. Do be aware that the exact dosage you have been prescribed may differ greatly from what is listed below. This is because each patient is different and the exact dosage is based on your exact needs and the extent of your pain. It will also be based off other factors, such as other drugs you are currently taking. You should, therefore, never adjust your dose unless you have been told to do so by your prescribing doctor.

When taking oral capsules:

  • Adults: Take one or two capsules every four to six hours when needed. Your doctor may alter your doses if needed, although the dose will never usually be more than eight capsules a day.
  • Children: The exact use and dosage will be determined by the prescribing doctor.

When taking oral elixir:

  • Adults and children aged 14 and above and weighing 46 kg and above: Take 11.25ml every four to six hours as necessary. Your doctor may increase your doses if needed, although the dose will never usually be more than 67.5ml a day.
  • Children aged between 10 and 13 years of age who weigh between 32 and 45 kg: Take 7.5ml every four to six hours as necessary. Your doctor may increase your doses if needed, although the dose will never usually be more than 45 ml a day.
  • Children aged between seven and nine years of age who weigh between 23 and 31 kg: Take 5.6ml every four to six hours as necessary. Your doctor may increase your doses if needed, although the dose will never usually be more than 33.6ml a day.
  • Children aged between four and six years of age who weigh between 16 and 22 kg: Take 3.75ml every four to six hours as necessary. Your doctor may increase your doses if needed, although the dose will never usually be more than 22.5ml a day.
  • Children aged between two and three years of age who weigh between 12 and 15 kg: Take 72.8ml every four to six hours as necessary. Your doctor may increase your doses if needed, although the dose will never usually be more than 16.8ml a day.
  • Children aged younger than two: The exact use and dosage will be determined by the prescribing doctor.

When taking oral solution (7.5mg per 325 mg per 15 ml):

  • Adults and children aged 14 and above and weighing 46 kg and above: Take one tablespoonful or 15 ml every four to six hours as necessary. Your doctor may increase your doses if needed, although the dose will never usually be more than six tablespoonfuls or 90ml a day.
  • Children aged between 10 and 13 years of age who weigh between 32 and 45 kg: Take two teaspoonfuls or 10ml every four to six hours as necessary. Your doctor may increase your doses if needed, although the dose will never usually be more than 12 teaspoonfuls or 60ml a day.
  • Children aged between seven and nine years of age who weigh between 23 and 31 kg: Take 1.5 teaspoonfuls or 7.5ml every four to six hours as necessary. Your doctor may increase your doses if needed, although the dose will never usually be more than nine teaspoonfuls or 45 ml a day.
  • Children aged between four and six years of age who weigh between 16 and 22 kg: Take one teaspoonful or 5 ml every four to six hours as necessary. Your doctor may increase your doses if needed, although the dose will never usually be more than six teaspoonfuls or 30ml a day.
  • Children aged between two and three years of age who weigh between 12 and 15 kg: Take 0.75 teaspoonfuls or 3.75ml every four to six hours as necessary. Your doctor may increase your doses if needed, although the dose will never usually be more than 4.5 teaspoonfuls or 22.5ml a day.
  • Children aged younger than two: The exact use and dosage will be determined by the prescribing doctor.

When taking oral solution (10mg per 325 mg per 15 ml):

  • Adults: Take one tablespoonful or 15 ml every four to six hours as necessary. Your doctor may increase your doses if needed, although the dose will never usually be more than six tablespoonfuls or 90ml a day.
  • Children aged 14 and above and weighing 46 kg and above: Take 2.25 teaspoonfuls or 11.25ml every four to six hours as necessary. Your doctor may increase your doses if needed, although the dose will never usually be more than 13.5 tablespoonfuls or 67.5ml a day.
  • Children aged between 10 and 13 years of age who weigh between 32 and 45 kg: Take 1.5 teaspoonfuls or 7.5ml every four to six hours as necessary. Your doctor may increase your doses if needed, although the dose will never usually be more than nine teaspoonfuls or 45 ml a day.
  • Children aged between seven and nine years of age who weigh between 23 and 31 kg: Take one teaspoonful or 5.6ml every four to six hours as necessary. Your doctor may increase your doses if needed, although the dose will never usually be more than 6.5 teaspoonfuls or 33.6ml a day.
  • Children aged between four and six years of age who weigh between 16 and 22 kg: Take 0.75 teaspoonfuls or 3.75ml every four to six hours as necessary. Your doctor may increase your doses if needed, although the dose will never usually be more than 4.5 teaspoonfuls or 22.5ml a day.
  • Children aged between two and three years of age who weigh between 12 and 15 kg: Take 0.5 teaspoonfuls or 2.8ml every four to six hours as necessary. Your doctor may increase your doses if needed, although the dose will never usually be more than 3.25 teaspoonfuls or 16.8ml a day.
  • Children aged younger than two: The exact use and dosage will be determined by the prescribing doctor.

When taking oral tablets (5mg per 325mg):

  • Adults taking Lortab®: Have one or two tablets every four to six hours when necessary. Your doctor may increase your doses if needed, although the dose will never usually be more than 12 tablets a day.
  • Adults taking generic tablets: The exact dose depends on the medicine's strength, and your doctor will be able to advise the suitable amount.
  • Children: The exact use and dosage will be determined by the prescribing doctor.

When taking oral tablets (7.5mg per 325mg):

  • Adults taking Lortab®: Have one tablet every four to six hours when necessary. Your doctor may increase your doses if needed, although the dose will never usually be more than six tablets a day.
  • Adults taking generic tablets: The exact dose depends on the medicine's strength, and your doctor will be able to advise the suitable amount.
  • Children: The exact use and dosage will be determined by the prescribing doctor.

When taking oral tablets (10mg per 325mg):

  • Adults taking Lortab®: Have one tablet every four to six hours when necessary. Your doctor may increase your doses if needed, although the dose will never usually be more than six tablets a day.
  • Adults taking generic tablets: The exact dose depends on the medicine's strength, and your doctor will be able to advise the suitable amount.
  • Children: The exact use and dosage will be determined by the prescribing doctor.

It is important that you take your doses as prescribed, as this will provide you with the maximum benefit. However, if for some reason you do miss a dose, you should take it as soon as possible. This is as long as it is not almost time for your next dose. If this is the case, then you should skip it and continue on your regular dosage schedule. It is important you do not double dose.

You should take this drug exactly as directed by your doctor. This means you shouldn't take it more often, for longer or in higher doses than you were told to do so. If you are elderly, then this is even more important, as you are more sensitive to effects that pain medicines have.

If you were to take too much of this combination for a long time, then it may become habit-forming. This means physical or mental dependence. You are also at risk of liver damage from large amounts of Acetaminophen, as well as at risk of overdosing.

When given Hydrocodone and Acetaminophen combination, you will find a patients' information leaflet. You should read this carefully and ask any questions you have of your doctor.

You should avoid measuring this drug with a teaspoon, as the average household teaspoon is not necessarily accurate. Instead, use an oral syringe, marked measuring spoon, medicine cup or dropper.

The Acetaminophen in this combination is otherwise known as Tylenol®. You should check all other medicines you are currently taking to see if they also contain Acetaminophen. When taken together, it is not safe for your daily intake of Acetaminophen to be greater than 4 grams (or 4,000 mg).

Interactions

It is possible that Hydrocodone and Acetaminophen combination will interact with other drugs you are currently taking. In many cases, your doctor will likely try to avoid these interactions. However, in other cases, it may still be the best course of treatment for the interactions to occur.

Either way, you should inform your doctor of all drugs you are currently taking so that they can come to an informed judgment as to how to proceed. They may find it necessary to alter other drugs you are taking, or to limit the doses of others in order to minimise side effects. Directly below is a list of the drugs with which it is not recommended you take Hydrocodone and Acetaminophen combination. Your doctor may alter one or both medicines if they see fit.

  • Naltrexone

Directly below is a list of drugs with which it is usually not recommended you take this drug combination. Your doctor may alter one or both doses you receive in order to limit interactions.

  • Buspirone

If you take any of the following drugs at the same time as Hydrocodone and Acetaminophen combination, then you may be at an increased chance of experiencing certain side effects. However, taking both may be the best course of treatment for you. Again, your doctor may limit your doses of one or both in order to limit these side effects.

  • Fosphenytoin

As well as interacting with drugs, it is possible that Hydrocodone and Acetaminophen combination may interact with certain parts of your dietary intake. As such, your doctor may need to adjust certain aspects of what you smoke, drink or eat. For example, they may need you to restrict how much tobacco you smoke or alcohol you drink.

Below is a list of such products that you should usually not consume at the same time as this drug. Your doctor may give you special instructions regarding the following:

  • Tobacco

If you take Hydrocodone and Acetaminophen combination at the same time as the following, you may be at an increased risk of experiencing certain side effects:

  • Cabbage

Finally, it is possible that this drug combination will interact with other medical problems you suffer from. You should inform your doctor of other medical conditions you have, and highlight any of the following, if applicable:

  • Digestion or stomach problems. Taking this medicine may cause the diagnosis of this condition to be masked

Warnings

Before being prescribed this medicine, your doctor will need to examine you to ensure it is safe and suitable for you. As a part of this, they will need to know about any allergies you suffer from. This includes allergies to animals, dyes, foods and preservatives.

At the time of writing, suitable studies have not been conducted using Hydrocodone and Acetaminophen tablets or capsules on children. As such, the exact effects it may have are unknown compared to adults, and the efficacy and safety have not been established.

There have been suitable studies performed on the use of the oral solution version of Hydrocodone and Acetaminophen in children. No problems have been indicated that would make this drug any less useful. However, the efficacy and safety have not yet been established in children aged below two.

The studies that have been performed on older patients have not presented any geriatric-specific problems that would make this drug any less useful for older patients. However, your doctor may need to adjust the doses prescribed to elderly patients, as they are more likely to suffer from age-related, kidney, heart and liver problems, as well as drowsiness and confusion.

At the time of writing, it is unclear as to whether suitable studies have taken place on the use of this drug combination on pregnant women. Your doctor can advise on any increased risks that may apply. If you do become pregnant or plan to while using this drug combination, you should inform your doctor immediately.

Similarly, there are no suitable studies highlighting how this drug affects breastfeeding women. Your doctor can advise of the increased risks and then weigh them against the benefits with you.

Whilst taking Hydrocodone and Acetaminophen combination, your doctor will need to see you at regular appointments to see how your treatment is progressing. It is vital you attend these, as they can check for any unwanted effects and make the necessary adjustments to your prescription.

It is both dangerous and against the law for anyone else to obtain and use this medicine when prescribed to you. You should, therefore, store this medicine in a safe and secure place.

Hydrocodone and Acetaminophen combination adds to the effects of CNS depressants and alcohol. Examples of CNS depressants include other prescription pain medicine or narcotics, medicine for seizures or barbiturates, anesthetics, including some dental anesthetics, antihistamines or medicine for allergies or colds, tranquilizers or sleeping medicine and sedatives or muscle relaxants. These drugs make you less alert and more drowsy.

Also, drinking three or more alcoholic beverages while taking this drug may increase your risk of getting liver damage. You should, therefore, check with your doctor before taking any of these drugs at the same time as Hydrocodone and Acetaminophen combination, as well as first approving the drinking of alcohol.

You should never use more than is prescribed to you, even if you feel it isn't working properly. This is because it can be habit-forming.

If you experience any of the following symptoms, check with your doctor immediately. They could be signs of liver damage.

  • Unusual weakness or tiredness

It is possible that this drug combination will cause serious skin reactions. If you experience any of the following, then check with your doctor how to proceed:

  • Red skin lesions

Hydrocodone and Acetaminophen drug combination can cause some patients to have a serious allergic reaction known as anaphylaxis. This requires immediate medical attention, as it is life-threatening. Contact your doctor straight away if you experience any of the following:

  • Hoarseness

Taking this drug may cause you to become lightheaded, drowsy or dizzy. As such you should not drive or perform other dangerous tasks like using machinery until you know how this drug affects you.

Taking narcotic for an extended period can lead to constipation. To counteract this, your doctor may advise you to drink lots of fluids, increase your fiber intake or to take laxatives. Constipation can lead to more serious problems, so follow any advice closely.

Before having any other medical tests performed, you should tell the doctor in charge that you are using this medicine as it may affect the results.

You should not suddenly stop taking this medicine. Instead, you should first check with your doctor how to stop. They will likely want you to gradually reduce the amount you are taking. This will help prevent or reduce unwanted withdrawal symptoms and prevent your condition getting worse. Withdrawal symptoms include the following:

  • Tremors

If you use this drug while pregnant, there is a chance that your baby will experience neonatal withdrawal syndrome. If your child experiences any of the following symptoms, then inform your doctor immediately:

  • Weight loss

Unless first approved by your doctor, you should not take any other drugs at the same time as Hydrocodone and Acetaminophen combination. This includes both prescription and non-prescription drugs, as well as any herbal or vitamin supplements.

Storage

You should store your medicine is a sealed container at room temperature and keep it away from direct light, heat and moisture. You should not allow it to freeze and should keep it safely away from children. If you have any medicine left at the end of your treatment, then you should dispose of it in a safe and sensible manner. Similarly, if you have any medicine that is out of date then you should dispose of it as well. If you need advice about doing so, then you can speak to your doctor.

Summary

If you are suffering from moderate to moderately severe pain, then Hydrocodone and Acetaminophen drug combination could well be a very useful drug in helping to relieve your suffering. However, it is not available to all patients and is only prescribed under certain circumstances. It has the ability to interact with a wide variety of other drugs and can cause a large array of side effects. It also has the ability to lead to some degree of drug dependency as it contains a narcotic.

Your doctor will, therefore, need to examine you properly beforehand. If you are prescribed this medicine, you should follow your doctor's prescription very closely, and never take it for longer or take more of this drug than you are told to do. They may also ask you to make certain lifestyle or dietary alterations in order to best treat your pain, so you should follow these closely as well. If you experience any unwanted side effects after taking this drug, or if you have any other questions regarding it, then you should address these to your doctor.