Medications and Drugs
Pharmacy Author: Omudhome Ogbru, PharmD
Medical and Pharmacy Editor: Jay W. Marks, MD
GENERIC NAME: hydrocodone/acetaminophen
BRAND NAMES: Vicodin, Vicodin ES, Anexsia, Lorcet, Lorcet Plus, Norco
DRUG CLASS AND MECHANISM: Hydrocodone is a narcotic pain-reliever and a cough
suppressant, similar to codeine. Hydrocodone blocks the receptors on nerve cells
in the brain that give rise to the sensation of pain. 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. For
more information please see acetaminophen (Tylenol).
PRESCRIPTION: Yes
GENERIC AVAILABLE: Yes
PREPARATIONS: Tablets, capsules and liquid. Among the many brands the dose of
acetaminophen ranges between 500 and 750 mg, and the dose of hydrocodone ranges
between 2.5 and 10 mg.
STORAGE: Hydrocodone/acetaminophen should be stored at room
temperature, between 15-30°C (59-86°F).
PRESCRIBED FOR: Hydrocodone/acetaminophen is prescribed for the relief of
moderate to moderately severe pain.
DOSING: 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.
DRUG INTERACTIONS: Combining alcohol and other sedatives with hydrocodone can
lead to increased sedation and even cause confusion. Combining carbamazepine
with acetaminophen may increase the risk of
liver toxicity.
PREGNANCY: There are no adequate studies of hydrocodone/acetaminophen in
pregnant women.
NURSING MOTHERS: Hydrocodone/acetaminophen is excreted in
breast milk, and,
therefore should be used cautiously by nursing mothers.
SIDE EFFECTS: The most frequent adverse reactions include lightheadedness,
dizziness, sedation, nausea, and vomiting. Other side effects include
drowsiness, constipation, 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.
Reference: FDA Prescribing Information
Last Editorial Review: 1/7/2008
Report Problems to the Food and Drug Administration
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.
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