hydrocodone and ibuprofen

Vicoprofen is a combination of an opioid analgesic (hydrocodone bitartrate, a pain reliever related to narcotics) and a nonsteroidal anti-inflammatory drug (ibuprofen). Both medications are effective for pain management. Hydrocodone and ibuprofen (Vicoprofen) is an opioid analgesic prescribed for the management of moderate to severe pain, used on a short-term basis. It is estimated that one tablet of Vicoprofen is as effective as two tablets of Tylenol #3 (acetaminophen 300 mg plus codeine 30 mg). Vicoprofen was approved by the FDA in 1997.

The most frequent side effects experienced with hydrocodone include:

• lightheadedness,
• dizziness,
• sedation,
• nausea,
• dyspepsia (indigestion),
• vomiting,
• anxiety,
• nervousness, and
• somnolence (drowsiness).

Other important side effects include constipation and spasm of the ureter, which can lead to difficulty in urinating.

The most common side effects of ibuprofen involve the gastrointestinal system. It can cause ulcerations, abdominal pain, cramping, nausea, gastritis, and even serious gastrointestinal bleeding. Sometimes, stomach ulceration and bleeding can occur without abdominal pain, and black tarry stools, weakness, and dizziness upon standing may be the only signs of internal bleeding. Rash, kidney impairment, ringing in the ears (tinnitus), and lightheadedness can also occur.

Hydrocodone can depress breathing, and is used with caution in the elderly, debilitated patients and those with a history of ulcer or serious lung disease. Hydrocodone can impair thinking and the physical abilities required for driving or operating machinery. Hydrocodone may be habit forming. Mental and physical dependence can occur but are unlikely when used for short-term pain relief.

The usual dose of Vicoprofen is one tablet every 4 to 6 hours as needed for pain. The manufacturer recommends a maximum of 5 tablets per day and a short-term duration of treatment (less than 10 days).

• Hydrocodone, like other narcotic pain-relievers, interacts with medications and drugs that slow the brain's processes, such as alcohol, barbiturates, skeletal muscle relaxants including carisoprodol (Soma), cyclobenzaprine (Flexeril), and benzodiazepines (for example, lorazepam [Ativan], and clonazepam [Klonopin]).
• Opioids such as hydrocodone can slow bowel motility. When combined with medications that possess anticholinergic activity, this effect on the bowel may be accentuated, leading to marked constipation. Such drugs include dicyclomine (Bentyl), some antihistamines (for example, carbinoxamine [Rondec], clemastine [Tavist], diphenhydramine [Benadryl], promethazine [Phenergan]); some phenothiazines (for example, thioridazine [Mellaril], triflupromazine [Stelazine]); some tricyclic antidepressants (for example, amitriptyline [Elavil, Endep] amoxapine [Asendin], clomipramine [Anafranil], protriptyline [Vivactil]); clozapine (Clozaril), cyclobenzaprine (Flexeril), and disopyramide (Norpace). The use of antidiarrheals (for example, diphenoxylate [Lomotil], loperamide [Imodium]) in persons taking opioid analgesics such as hydrocodone can lead to severe constipation and possibly greater sedation.
• Cimetidine (Tagamet), when used with opiate analgesics such as hydrocodone, can cause confusion, disorientation, seizures or respiratory depression by increasing blood concentrations of the opiate.
• Ibuprofen, which has blood thinning (anticoagulant) properties, is used with caution in patients taking other blood thinning anticoagulants such as warfarin, because of an increased risk of bleeding. Concurrent use of ibuprofen and clopidogrel (Plavix) can also lead to increased risk of bleeding. Patients taking lithium (Eskalith, Lithobid) can develop toxic blood lithium levels if ibuprofen is taken at the same time. Ibuprofen may increase methotrexate (Rheumatrex, Trexall) toxicity when used together.

Hydrocodone and ibuprofen crosses the placenta. However, there is not enough information known about the effects of hydrocodone and ibuprofen on the fetus. Physicians may choose to use hydrocodone and ibuprofen if the benefits outweigh potential risks.

It is not known if hydrocodone is secreted in breast milk.

What preparations of hydrocodone and ibuprofen are available?

• Tablets: hydrocodone bitartrate 7.5 mg and ibuprofen 200 mg.

How should I keep hydrocodone and ibuprofen stored?

• Tablets should be stored at room temperature between 15 C - 30 C (59 F - 86 F).