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Acetaminophen and benzhydrocodone

Generic Name: acetaminophen and benzhydrocodone (a SEET a MIN oh fen and BENZ hye dro KOE done)
Brand Name: Apadaz

Medically reviewed by on Apr 17, 2019 – Written by Cerner Multum

What is acetaminophen and benzhydrocodone?

Benzhydrocodone is an opioid pain medication. Acetaminophen is a less potent pain reliever that increases the effects of hydrocodone.

Acetaminophen and benzhydrocodone is a combination medicine for short-term use to relieve moderate to severe pain.

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

Important Information

MISUSE OF OPIOID MEDICINE CAN CAUSE ADDICTION, OVERDOSE, OR DEATH. Keep the medication in a place where others cannot get to it.

An overdose of acetaminophen can damage your liver or cause death. Call your doctor at once if you have pain in your upper stomach, loss of appetite, dark urine, or jaundice (yellowing of your skin or eyes).

Fatal side effects can occur if you use opioid medicine with alcohol, or with other drugs that cause drowsiness or slow your breathing.

Stop taking acetaminophen and benzhydrocodone and call your doctor right away if you have skin redness or a rash that spreads and causes blistering and peeling.

Before taking this medicine

You should not use this medicine if you are allergic to acetaminophen (Tylenol) or hydrocodone.

Tell your doctor if you have ever had:

  • liver disease, cirrhosis;

  • a drug or alcohol addiction;

  • urination problems;

  • kidney disease; or

  • problems with your thyroid, pancreas, or gallbladder.

If you use opioid medicine while you are pregnant, your baby could become dependent on the drug. This can cause life-threatening withdrawal symptoms in the baby after it is born. Babies born dependent on opioids may need medical treatment for several weeks.

You should not breast-feed while using this medicine.

How should I take acetaminophen and benzhydrocodone?

Follow the directions on your prescription label and read all medication guides. Never use acetaminophen and benzhydrocodone in larger amounts, or for longer than 14 days. An overdose can damage your liver or cause death. Tell your doctor if you feel an increased urge to take more of this medicine.

Never share this medicine with another person, especially someone with a history of drug abuse or addiction. MISUSE CAN CAUSE ADDICTION, OVERDOSE, OR DEATH. Keep the medicine in a place where others cannot get to it. Selling or giving away acetaminophen and benzhydrocodone is against the law.

Do not stop using acetaminophen and benzhydrocodone suddenly, or you could have unpleasant withdrawal symptoms. Ask your doctor how to safely stop using this medicine.

Store at room temperature away from moisture and heat. Keep track of your medicine. You should be aware if anyone is using it improperly or without a prescription.

Do not keep leftover opioid medication. Just one dose can cause death in someone using this medicine accidentally or improperly. Ask your pharmacist where to locate a drug take-back disposal program. If there is no take-back program, flush the unused medicine down the toilet.

What happens if I miss a dose?

Since acetaminophen and benzhydrocodone is used for pain, you are not likely to miss a dose. Skip any missed dose if it is almost time for your next dose. Do not use two doses at one time.

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 benzhydrocodone can be fatal.

Early overdose symptoms may 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 can also cause severe muscle weakness, pinpoint pupils, very slow breathing, extreme drowsiness, or coma.

What should I avoid while taking acetaminophen and benzhydrocodone?

Avoid driving or operating machinery until you know how this medicine will affect you. Dizziness or drowsiness can cause falls, accidents, or severe injuries.

Ask a doctor or pharmacist before using any other medicine that may contain acetaminophen (sometimes abbreviated as APAP). Taking certain medications together can lead to a fatal overdose.

Avoid drinking alcohol. It may increase your risk of liver damage.

Acetaminophen and benzhydrocodone side effects

Get emergency medical help if you have signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Opioid medicine can slow or stop your breathing, and death may occur. A person caring for you should seek emergency medical attention if you have slow breathing with long pauses, blue colored lips, or if you are hard to wake up.

In rare cases, acetaminophen may cause a severe skin reaction that can be fatal. Stop taking acetaminophen and benzhydrocodone and call your doctor right away if you have skin redness or a rash that spreads and causes blistering and peeling.

Call your doctor at once if you have:

  • chest pain, fast heartbeats, shallow breathing;

  • extreme drowsiness;

  • a light-headed feeling, like you might pass out;

  • confusion; or

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

Seek medical attention right away if you have symptoms of serotonin syndrome, such as: agitation, hallucinations, fever, sweating, shivering, fast heart rate, muscle stiffness, twitching, loss of coordination, nausea, vomiting, or diarrhea.

Serious side effects may be more likely in older adults and those who are overweight, malnourished, or debilitated.

Common side effects include:

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 benzhydrocodone dosing information

Usual Adult Dose for Pain:

Individualize therapy taking into account severity of pain, prior analgesic treatment experience, and risk factors for addiction, abuse, and misuse:

As First Opioid Analgesic:
Initial dose: 1 or 2 tablets (acetaminophen 325 to 650 mg/benzhydrocodone 6.12 to 12.24 mg) orally every 4 to 6 hours as needed for pain
-Titrate to a dose that provides adequate analgesia and minimizes adverse reactions
Maximum dose: 12 tablets/24 hours
Maximum acetaminophen dose (including all acetaminophen-containing products): 4000 mg in a 24-hour period
Duration of therapy: 7 to 14 days

Equivalence to Hydrocodone Bitartrate:
-Benzhydrocodone 4.08 mg equivalent to hydrocodone bitartrate 5 mg
-Benzhydrocodone 6.12 mg equivalent to hydrocodone bitartrate 7.5 mg
-Benzhydrocodone 8.16 mg equivalent to hydrocodone bitartrate 10 mg

-This drug should be reserved for patients for whom alternative treatment options (e.g. non-opoid analgesics) have not been tolerated or are not expected to be tolerated; OR have not provided adequate analgesia or are not expected to provide adequate analgesia.
-Use the lowest effective dose for the shortest duration consistent with individual patient treatment goals.
-Monitor closely for respiratory depression, especially in the first 24 to 72 hours of initiating therapy and following any increase in dose.
-As with all opioid drugs and opioid formulations, inter-patient variability is possible; if converting from other opioids to this drug, it is safer to underestimate patient requirements than overestimate dose and manage an adverse reaction due to overdose.

Use: For the short-term management of acute pain severe enough to require an opioid analgesic and for which alternative treatments are inadequate.

What other drugs will affect acetaminophen and benzhydrocodone?

You may have breathing problems or withdrawal symptoms if you start or stop taking certain other medicines. Tell your doctor if you also use an antibiotic, antifungal medication, heart or blood pressure medication, seizure medication, or medicine to treat HIV or hepatitis C.

Opioid medication can interact with many other drugs and cause dangerous side effects or death. Be sure your doctor knows if you also use:

This list is not complete. Other drugs may affect acetaminophen and benzhydrocodone, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed here.

Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.