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Acetaminophen/hydrocodone Patient Tips

Medically reviewed on Sep 13, 2017 by C. Fookes, BPharm

How it works

  • Acetaminophen/hydrocodone is a combination of two different pain-relief medicines with two different mechanisms of action.
  • Experts aren't sure exactly how acetaminophen works, but suspect it blocks a specific type of cyclooxygenase (COX) enzyme, located mainly in the brain. Hydrocodone binds to specific receptors known as mu opioid receptors that block pain signals on their way to the brain.
  • Acetaminophen/hydrocodone belongs to the group of medicines known as combination narcotic analgesics. It may also be called a combination opioid analgesic.

Upsides

  • May be used to relieve moderate-to-moderately severe pain unresponsive to other treatment options.
  • The combination is more effective than either drug alone.
  • Both drugs last for a similar length of time in the body which makes them appropriate to be given together.
  • Available in tablet and oral solution forms.
  • Has been FDA-approved for use in children; however, because of its high potential for addiction, acetaminophen/hydrocodone should only be given to children if there are no other alternatives.
  • Generic acetaminophen/hydrocodone is available.

Downsides

If you are between the ages of 18 and 60, take no other medication or have no other medical conditions, side effects you are more likely to experience include:

  • Drowsiness or dizziness which may impair reaction skills and affect a person's ability to drive or operate machinery (hydrocodone component). Avoid alcohol.
  • Stomach upsets including nausea, vomiting, and constipation (laxatives may be required); shortness of breath; dizziness; and low blood pressure (hydrocodone component). Hydrocodone may be more likely to cause constipation than other opioids such as oxycodone.
  • Excessive dosages of acetaminophen can lead to liver injury or death. Care must be taken not to take additional acetaminophen from other sources.
  • Unlike NSAID pain relievers like ibuprofen, acetaminophen does not have any appreciable anti-inflammatory action.
  • Hydrocodone is habit forming and potentially abusable. The combination of acetaminophen and hydrocodone should only be used short-term at the lowest effective dose when other nonopioid analgesics are not effective. Legitimate supplies of products containing hydrocodone may be sought out by drug seekers. Hydrocodone is one of the most abused opioids in the United States.
  • Abrupt discontinuation of any hydrocodone-containing medication in a person who has become physically dependent on it may lead to a withdrawal syndrome and symptoms such as restlessness, pupil dilation, watery eyes and a runny nose, sweating, muscle aches, insomnia, irritability and gastrointestinal complaints. Babies born to mothers who are physically dependent on hydrocodone will also be physically dependent.
  • Rarely, serious, life-threatening, breathing problems may occur attributable to the hydrocodone component. The risk is greater with higher dosages of acetaminophen/hydrocodone, in people with pre-existing respiratory disease, in seniors or the frail, or in those taking other medications that cause respiratory depression (such as benzodiazepines).
  • Interaction or overdosage may also cause serotonin syndrome. Symptoms include mental status changes such as agitation, hallucinations, coma, or delirium; a fast heart rate; dizziness; flushing; muscle tremor or rigidity; and stomach symptoms (including nausea, vomiting, and diarrhea).
  • May not be suitable for people with pre-existing respiratory depression or respiratory disease, with seizure disorders or a head injury, people with gastrointestinal obstruction, or recent use of monoamine oxidase inhibitors.

Notes: In general, seniors or children, people with certain medical conditions (such as liver or kidney problems, heart disease, diabetes, seizures) or people who take other medications are more at risk of developing a wider range of side effects. For a complete list of all side effects, click here.

Bottom Line

Acetaminophen/hydrocodone moderate-to-severe pain that is unrelieved by nonopioid analgesics; however, its use is limited by the dependence and addiction potential of the hydrocodone component and the risk of respiratory depression (unusually slow and shallow breathing).

Tips

  • Short-term use only. Not recommended for long-term use.
  • Do not exceed the recommended dosage.
  • Call emergency services if you experience any breathing difficulties, wheezing, itching, or facial swelling.
  • Call your doctor if you experience nausea or vomiting, stomach pain, itching, yellowing of your skin or eyes (jaundice), or dark (brown) urine, or light-colored stools.
  • Tell your doctor if you think you have become addicted to this combination drug.
  • Keep out of the reach of children and pets.

Response and Effectiveness

Peak concentrations usually reached within 1.5 hours. Duration of effect varies among individuals, but, in general, may last from 4 to 6 hours. Only take as directed by your doctor.

References

Hydrocodone and acetaminophen [Package Insert]. Revised 02/2017. Par Pharmaceutical. https://www.drugs.com/pro/hydrocodone-and-acetaminophen.html

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

  • Disclaimer: Every effort has been made to ensure that this information is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. This drug information does not endorse drugs, diagnose patients or recommend therapy. It is an informational resource designed as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Drugs.com does not assume any responsibility for any aspect of healthcare administered with the aid of this information. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2017 Drugs.com. Revision Date: 2017-09-13 20:44:05

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