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Lortab Patient Tips

Medically reviewed on Oct 31, 2017 by C. Fookes, BPharm.

How it works

  • Lortab is a brand name for a combination acetaminophen/hydrocodone tablet. Acetaminophen and hydrocodone are two different pain-relieving medicines with two different mechanisms of action.
  • Experts aren't sure exactly how acetaminophen works, but suspect it blocks a specific type of cyclo-oxygenase (COX) enzyme, located mainly in the brain. Hydrocodone is metabolized to hydromorphone (the active component) which binds to specific receptors known as opioid receptors that block pain signals on their way to the brain.
  • Lortab belongs to the group of medicines known as combination narcotic analgesics. It may also be called a combination opioid analgesic.

Upsides

  • Effective combination drug for the short-term relief of moderate-to-moderately severe pain. Use is limited by the addiction and dependence potential of hydrocodone component. Hydrocodone can also cause constipation.
  • Some people find taking fixed-dose combination tablets easier to take than taking two different medicines.
  • Lortab is available as a generic under the name Acetaminophen/Hydrocodone.

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 (a component of Lortab) 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 (a component of Lortab) does not have any appreciable anti-inflammatory action.
  • Hydrocodone (a component of Lortab) is habit-forming and potentially abusable. Lortab 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.
  • The dosage of acetaminophen contained in one tablet of Lortab may not provide an effective dosage of acetaminophen; however, people taking Lortab should not supplement with extra acetaminophen.
  • Rarely, serious, life-threatening, breathing problems may occur attributable to the hydrocodone component. The risk is greater with higher dosages of Lortab, 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).
  • Hydrocodone is metabolized to hydromorphone by CYP2D6. Because CYP2D6 exhibits genetic polymorphism, there is potentially a wide interindividual variation in the way individuals respond to hydrocodone.
  • 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

Lortab is a combination analgesic used for the short-term relief of moderate-to-moderately severe pain; however, use is limited by the dependence and addiction potential of the hydrocodone component.

Tips

  • Short-term use only. Not recommended for long-term use. Do not exceed the recommended total daily dosage.
  • Do not drive or perform other hazardous tasks if Lortab makes you drowsy or impairs your reaction skills (attributable to the hydrocodone component). Avoid alcohol.
  • Different strengths of Lortab are available. Make sure you take the correct tablet and do not exceed the recommended dosage.
  • Seek urgent medical help 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.
  • Avoid taking extra acetaminophen while taking Lortab (acetaminophen may be "hidden" in some combination cold and flu treatments).
  • Keep out of the reach of children and pets.

Response and Effectiveness

  • Peak effects of acetaminophen (a component of Lortab) are reached within 30-60 minutes of administration and the analgesic effects of acetaminophen last between three and four hours. Peak effects of hydrocodone (a component of Lortab) are reached within 1.3 hours and the effects last for four to six hours.
  • Once absorbed, hydrocodone is metabolized by hepatic enzymes CYP2D6 to hydromorphone which is the major metabolite of hydrocodone and has an approximately 10 to 33 fold higher binding affinity (in some cases as much as a 100-fold higher binding affinity) for the mu receptor than hydrocodone. Other hepatic enzymes are involved in the elimination of metabolized hydrocodone.
  • Because CYP2D6 exhibits genetic polymorphism, there is potentially a wide interindividual variation in the way individuals respond to hydrocodone.

References

Lortab (hydrocodone bitartrate and acetaminophen) [Package Insert]. Revised 10/2014. UCB, Inc. https://www.drugs.com/pro/lortab.html

  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Lortab 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: 2017-11-01 00:19:24

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