What is Vicodin
Vicodin also known as Hydrocodone/paracetamol, also known as hydrocodone/acetaminophen, is the combination of the pain medications hydrocodone and paracetamol. It is used to treat moderate to severe pain. It is taken by mouth. Recreational use is common in the United
Dosage should be adjusted according to the severity of the pain and the response of the patient. However, it should be kept in mind that tolerance to hydrocodone can develop with continued use and that the incidence of untoward effects is dose related.
VICODIN® (Hydrocodone Bitartrate and Acetaminophen Tablets, USP 5 mg/300 mg): The usual adult dosage is one or two tablets every four to six hours as needed for pain. The total daily dosage should not exceed 8 tablets.
VICODIN ES® (Hydrocodone Bitartrate and Acetaminophen Tablets, USP 7.5 mg/300 mg): The usual adult dosage is one tablet every four to six hours as needed for pain. The total daily dosage should not exceed 6 tablets.
VICODIN HP® (Hydrocodone Bitartrate and Acetaminophen Tablets, USP 10 mg/300 mg): The usual adult dosage is one tablet every four to six hours as needed for pain. The total daily dosage should not exceed 6 tablets.
How it works
- Vicodin is a brand (trade) name for a combination tablet containing acetaminophen and hydrocodone.
- 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, which inhibits prostaglandin synthesis. Hydrocodone binds to specific receptors known as mu opioid receptors that block pain signals on their way to the brain.
- Hydrocodone belongs to the group of drugs known as opioids or opioid analgesics. Hydrocodone may also be called a narcotic analgesic. Therefore, Vicodin belongs to the group of medicines known as combination narcotic analgesics.
- May be used to treat moderate-to-moderately severe pain that is unrelieved by nonopioid analgesics.
- Vicodin can also help stop a dry cough (hydrocodone component).
- The combination of acetaminophen and hydrocodone is more effective than either drug alone.
- Generic Vicodin is available under the name acetaminophen/hydrocodone.
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:
- Stomach upsets including nausea, vomiting, and constipation; shortness of breath; dizziness; low blood pressure; and headache (hydrocodone component).
- Drowsiness which may impair reaction skills and affect a person’s ability to drive or operate machinery (hydrocodone component). Alcohol should be avoided.
- Rarely, serious, life-threatening, breathing problems (hydrocodone component).
- Vicodin is habit-forming and potentially abusable (attributable to the hydrocodone component). Vicodin should only be used short-term at the lowest effective dose when other nonopioid analgesics are not effective. Legitimate supplies of Vicodin may be sought out by drug seekers.
- Tolerance may develop if taken for long periods of time (hydrocodone component); which means that Vicodin may no longer work at the prescribed dosage. Talk to your doctor if this happens.
- Rarely, liver failure especially at dosages greater than 4000mg/day (acetaminophen component).
- The hydrocodone component of Vicodin may interact with a number of other drugs, including those that affect hepatic enzymes CYP 2D6, and those that also cause respiratory depression (such as other opioids, benzodiazepines, and alcohol).
- 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 some people including those who have exhibited previous cross-sensitivity to other opioid analgesics, with head injury or raised intracranial pressure, with lung disease, with acute abdominal conditions or postoperatively.
- May be taken with or without food.
- Intended for short-term use only. Long-term use may lead to addiction and dependence. Vicodin may need to be discontinued slowly depending on the duration of use. Talk to your doctor about a tapering schedule.
- May cause drowsiness which may impair your reaction skills and affect your ability to drive or operate machinery (hydrocodone component). Avoid alcohol.
- Avoid alcohol while taking Vicodin. Alcohol can contribute to the sedative effects of hydrocodone and also increase the risk of respiratory depression.
- Different strengths of Vicodin are available. Make sure you take the correct tablet and do not exceed the recommended dosage.
- Vicodin may make you feel dizzy when getting up from a lying down or sitting position to standing. Always get up slowly, but talk with your doctor if this dizziness results in a fall.
- Vicodin may cause constipation which can be relieved with laxatives. Talk to your doctor if you experience any troublesome side effects.
- Seek urgent medical advice if you experience any excessive sedation, breathing difficulties, wheezing, rash, itching, or facial swelling. Call emergency services if you suspect somebody has overdosed on Vicodin (pinpoint pupils may be indicative of overdosage).
- Tell your doctor if you think you have become addicted to this combination drug or the usual dosage does not appear to be working.
- Avoid taking extra acetaminophen while taking Vicodin. Be especially cautious when taking cough and cold remedies in addition to Vicodin. Some of these may also contain acetaminophen. Always check with your doctor or pharmacist that products you buy over-the-counter are compatible with Vicodin
- Do not use during pregnancy and breastfeeding unless specifically recommended by your doctor.
- Keep this medicine in a safe place and out of the reach of children and pets. Accidental ingestion can result in a fatal overdose of Vicodin, especially in children, and acetaminophen is toxic to dogs and cats. Never give Vicodin to children without a doctor’s advice.
Response and Effectiveness
- It takes approximately 1.3 hours for the hydrocodone component of Vicodin to reach peak concentrations. Hydrocodone is metabolized entirely by the CYP2D6 hepatic enzymes to hydromorphone. The pain and cough-relieving effects of hydrocodone last for three to four hours; however it may take a day or two for hydrocodone and its metabolite hydromorphone to be completely cleared by the body.
- The peak analgesic effects of acetaminophen are reached within 30 to 60 minutes of oral administration and last for three to four hours.
- Note that up to 10% of Caucasians, 6% of Mexican-Americans, and 5% of African-Americans are poor metabolizers at CYP2D6 and are unlikely to metabolize hydrocodone into hydromorphone, which may limit its effect. 30% of Ethiopians, 20% of Saudis, 10% of Portuguese and Greeks, and 4% of North Americans are ultra-rapid metabolizers at CYP 2D6 and may experience excessive side effects, such as extreme sleepiness, confusion, and shallow breathing, even with normal dosages of Vicodin.
Before taking this medicine
You should not use Vicodin if you are allergic to acetaminophen (Tylenol) or hydrocodone, or if you have recently used alcohol, sedatives, tranquilizers, or other narcotic medications.
Do not use this medicine if you have taken a MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, phenelzine, rasagiline, selegiline, and tranylcypromine.
Some medicines can interact with hydrocodone and cause a serious condition called serotonin syndrome. Be sure your doctor knows if you also take medicine for depression, mental illness, Parkinson’s disease, migraine headaches, serious infections, or prevention of nausea and vomiting. Ask your doctor before making any changes in how or when you take your medications.
You should not use Vicodin if you have:
- severe asthma or breathing problems; or
- a blockage in your stomach or intestines.
To make sure Vicodin is safe for you, tell your doctor if you have ever had:
- breathing problems, sleep apnea;
- liver disease;
- a drug or alcohol addiction.
Vicodin is more likely to cause breathing problems in older adults and people who are severely ill, malnourished, or otherwise debilitated.
If you use narcotic 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 habit-forming medicine may need medical treatment for several weeks. Tell your doctor if you are pregnant or plan to become pregnant.
Acetaminophen and hydrocodone can pass into breast milk and may harm a nursing baby. You should not breast-feed while using Vicodin.
How should I take Vicodin?
Take Vicodin exactly as prescribed. Follow all directions on your prescription label. Never take this medicine in larger amounts, or for longer than prescribed. An overdose can damage your liver or cause death. Tell your doctor if the medicine seems to stop working as well in relieving your pain.
Hydrocodone may be habit-forming, even at regular doses. Never share Vicodin with another person, especially someone with a history of drug abuse or addiction. MISUSE OF NARCOTIC MEDICINE CAN CAUSE ADDICTION, OVERDOSE, OR DEATH, especially in a child or other person using the medicine without a prescription. Selling or giving away Vicodin is against the law.
If you need surgery or medical tests, tell the doctor ahead of time that you are using this medicine. You may need to stop using the medicine for a short time.
Do not stop using Vicodin suddenly after long-term use, or you could have unpleasant withdrawal symptoms. Ask your doctor how to safely stop using Vicodin.
Store at room temperature away from moisture and heat. Keep track of the amount of medicine used from each new bottle. Hydrocodone is a drug of abuse and you should be aware if anyone is using your medicine improperly or without a prescription.
Always check your bottle to make sure you have received the correct pills (same brand and type) of medicine prescribed by your doctor.
What happens if I miss a dose?
Since Vicodin is taken as needed, you may not be on a dosing schedule. If you are taking the medication regularly, take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not use extra medicine to make up the missed dose.
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 hydrocodone can be fatal.
The first signs of an acetaminophen overdose 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 symptoms may also include extreme drowsiness, pinpoint pupils, cold and clammy skin, muscle weakness, fainting, weak pulse, slow heart rate, coma, blue lips, shallow breathing, or no breathing
What should I avoid while taking Vicodin?
Vicodin may impair your thinking or reactions. Avoid driving or operating machinery until you know how Vicodin will affect you. Dizziness or severe drowsiness can cause falls or other accidents.
Ask a doctor or pharmacist before using any other cold, allergy, pain, or sleep medication. Acetaminophen (sometimes abbreviated as APAP) is contained in many combination medicines. Taking certain products together can cause you to get too much acetaminophen which can lead to a fatal overdose. Check the label to see if a medicine contains acetaminophen or APAP.
Vicodin side effects
Get emergency medical help if you have signs of an allergic reaction to Vicodin: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
In rare cases, acetaminophen may cause a severe skin reaction that can be fatal. This could occur even if you have taken acetaminophen in the past and had no reaction. Stop taking Vicodin and call your doctor right away if you have skin redness or a rash that spreads and causes blistering and peeling. If you have this type of reaction, you should never again take any medicine that contains acetaminophen.
Call your doctor at once if you have:
- noisy breathing, sighing, shallow breathing, breathing that stops during sleep;
- a light-headed feeling, like you might pass out;
- confusion, unusual thoughts or behavior;
- seizure (convulsions);
- easy bruising or bleeding;
- infertility, missed menstrual periods;
- impotence, sexual problems, loss of interest in sex;
- liver problems – nausea, upper stomach pain, itching, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes); or
- low cortisol levels – nausea, vomiting, loss of appetite, dizziness, worsening tiredness or weakness.
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.
Common Vicodin side effects include:
- drowsiness, headache;
- upset stomach, constipation.
hat other drugs will affect Vicodin?
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.
Vicodin can interact with many other drugs and cause dangerous side effects or death. Be sure your doctor knows if you also use:
- cold or allergy medicines, bronchodilator asthma/COPD medication, or a diuretic (“water pill”);
- medicines for motion sickness, irritable bowel syndrome, or overactive bladder;
- other narcotic medications – opioid pain medicine or prescription cough medicine;
- a sedative like Valium – diazepam, alprazolam, lorazepam, Xanax, Klonopin, Versed, and others.
Hydrocodone can slow or stop your breathing. Never use this medicine in larger amounts, or for longer than prescribed. Narcotic pain medicine may be habit-forming, even at regular doses. Never share Vicodin with another person, especially someone with a history of drug abuse or addiction. Keep the medication in a place where others cannot get to it.
MISUSE OF NARCOTIC MEDICINE CAN CAUSE ADDICTION, OVERDOSE, OR DEATH, especially in a child or other person using the medicine without a prescription.
Do not use Vicodin if you have used a MAO inhibitor in the past 14 days, such as isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, or tranylcypromine.
Do not take more of Vicodin than is recommended. An overdose of acetaminophen can damage your liver or cause death. Call your doctor at once if you have nausea, pain in your upper stomach, itching, loss of appetite, dark urine, clay-colored stools, or jaundice (yellowing of your skin or eyes).
Stop taking Vicodin and call your doctor right away if you have skin redness or a rash that spreads and causes blistering and peeling.
Remember, keep this and all other medicines out of the reach of children, never share your medicines with others and use Vicodin only for the indication prescribed.
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.