Vicodin (hydrocodone bitartrate and acetaminophen [Tylenol])

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Vicodin (hydrocodone bitartrate and acetaminophen [Tylenol])

Other Names: Vicodin ES, Vicodin HP, hydrocodone apap 5/500, Anexsia, Co-Gesic, Hydrocet, Lorcet, Lortab, Maxidone, Norco, Stagesic, Ugesic, Vendone, Vanacet, Zydone

About Vicodin | Hydrocodone

Vicodin is a mix of hydrocodone, a narcotic (semi-synthetic opiate) pain medication (analgesic), and acetaminophen (a non-narcotic analgesic), which relieves pain better than either medication taken alone. Hydrocodone acts on the central nervous system and smooth muscle tissue, slowing the central nervous system. It is not clear exactly how acetaminophen works to ease pain. Vicodin is only available by prescription.

Vicodin, Vicodin ES, and Vicodin-HP are all formulated with different dosages of hydrocodone and acetaminophen. Vicodin has few side effects when taken as recommended by your doctor, but some cautions should be observed.

Interactions may occur with certain medications that could alter or increase the effect of either Vicodin, or the other medication.

Vicodin Side Effects

Vicodin side effects are usually mild, but as with all narcotic pain medications, it can impair performance. If you feel lightheaded or nauseous, lying down may alleviate these symptoms. Driving or operating heavy machinery is not advised, as Vicodin can interfere with mental and physical abilities. Become familiar with your reaction to Vicodin before performing potentially hazardous tasks while taking it.

Vicodin side effects are typically dosage related, and may increase even if the medication is no longer as effective at relieving pain.

Cough Reflex: Hydrocodone is a cough suppressant, and should be used with care in patients with heart disease, who have just undergone an operation, or have a lung disease.

Breathing: High doses of Vicodin, or patient sensitivity, can cause breathing irregularity or other respiratory depression. If you have breathing difficulties, Vicodin may not be right for you.

Head Injuries: Hydrocodone's narcotic effects can cause an increase of pressure in the cerebral and spinal fluid. If a patient has suffered a head injury, both the pressure increase and the respiratory suppression can be exaggerated. Hydrocodone may interfere with an accurate diagnosis or treatment of head injuries.

Acute Abdominal Conditions: Vicodin may interfere with diagnosis and treatment of acute abdominal conditions.

Dependence: Mental and physical dependence can develop if Vicodin is used for long periods of time. Long use of hydrocodone can create a tolerance condition where the medication no longer works at the initial dosage. Acetaminophen is not known to cause dependence.

Hearing: In extremely rare cases, long-term over dosage is suspected to have caused hearing impairment. Therapeutic use of Vicodin at recommended doses, for the treatment of temporary conditions, has not been seen to produce this effect.

Overdose: Hydrocodone overdose is characterized by slowed breathing, extreme drowsiness progressing to stupor or coma, limp muscles, or cold, clammy skin. Severe hydrocodone overdose may result in death due to cardiac arrest or stopped breathing. Acetaminophen overdose can result in severe liver poisoning, but rarely has this effect in doses under 10g. An overdose of acetaminophen may not show symptoms for two to four days, but must be treated within twenty-for hours to prevent liver damage or death. Seek emergency medical treatment immediately if you suspect an overdose of this pain medication. Vicodin dosage for adults should be kept to a maximum of 8 tablets per day. Severe side effects very rarely occur at this dosage of Vicodin.

Cautions: Vicodin should be prescribed with caution to patients with 's disease or kidney, liver, thyroid, or urogenital tract problems. Tell your doctor if you have ever had an allergic reaction to Vicodin, or any other medication.

Vicodin Interactions

The hydrocodone in Vicodin works by slowing the central nervous system. It should be used with caution with other drugs that have similar effects. It can change or increase the effects of certain drugs, and your physician should be advised if you are taking any of the following.

Alcohol - Hydrocodone and alcohol can accelerate central nervous system depression. Avoid mixing the two, as this could potentially result in a fatal overdose. Alcohol use combined with acetaminophen can accelerate or increase the risk of liver damage or stomach bleeding.

Antihistamines like Tavist

Aspirin (or any salicylate, such as salicylamide, or salicylic acid) can cause kidney or liver damage when taken in high doses, and over long periods of time, in combination with acetaminophen. When taken in the recommended doses, for a short time, it has not been seen to produce this effect.

Benzodiazepines (a class of antidepressants, anti-panic agents, and muscle relaxants) such as Valium (diazepam), Halcion (triazolam), Restoril (temazepam), Librium(chlordiazepoxide), Xanax (alprazolam), Tranxene-SD (clorazepate), Paxipam (halazepam), ProSom (estazolam), Klonopin (clonazepam), and others, should be used cautiously with Vicodin.

MAO inhibitors - Hydrocodone must not be mixed with MAO (monoamine oxidase) inhibitors such as the antidepressants Nardil, Marplan, or Parnate. It should not be used within 2 weeks of stopping these medications.

Narcotic/opioid pain medications of any other kind, like Codeine, Demerol (meperidine), Buprenex (buprenorphine), Darvon (propoxyphene), Dilaudid (hydromorphone), MS Contin or Kadian (morphine), nalbuphine, Percocet (oxycodone, acetaminophen), Stadol (butorphanol), Talwin compound (pentazocine), Vicoprofen (hydrocodone, ibuprofen), or OxyContin (oxycodone) should not be mixed with Vicodin.

Oral contraceptives - These may interact with acetaminophen

Pain medication - Do not mix Vicodin with any over the counter pain medication, as this will increase the risk of side effects. If your doctor has prescribed a rotating schedule of different types of pain medication, wait the recommended amount of time between doses. Check any cold or flu medication you may need to take to be sure it does not contain additional pain medication.

Protease inhibitors like AZT (zidovudine) or Norvir (ritonavir) - Narcotic pain medication may increase blood levels of these drugs, potentially making side effects more severe.

Sedatives like Fioricet (butalbital, acetaminophen, and caffeine), Fiorinal (butalbital, aspirin, and caffeine), Phenobarbitol, Seconal, or other barbiturates.

Skeletal muscle relaxants such as Flexeril (cyclobenzaprine), Soma (carisoprodol), or Robaxin (methocarbamol) may cause oversedation in combination with this medication.

Sleep medication like Ambien (zolpidem), Sonata (zaleplon), or over the counter sleeping pills should be used with hydrocodone only as, and if, advised by your doctor.

Tranquilizers such as Haldol (haloperidol), Mellaril (thioridazine), or Thorazine (chlorpromazine) may cause oversedation.

Trexan (naltrexone) - Causes narcotic pain medication to be ineffective.

Tricyclic antidepressants such as Elavil (amitriptyline), Asendin (amoxapine), Anafranil (clomipramine), Pertofrane or Norpramin (desipramine), Sinequan (doxepin), Tofranil (imipramine), Aventyl or Pamelor (nortriptyline), Vivactil (protriptyline), and Surmontil (trimipramine), may increase the central nervous system suppressant effects from either the antidepressant, or the hydrocodone in Vicodin.

Ultram (tramadol) - Can increase the likelihood of respiratory depression when taken with hydrocodone.

In addition to the above medications, tell your doctor if you are using any other major antidepressants, pain medications, or central nervous system depressants in combination with hydrocodone. Be cautious about taking Vicodin with any medicine warning that it 'may cause drowsiness.'

Vicodin Dosages

Vicodin, or hydrocodone apap, comes in the following prescription dosages, and is usually taken every 4-6 hours:

Vicodin - (5 mg hydrocodone, 500 mg acetaminophen) Typical doses of Vicodin are 1-2 tablets, up to 8 tablets per day.

Vicodin ES - (7.5 mg hydrocodone, 750 mg acetaminophen) Typical doses of Vicodin ES are one tablet, up to 5 tablets per day.

Vicodin HP - (10 mg hydrocodone, 660 mg acetaminophen) Typical doses of Vicodin HP are one tablet, up to 6 tablets per day.

The dosage recommendations above are for Vicodin brand tablets only. If your prescription is for another brand of hydrocodone, such as Lorcet, Lortab, or Maxidone, the dosages may be different. Higher doses of acetaminophen could increase the risk of severe liver toxicity. Do not exceed these guidelines without the express recommendation of your doctor.

If you miss a dose of Vicodin, take it as soon as you remember. If you are within an hour or so of your next dose, skip the missed dose and go back to your schedule. Taking double doses of Vicodin is not recommended, as it increases the risk of side effects and drug interactions. Do not take another dose of Vicodin if you feel dizzy, or lethargic, particulary if you are taking it in combination with other medication.

Vicodin and Pregnancy

Vicodin has not been well studied for effects during pregnancy. Caution is advised in prescribing vicodin to pregnant women.

Babies born to mothers taking opiate pain medications like hydrocodone can experience withdrawal symptoms after birth. The hydrocodone withdrawal symptoms in the baby may include: irritability, hyperactivity, tremors, faster breathing, increased stools, fever, vomiting, sneezing, and yawning. The severity of the symptoms is not always tied to how much, or how long the mother used hydrocodone (or other opiate).

Vicodin and Children

Vicodin has not been well studied for effects on children.

Vicodin and Seniors

Vicodin does not seem to affect the senior population differently, but lower starting dosages are recommended. There is a higher occurrence among the elderly of 's disease or kidney, liver, thyroid, or urogenital tract problems, and these conditions indicate careful administration of this pain medication. Hydrocodone should be prescribed with care to these patients, and the elderly may have to be watched more carefully for respiratory depression. Vicodin should be used cautiously with any patient in a weakened condition.

What Vicodin Treats

Vicodin is commonly prescribed as a medication for moderate to somewhat severe pain.

Vicodin is a trademark of Knoll Pharmaceuticals, now Abbott Laboratories Vicodin ES and Vicodin HP are also trademarks of Abbott Laboratories Lorcet is a trademark of Forest Lortab is a trademark of UCB Maxidone is a trademark of Back to top

This document is provided for information only; it is not intended to diagnose symptoms, prescribe treatment, or to substitute for consultation with a physician. While we have made every effort to ensure that this information is accurate and extensive, only your doctor can tell you if a medication, or drug combination, is safe for you. Information intended for US residents only.