Acetaminophen and hydrocodone

Name: Acetaminophen and hydrocodone

What is acetaminophen and hydrocodone?

Hydrocodone is an opioid pain medication. An opioid is sometimes called a narcotic.

Acetaminophen is a less potent pain reliever that increases the effects of hydrocodone.

Acetaminophen and hydrocodone is a combination medicine used to relieve moderate to severe pain.

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

Important information

Tell your doctor if you drink more than three alcoholic beverages per day or if you have ever had alcoholic liver disease (cirrhosis). You may not be able to take medication that contains acetaminophen.

Hydrocodone may be habit-forming and should be used only by the person it was prescribed for. Keep the medication in a secure place where others cannot get to it. Acetaminophen and hydrocodone can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.

Tell your doctor if the medicine seems to stop working as well in relieving your pain.

Before taking this medicine

Do not use this medication if you are allergic to acetaminophen (Tylenol) or hydrocodone. Hydrocodone may be habit-forming and should be used only by the person it was prescribed for. Acetaminophen and hydrocodone should never be given to another person, especially someone who has a history of drug abuse or addiction. Keep the medication in a secure place where others cannot get to it.

Before using acetaminophen and hydrocodone, tell your doctor if you are allergic to any drugs, or if you have:

  • asthma, COPD, sleep apnea, or other breathing disorders;

  • liver or kidney disease;

  • a history of head injury or brain tumor;

  • low blood pressure;

  • a stomach or intestinal disorder;

  • underactive thyroid;

  • Addison's disease or other adrenal gland disorder;

  • curvature of the spine;

  • mental illness; or

  • a history of drug or alcohol addiction.

If you have any of these conditions, you may not be able to use acetaminophen and hydrocodone, or you may need a dosage adjustment or special tests during treatment.

Tell your doctor if you drink more than three alcoholic beverages per day or if you have ever had alcoholic liver disease (cirrhosis). You may not be able to take medication that contains acetaminophen.

FDA pregnancy category C. This medication may be harmful to an unborn baby, and could cause breathing problems or addiction/withdrawal symptoms in a newborn. Tell your doctor if you are pregnant or plan to become pregnant during treatment. Acetaminophen and hydrocodone can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

Older adults may be more sensitive to the effects of this medicine.

What should I avoid?

This medication can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert. Do not use any other over-the-counter cough, cold, allergy, or pain medication without first asking your doctor or pharmacist. Acetaminophen is contained in many medicines available over the counter. If you take certain products together you may accidentally take too much acetaminophen. Read the label of any other medicine you are using to see if it contains acetaminophen. Avoid drinking alcohol while taking acetaminophen and hydrocodone. Alcohol may increase your risk of liver damage while taking acetaminophen. Cold or allergy medicine, narcotic pain medicine, sleeping pills, muscle relaxers, antidepressants, or seizure medication can add to sleepiness caused by hydrocodone, or could slow your breathing. Tell your doctor if you need to use any of these other medicines while you are taking acetaminophen and hydrocodone.

Liver Dose Adjustments

Dosage adjustments in patients with liver dysfunction should be done cautiously.

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.

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).

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.

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Acetaminophen / hydrocodone Pregnancy Warnings

FDA pregnancy category: C Acetaminophen-hydrocodone should only be given during pregnancy when benefit outweighs risk.

Babies born to mothers who have been taking opioids regularly prior to delivery will be physically dependent. Withdrawal signs include irritability and excessive crying, tremors, hyperactive reflexes, increased respiratory rate, increased stools, sneezing, yawning, vomiting, and fever. FDA pregnancy category C: Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks.

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