Acetaminophen and hydrocodone

Name: Acetaminophen and hydrocodone

What is the most important information I should know about acetaminophen and hydrocodone?

This medicine can slow or stop your breathing, and may be habit-forming. Use only your prescribed dose. Never share acetaminophen and hydrocodone with another person.

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 this medicine if you have used an MAO inhibitor in the past 14 days, such as isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, or tranylcypromine.

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 this medicine and call your doctor right away if you have skin redness or a rash that spreads and causes blistering and peeling.

What should I discuss with my healthcare provider before taking acetaminophen and hydrocodone?

You should not use this medicine 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 an 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.

To make sure this medicine is safe for you, tell your doctor if you have:

  • liver disease, cirrhosis, or if you drink more than 3 alcoholic beverages per day;

  • a history of alcoholism or drug addiction;

  • diarrhea, inflammatory bowel disease, bowel obstruction, severe constipation;

  • kidney disease;

  • low blood pressure, or if you are dehydrated;

  • a history of head injury, brain tumor, or stroke;

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

  • if you use a sedative like Valium (diazepam, alprazolam, lorazepam, Ativan, Klonopin, Restoril, Tranxene, Versed, Xanax, and others).

This medicine 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 this medicine.

What should I avoid while taking acetaminophen and hydrocodone?

This medication may impair your thinking or reactions. Avoid driving or operating machinery until you know how acetaminophen and hydrocodone 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.

Avoid drinking alcohol. It may increase your risk of liver damage while taking acetaminophen.

What other drugs will affect acetaminophen and hydrocodone?

Narcotic (opioid) medication can interact with many other drugs and cause dangerous side effects or death. Be sure your doctor knows if you also use:

  • other narcotic medications--opioid pain medicine or prescription cough medicine;

  • drugs that make you sleepy or slow your breathing--a sleeping pill, muscle relaxer, sedative, tranquilizer, or antipsychotic medicine; or

  • drugs that affect serotonin levels in your body--medicine for depression, Parkinson's disease, migraine headaches, serious infections, or prevention of nausea and vomiting.

This list is not complete. Other drugs may interact with acetaminophen and hydrocodone, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

Usual Adult Dose for Pain

Tablets:
Recommended dose:
Acetaminophen-hydrocodone 300 mg-5 mg: 1 to 2 tablets orally every 4 to 6 hours as needed
Acetaminophen-hydrocodone 300 mg-7.5 mg: 1 tablet orally every 4 to 6 hours as needed
Acetaminophen-hydrocodone 300 mg-10 mg: 1 tablet orally every 4 to 6 hours as needed
Maximum dose:
Acetaminophen-hydrocodone 300 mg-5 mg: 8 tablets daily
Acetaminophen-hydrocodone 300 mg-7.5 mg: 6 tablets daily
Acetaminophen-hydrocodone 300 mg-10 mg: 6 tablets daily

Liquid:
Recommended dose:
15 mL (acetaminophen-hydrocodone 325 mg-7.5 mg) orally every 4 to 6 hours as needed
Maximum dose: 6 tablespoonfuls daily

Comments:
Dosage should be adjusted according to severity of the pain and the response of the patient. Tolerance to hydrocodone can develop with continued use and the incidence of side effects is dose related.

Approved indication: For the relief of moderate to moderately severe pain

Renal Dose Adjustments

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

Precautions

Consult WARNINGS section for dosing related precautions.

Dialysis

Dosage adjustments in dialysis patients should be done cautiously.

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.
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