About Vicodin
Vicodin is a mix of a narcotic and non-narcotic pain medication,
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 isn't
clear just how acetaminophen works to ease pain.
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.
This narcotic pain medication has the potential to be habit
forming. Take no more than your doctor's guidelines suggest,
as there is a risk of overdose. You may also be at risk for
overdose if you use Vicodin in combination with alcohol, other
prescription or over the counter pain medication, or other
medication that magnifies it's effects, either increasing
central nervous system depression or putting undue stress
on the liver.
Vicodin is only available by prescription.
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 Addison'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 narcotic 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.
- Desyrel (trazodone) - Risk of additive
CNS depression.
- 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.
- Norflex (orphenadrine) - Risk of oversedation.
- 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), Skelaxin (metaxalone), 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 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 Watson
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This document is provided for information only. It is not a substitute for consultation with a physician, either to diagnose symptoms or prescribe treatment. Any dosages mentioned are general guidelines only, please follow the directions of your doctor or pharmacist exactly when taking medication. We have made every effort to ensure that this information is accurate, but only your doctor can say if a medication, or drug combination, is safe for you. Information intended for US residents only.
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