Taking certain medications together can lead to a fatal overdose. Get emergency medical help if you have signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
Opioid medicine can slow or stop your breathing, and death may occur. 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. Serious breathing problems may be more likely in older adults and in those who are debilitated or have wasting syndrome or chronic breathing disorders.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. 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. Opioid medication can interact with many other drugs and cause dangerous side effects or death. Be sure your doctor knows if you also use:. This list is not complete. Other drugs may affect acetaminophen and hydrocodone, including prescription and over-the-counter medicines, vitamins, and herbal products.
Not all possible interactions are listed here. Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
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The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient.
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For Parents. Meet Our Providers Learn about our group of providers that has helped families for generations. Norco slide 5 of 29, Norco,. Norco slide 26 of 29, Norco,. This information does not replace the advice of a doctor. Healthwise, Incorporated, disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use.
Learn how we develop our content. Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated. Acetaminophen-Hydrocodone mg Norco slide 7 of 10, Norco ,. Norco mg slide 8 of 10, Norco mg,. Norco 7. Xodol mg mg slide 10 of 10, Xodol mg mg,. What is the most important information I should know about 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. What should I discuss with my healthcare provider before taking acetaminophen and hydrocodone?
How should I take acetaminophen and hydrocodone? What happens if I miss a dose? What happens if I overdose? What should I avoid while taking acetaminophen and hydrocodone? Avoid drinking alcohol. It may increase your risk of liver damage while taking acetaminophen.
What are the possible side effects of acetaminophen and hydrocodone? What other drugs will affect acetaminophen and hydrocodone? Where can I get more information? Your pharmacist can provide more information about acetaminophen and hydrocodone. Copyright Cerner Multum, Inc. Version: Your use of the content provided in this service indicates that you have read, understood and agree to the End-User License Agreement, which can be accessed by clicking on this link.
Top of Page. 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.
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 acetaminophen and hydrocodone? Call your doctor at once if you have: shallow breathing, slow heartbeat; 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.
Common side effects include: drowsiness, headache; upset stomach, constipation; blurred vision; or dry mouth. 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.
The withdrawal signs include irritability and excessive crying, tremors, hyperactive reflexes, increased respiratory rate, increased stools, sneezing, yawning, vomiting, and fever. The intensity of the syndrome does not always correlate with the duration of maternal opioid use or dose. There is no consensus on the best method of managing withdrawal. As with all narcotics, administration of hydrocodone bitartrate and acetaminophen tablets to the mother shortly before delivery may result in some degree of respiratory depression in the newborn, especially if higher doses are used.
Acetaminophen is excreted in breast milk in small amounts, but the significance of its effects on nursing infants is not known. It is not known whether hydrocodone is excreted in human milk. Because many drugs are excreted in human milk and because of the potential for serious adverse reactions in nursing infants from hydrocodone and acetaminophen, a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother.
Clinical studies of hydrocodone bitartrate and acetaminophen tablets did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently from younger subjects.
Other reported clinical experience has not identified differences in responses between the elderly and younger patients. In general, dose selection for an elderly patient should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic, renal, or cardiac function, and of concomitant disease or other drug therapy. Hydrocodone and the major metabolites of acetaminophen are known to be substantially excreted by the kidney.
Because elderly patients are more likely to have decreased renal function, care should be taken in dose selection, and it may be useful to monitor renal function. Hydrocodone may cause confusion and over-sedation in the elderly; elderly patients generally should be started on low doses of hydrocodone bitartrate and acetaminophen tablets and observed closely.
The most frequently reported adverse reactions are lightheadedness, dizziness, sedation, nausea and vomiting. These effects seem to be more prominent in ambulatory than in nonambulatory patients, and some of these adverse reactions may be alleviated if the patient lies down. Central Nervous System: Drowsiness, mental clouding, lethargy, impairment of mental and physical performance, anxiety, fear, dysphoria, psychic dependence, mood changes.
Gastrointestinal System: Prolonged administration of hydrocodone bitartrate and acetaminophen tablets may produce constipation. Genitourinary System: Ureteral spasm, spasm of vesical sphincters and urinary retention have been reported with opiates. Special Senses: Cases of hearing impairment or permanent loss have been reported predominantly in patients with chronic overdose. The following adverse drug events may be borne in mind as potential effects of acetaminophen: allergic reactions, rash, thrombocytopenia, agranulocytosis.
Hydrocodone bitartrate and acetaminophen tablets, and other opioids, used in analgesia can be abused and are subject to criminal diversion. Addiction is a primary, chronic, neurobiologic disease, with genetic, psychosocial, and environmental factors influencing its development and manifestations. It is characterized by behaviors that include one or more of the following: impaired control over drug use, compulsive use, continued use despite harm, and craving.
Drug addiction is a treatable disease utilizing a multidisciplinary approach, but relapse is common. Drug-seeking tactics include emergency calls or visits near the end of office hours, refusal to undergo appropriate examination, testing or referral, repeated "loss" of prescriptions, tampering with prescriptions and reluctance to provide prior medical records or contact information for other treating physician s.
Abuse and addiction are separate and distinct from physical dependence and tolerance. Physical dependence usually assumes clinically significant dimensions only after several weeks of continued opioid use, although a mild degree of physical dependence may develop after a few days of opioid therapy. Tolerance, in which increasingly large doses are required in order to produce the same degree of analgesia, is manifested initially by a shortened duration of analgesic effect, and subsequently by decreases in the intensity of analgesia.
The rate of development of tolerance varies among patients. Physicians should be aware that abuse of opioids can occur in the absence of true addiction and is characterized by misuse for non-medical purposes, often in combination with other psychoactive substances. Hydrocodone bitartrate and acetaminophen tablets, like other opioids, may be diverted for non-medical use. Record-keeping of prescribing information, including quantity, frequency, and renewal requests is strongly advised. Proper assessment of the patient, proper prescribing practices, periodic re-evaluation of therapy, and proper dispensing and storage are appropriate measures that help to limit abuse of opioid drugs.
Following an acute overdosage, toxicity may result from hydrocodone or acetaminophen. In severe overdosage, apnea, circulatory collapse, cardiac arrest and death may occur.
In acetaminophen overdosage: dose-dependent, potentially fatal hepatic necrosis is the most serious adverse effect. Renal tubular necrosis, hypoglycemic coma, and thrombocytopenia may also occur. Early symptoms following a potentially hepatotoxic overdose may include: nausea, vomiting, diaphoresis and general malaise. Clinical and laboratory evidence of hepatic toxicity may not be apparent until 48 to 72 hours post-ingestion.
In adults, hepatic toxicity has rarely been reported with acute overdoses of less than 10 grams, or fatalities with less than 15 grams. A single or multiple overdose with hydrocodone and acetaminophen is a potentially lethal polydrug overdose, and consultation with a regional poison control center is recommended. Immediate treatment includes support of cardiorespiratory function and measures to reduce drug absorption.
Vomiting should be induced mechanically, or with syrup of ipecac, if the patient is alert adequate pharyngeal and laryngeal reflexes. The first dose should be accompanied by an appropriate cathartic. If repeated doses are used, the cathartic might be included with alternate doses as required. Hypotension is usually hypovolemic and should respond to fluids. Vasopressors and other supportive measures should be employed as indicated.
A cuffed endotracheal tube should be inserted before gastric lavage of the unconscious patient and, when necessary, to provide assisted respiration. Meticulous attention should be given to maintaining adequate pulmonary ventilation.
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