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Metabolism Hepatic Elimination half-life 4-8 hours Excretion {{{excretion}}} Pregnancy category Category C (USA) Legal status Class A (UK), Schedule II/III (USA) Routes of administration Oral Hydrocodone or dihydrocodeinone (marketed as Vicodin, Anexsia, Dicodid, Hycodan, Hycomine, Lorcet, Lortab, Norco, Hydroco, Tussionex, Vicoprofen) is an opioid derived from either of the naturally occurring opiates codeine or thebaine. Hydrocodone is an orally active narcotic analgesic and antitussive. Sales and production of this drug have increased significantly in recent years, as have diversion and illicit use. Hydrocodone is commonly available in tablet, capsule and syrup form. Hydrocodone Bitrate 10mg/ Acetaminophen 650mgAs a narcotic, hydrocodone relieves pain by binding to opioid receptors in the brain and spinal cord. It may be taken with or without food. When taken with alcohol, it can intensify drowsiness. It may interact with monoamine oxidase inhibitors, as well as other drugs that cause drowsiness. It is in FDA pregnancy category C: its effect on an embryo or fetus is not clearly known and pregnant women should consult their physicians before taking it. Common side effects include dizziness, lightheadedness, nausea, drowsiness, euphoria, vomiting, and constipation. Some less common side effects are allergic reaction, blood disorders, changes in mood, mental fogginess, anxiety, lethargy, difficulty urinating, spasm of the ureter, irregular or depressed respiration and rash. Hydrocodone can be habit-forming , and can lead to physical and psychological addiction. In the U.S., pure hydrocodone and forms containing more than 15 mg per dosage unit are called hydrocodone compounds and are considered Schedule II drugs. Those containing less than 15 mg per dosage unit are Schedule III drugs. Hydrocodone is typically found in combination with other drugs such as paracetamol (acetaminophen), aspirin, ibuprofen and homatropine methylbromide. In the UK it is listed as a Class A drug under the Misuse of Drugs Act 1971. Overdosing Risks The presence of acetaminophen in hydrocodone-containing products deters many drug users from taking excessive amounts. However, some users will get around this by extracting a portion of the acetaminophen using hot/cold water, taking advantage of the water-soluble element of the drug. It is not uncommon for addicts to have liver problems from consuming excessive amounts of acetaminophen over a long period of time; taking 10 to 15 grams of acetaminophen in a period of 24 hours typically results in severe hepatotoxicity, and doses exceding 15 grams a day have been reported as fatal.[1] It is this factor that leads many addicts to use only single entity opiates such as OxyContin. Daily consumption of hydrocodone should not excede 40 milligrams. [2] Symptoms of hydrocodone overdosage include respiratory depression, extreme somnolence, coma, stupor, cold and/or clammy skin, sometimes bradycardia, and hypotension. A severe overdose may involve circulatory collapse, cardiac arrest and/or death. Hydrocodone addictions are most commonly found in contact sports, such as American football, rugby, boxing and wrestling. Pills containing Hydrocodone (by Watson Laboratories, Inc.) [3] Trademark Names Hydrocodone Bitartrate / Acetaminophen Tablets USP Appearance 2.5mg / 500mg white tablets bisected on one side & debossed with WATSON 388 on the other side Lortab 2.5/500 5mg / 400mg Zydone 5/400 5mg / 500mg white tablets bisected on one side & debossed with WATSON 349 on the other side Lortab 5/500, Vicodin 5/500 7.5mg / 325mg light orange tablets bisected on one side & debossed with WATSON 3203 on the other side Norco 7.5/325 7.5mg / 400mg Zydone 7.5/400 7.5mg / 500mg white tablets bisected on one side & debossed with WATSON 385 on the other side Lortab 7.5/500 7.5mg / 650mg pink tablets bisected on one side & debossed with WATSON 502 on the other side Anexsia 7.5/650 7.5mg / 750mg white tablets bisected on one side & debossed with WATSON 387 on the other side Vicodin ES, Vicodin 7.5/750 10mg / 325mg yellow tablets bisected on one side & debossed with WATSON 853 on the other side Norco 10/325 10mg / 400mg Zydone 10/400 10mg / 500mg blue tablets bisected on one side & debossed with WATSON 540 on the other side Lortab 10/500 10mg / 650mg light green tablets bisected on one side & debossed with WATSON 503 on the other side Lorcet10/650 10mg / 660mg white tablets bisected on one side & debossed with WATSON 517 on the other side Vicodin HP, Vicodin 10/660 10mg / 750mg yellow tablets bisected on one side & debossed with WATSON 853 on the other side Maxidone External links DEA Scheduling Information This entry is from Wikipedia, the leading user-contributed encyclopedia. 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It should not be construed to indicate that use of the drug is safe, appropriate, or effective for you. Consult your healthcare professional before using this drug. Uses This medication is a combination of a narcotic (hydrocodone) and a non-narcotic (acetaminophen) used to relieve moderate to severe pain. Hydrocodone works by binding to opioid receptors in the brain and spinal cord, and acetaminophen decreases the formation of prostaglandins, therefore relieving pain. Hydrocodone relieves pain. Acetaminophen is a less potent pain reliever that increases the effects of hydrocodone. Together, acetaminophen and hydrocodone are most commonly used to relieve moderate-to-severe pain. Acetaminophen and hydrocodone may also be used for purposes other than those listed here. How to Use Take acetaminophen and hydrocodone exactly as directed by your doctor. Take each dose with a full glass of water. Take acetaminophen and hydrocodone with food or milk if it upsets your stomach. Never take more of this medication than is prescribed for you. Too much acetaminophen and hydrocodone could be very harmful. Do not stop taking acetaminophen and hydrocodone suddenly if you have been taking it continuously for more than 5 to 7 days. Stopping suddenly could cause withdrawal symptoms and make you feel uncomfortable. Your doctor may want to gradually reduce your dose. Possible Side Effects Stop taking acetaminophen and hydrocodone and seek emergency medical attention if you experience any of the following: an allergic reaction (difficulty breathing; closing of your throat; swelling of your lips, tongue, or face; or hives); slow, weak breathing; seizures; cold, clammy skin; severe weakness or dizziness; unconsciousness; yellowing of the skin or eyes; or unusual fatigue, bleeding, or bruising. Less serious side effects may be more likely to occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome. Precautions Hydrocodone is habit forming and should only be used under close supervision if you have an alcohol or drug addiction. Before taking this medication, tell your doctor if you have kidney disease; liver disease; asthma; urinary retention; an enlarged prostate; hypothyroidism; seizures epilepsy; gallbladder disease; a head injury; or Addison's disease. Do not take this medication without first talking to your doctor if you are pregnant or breast-feeding a baby. If you are younger than 18 years of age or older than 60 years of age, you may be more likely to experience side effects from acetaminophen and hydrocodone therapy. Use extra caution. Drug Interactions Do not take acetaminophen and hydrocodone if you have taken a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), phenelzine (Nardil), or tranylcypromine (Parnate) in the last 14 days. Dangerous side effects could result. The most serious interactions affecting acetaminophen and hydrocodone are with those drugs that also cause sedation. Numerous drugs may lead to dangerous sedation if taken with acetaminophen and hydrocodone: Talk to your doctor and pharmacist before taking any prescription or over the counter medicines. Many other drugs contain acetaminophen, especially over-the-counter pain, fever, cold, and allergy medications. Notes Avoid alcohol while taking acetaminophen and hydrocodone. Alcohol will greatly increase the drowsiness and dizziness caused by acetaminophen and hydrocodone and could be dangerous. Also, acetaminophen can damage your liver if you drink three or more alcoholic beverages a day. Avoid sleeping pills, tranquilizers, sedatives, and antihistamines except under the supervision of your doctor. These medications also may cause dangerous sedation. Do not share acetaminophen and hydrocodone with others for whom it was not prescribed, since they may have a problem that is not effectively treated by this drug. Missed Dose Take the missed dose as soon as you remember. Do not take a double dose of this medication. Wait the prescribed amount of time before taking your next dose. Storage Store at room temperature away from moisture and heat. Keep this and all medications out of the reach of children. Hydrocodone Hydrocodone is an effective antitussive (anti-cough) agent, and as an opiate it is also an effective analgesic for mild to moderate pain control. Five mg of hydrocodone is equivalent to 30 mg of codeine when administered orally. Early comparisons concluded that hydrocodone and morphine were equipotent for pain control in humans. However, it is now considered that a dose of 15 mg (1/4 gr) of hydrocodone is equivalent to 10 mg (1/6 gr) of morphine. Hydrocodone is considered to be morphine-like in all respects. There are over 200 products containing hydrocodone in the U.S. In its most usual product forms hydrocodone is combined with acetaminophen (Vicodin, Lortab), but it is also combined with aspirin (Lortab ASA), ibuprofen (Vicoprofen), and antihistamines (Hycomine). Both tablet and liquid forms of hydrocodone are available (e.g., Tussionex) Hydrocodone is in Schedule II of the Controlled Substances Act. Preparations containing hydrocodone in combination with other non-narcotic medicinal ingredients are in Schedule III. Vicodin, hydrocodone in combination with acetaminophen, is a commonly abused version of hydrocodone. Vicodin, as with all narcotic analgesics, can be habit forming---causing dependence, tolerance, and withdrawal symptoms if not used as it is prescribed. Even when used as prescribed, the following effects are possible: COMMON SIDE EFFECTS MAY INCLUDE: dizziness, light-headedness, nausea, sedation, vomiting, and constipation. LESS COMMON SIDE EFFECTS: allergic reactions, blood disorders, mood changes, mental cloudiness, anxiety, lethargy, urine retention, ureteral spasm, irregular breathing, respiratory depression, and skin rash. SYMPTOMS OF OVERDOSE: bluish tinge to skin, cold and clammy skin, extreme sleepiness progressing to a possible state of unresponsiveness or coma, heart problems, heavy perspiration, kidney problems, limp muscles, liver failure, low blood pressure, nausea, slow heartbeat, troubled or slowed breathing, and vomiting. HYDROCODONE. MORE INFORMATION. BUY HYDROCODONE. * In rare cases, the use of ibuprofen has caused serious side effects. Contact your doctor immediately if you experience black, bloody or tarry stools abdominal pain bloody vomit blurred vision or other visual problems rash sudden weight gain or swelling. * Do not take other prescription or over-the-counter medications that contain ibuprofen (Motrin, Advil, others) while taking hydrocodone and ibuprofen without first talking to your doctor. * Never take more hydrocodone and ibuprofen than is prescribed for you. If your pain is not being adequately treated, talk to your doctor. * Use caution when driving, operating machinery, or performing other hazardous activities. Hydrocodone and ibuprofen may cause drowsiness or dizziness. If you experience drowsiness or dizziness, avoid these activities. * Do not drink alcohol while taking hydrocodone and ibuprofen. Alcohol may increase drowsiness or dizziness. Alcohol may also increase the risk of dangerous stomach bleeding while taking this medication. * Hydrocodone and ibuprofen may cause constipation. Drink plenty of water (six to eight full glasses a day) to lessen this side effect. Increasing the amount of fiber in your diet may also help to alleviate constipation. BUY HYDROCODONE NOW!!! What is hydrocodone and ibuprofen? The hydrocodone is a narcotic analgesic that acts in the central nervous system to relieve pain. If hydrocodone is used for a long time, it may become habit-forming (causing mental orphysical dependence). Physical dependence may lead to withdrawal side effects when you stop taking the medicine. Since hydrocodone and ibuprofen combination is only used for short-term (10 days or less) relief of pain, physical dependence will probably not occur. Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) used in this combination to relieve inflammation, swelling, and pain. 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We collect facts from name-brand reference titles for you, for free. http://www.answers.com [today's views: 1] Hydrocodone-APAP 5/500mg ( 15 tabs) (Gen. Vicodin) 2.9 Hydrocodone-APAP 5/500mg ( 30 tabs) (Gen. Vicodin) 5.9 Hydrocodone-APAP 5/500mg ( 60 tabs) (Gen. Vicodin) 10.9 Hydrocodone-APAP 5/500mg ( 90 tabs) (Gen. Vicodin) 16.9 Hydrocodone-APAP 7.5/500mg ( 30 tabs) (Gen. Lortab) 6.1 Hydrocodone-APAP 7.5/500mg ( 90 tabs) (Gen. Lortab) 18.6 Hydrocodone-APAP 7.5/500mg (120 tabs) (Gen. Lortab) 24.7 Hydrocodone-APAP 7.5/750mg ( 15 tabs) (Gen. Vicodin ES) 2.9 Hydrocodone-APAP 7.5/750mg ( 30 tabs) (Gen. Vicodin ES) 6.9 Hydrocodone-APAP 7.5/750mg ( 60 tabs) (Gen. Vicodin ES) 10.9 Hydrocodone-APAP 7.5/750mg ( 90 tabs) (Gen. Vicodin ES) 16.9 Hydrocodone-APAP 7.5/750mg (120 tabs) (Gen. Vicodin ES) 22.5 Hydrocodone-APAP 10/325 ( 30 tabs) (Gen. Norco) 9.5 Hydrocodone-APAP 10/325 ( 60 tabs) (Gen. Norco) 19.3 Hydrocodone-APAP 10/325 ( 90 tabs) (Gen. 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Acetaminophen-hydrocodone is also available as caplets. What should my health care professional know before I take acetaminophen-hydrocodone? They need to know if you have any of these conditions:; drink more than 3 alcohol-containing drinks per day; anemia; infection; heart or circulation problems; lung disease or breathing difficulties; kidney disease; liver disease; problems urinating; seizures or other neurologic disorders; hepatitis; constipation; an unusual or allergic reaction to acetaminophen, hydrocodone, other opioid analgesics, foods, dyes or preservatives; pregnant or trying to get pregnant; breast-feeding How should I take this medicine? Take acetaminophen-hydrocodone tablets or capsules by mouth. Follow the directions on the prescription label. Swallow the tablets whole with a full glass of water. You can take acetaminophen-hydrocodone with food to prevent stomach upset. Do not take your medicine more often than directed. Contact your pediatrician or health care professional regarding the use of this medicine in children. Special care may be needed. Do not share this medicine with anyone. What if I miss a dose? If you miss a dose, take it as soon as you can. If it is almost time for your next dose, take only that dose. Do not take double or extra doses. What drug(s) may interact with acetaminophen-hydrocodone?; medicines for seizures; medicines for high blood pressure; alcohol; warfarin; cimetidine; antacids Because acetaminophen-hydrocodone can cause drowsiness, other medicines that also cause drowsiness may increase this effect of acetaminophen-hydrocodone. Some other medicines that cause drowsiness are:; alcohol-containing medicines; barbiturates such as phenobarbital; certain antidepressants or tranquilizers; muscle relaxants; certain antihistamines used in cold medicines Tell your prescriber or health care professional about all other medicines you are taking, including non-prescription medicines, nutritional supplements, or herbal products. Also tell your prescriber or health care professional if you are a frequent user of drinks with caffeine or alcohol, if you smoke, or if you use illegal drugs. These may affect the way your medicine works. Check with your health care professional before stopping or starting any of your medicines. What side effects may I notice from taking acetaminophen-hydrocodone? Elderly patients are more likely to get side effects. Side effects that you should report to your prescriber or health care professional as soon as possible:; chest pain or irregular heartbeat; difficulty breathing, wheezing; severe rash; cold, clammy skin; unusual weakness; fever, chills, muscle aches and pains Side effects that usually do not require medical attention (report to your prescriber or health care professional if they continue or are bothersome):; constipation; dizziness, drowsiness; confusion; gas or heartburn; nausea, vomiting; dry mouth; itching; flushing; pinpoint pupils What should I watch for while taking acetaminophen-hydrocodone? Tell your prescriber or health care professional if your pain does not go away, if it gets worse, or if you have new or different type of pain. Do not take other pain medicines with acetaminophen-hydrocodone without advice. Use exactly as directed by your prescriber or health care professional. Do not take more than the recommended dose due to the possibility of liver damage or effects on your breathing. If you get flu-like symptoms (fever, chills, muscle aches and pains), call your prescriber or health care professional; do not treat yourself. If you are receiving cancer chemotherapy or other immunosuppression medicine, do not take acetaminophen with out checking with your prescriber or health care professional. Acetaminophen may hide the signs of an infection such as fever or pain. To reduce unpleasant effects on your throat and stomach, take acetaminophen-hydrocodone with a full glass of water and never just before lying down. You may also take it with food or milk. Acetaminophen-hydrocodone may make you drowsy when you first start taking it or change doses. Do not drive, use machinery, or do anything that needs mental alertness until you know how acetaminophen-hydrocodone affects you. Do not sit or stand up quickly. This reduces the risk of dizzy or fainting spells. These effects may be worse if you are an older patient. The drowsiness should decrease after taking acetaminophen-hydrocodone for a couple of days. If you have not slept because of your pain, you may sleep more the first few days your pain is controlled to catch-up on missed sleep. Be careful taking other medicines that may also make you tired. This effect may be worse when taking these medicines with acetaminophen-hydrocodone. Alcohol can increase possible drowsiness, dizziness, confusion and affect your breathing. Alcohol can increase possible damage to your liver. Avoid alcohol while taking acetaminophen-hydrocodone. Acetaminophen-hydrocodone can cause constipation. Make sure to take a laxative and/or a stool softener. Try to have a bowel movement at least every 2-3 days. If you do not have a bowel movement for 3 days or more call your prescriber or health care professional. They may recommend using an enema or suppository to help you move your bowels. Many non-prescription medicines contain acetaminophen as an ingredient. Always read the labels carefully to avoid taking an accidental overdose, which can be dangerous. Acetaminophen can affect the results from some blood sugar tests used by diabetic patients. Check with your prescriber or health care professional before you change your diet or the dose of your diabetic medicine. If you are going to have surgery tell your prescriber or health care professional that you are taking acetaminophen-hydrocodone. Where can I keep my medicine? Keep out of the reach of children in a container that small children cannot open. Do not share or give this medicine to anyone else. Avoid accidental swallowing of acetaminophen-hydrocodone by someone (especially children) other than for whom it was prescribed as this may result in severe side effects and possibly death. Store at room temperature between 15 and 30 degrees C (59 and 86 degrees F). Protect from light. Keep container tightly closed. 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Hydrocodone or dihydrocodeinone (marketed as Vicodin, Anexsia, Dicodid, Hycodan, Hycomine, Lorcet, Lortab, Norco, Hydroco, Tussionex, Vicoprofen) is an opioid derived from either of the naturally occurring opiates codeine or thebaine. Hydrocodone is an orally active narcotic analgesic and antitussive. Sales and production of this drug have increased significantly in recent years, as have diversion and illicit use. Hydrocodone is commonly available in tablet, capsule and syrup form. Hydrocodone Bitartrate 10mg/ Acetaminophen 650mgAs a narcotic, hydrocodone relieves pain by binding to opioid receptors in the brain and spinal cord. It may be taken with or without food. When taken with alcohol, it can intensify drowsiness. It may interact with monoamine oxidase inhibitors, as well as other drugs that cause drowsiness. It is in FDA pregnancy category C: its effect on an embryo or fetus is not clearly known and pregnant women should consult their physicians before taking it. Common side effects include dizziness, lightheadedness, nausea, drowsiness, euphoria, vomiting, and constipation. Some less common side effects are allergic reaction, blood disorders, changes in mood, mental fogginess, anxiety, lethargy, difficulty urinating, spasm of the ureter, irregular or depressed respiration and rash. Hydrocodone can be habit-forming , and can lead to physical and psychological addiction. In the U.S., pure hydrocodone and forms containing more than 15 mg per dosage unit are considered Schedule II drugs. Those containing less than or equal to 15 mg per dosage unit in combination with acetaminophen or another non-controlled drug are called hydrocodone compounds and are considered Schedule III drugs. Hydrocodone is typically found in combination with other drugs such as paracetamol (acetaminophen), aspirin, ibuprofen and homatropine methylbromide. The purpose of the non-controlled drugs in combination is often twofold. 1) To provide increased analgesia via drug synergy. 2) To limit the intake of hydrocodone by causing unpleasant and often unsafe side effects at higher than prescribed doses (See Below). In the UK it is listed as a Class A drug under the Misuse of Drugs Act 1971. [edit] Commercial medications containing hydrocodone When sold commercially, hydrocodone often is combined with another medication. Those combined with acetaminophen are known by various trademark names, such as Vicodin and Lortab. Hydrocodone also can be combined with aspirin (e.g., Lortab ASA), ibuprofen (e.g., Vicoprofen), and certain antihistamines (e.g., Chemdal HD). Below are some of the commercially available medications containing hydrocodone, listed by manufacturer Like Quaalude and Valium in the 1970's, Vicodin has become not just a drug but a symbol, and its presence in a lyric or a screenplay can be seen as a comment on the obsessions of the early twenty-first century. Some of the places where the brand name has appeared in popular culture include: In the television series House, Gregory House (played by Hugh Laurie) is a brilliant but difficult doctor who takes massive amounts of Vicodin to manage chronic pain. In the short-lived, controversial television series The Book of Daniel, Aidan Quinn plays an Episcopal priest who is hooked on Vicodin. The song "Company" by Third Eye Blind features the lyric "Mix it up with Vicodin/ 'Cause anything's better than this". The metalcore band Atreyu have a song called "Five Vicodin Chased with a Shot of Clarity". Terra Naomi, the singer-songwriter, recorded a "Vicodin Song" which includes the lyric "I've got Vicodin, do you want to come over?" Several songs by Eminem mention Vicodin. In the song "Feel Good Hit of the Summer" by Queens of the Stone Age, the phrase "Nicotine, Valium, Vicodin, marijuana, ecstasy and alcohol. Cocaine" is repeated over the song. The song "Diary Of A San Fernando Sexx Star" by Butch Walker has the lyric "So you popped a Vicodin and ran away from everyone, and everything you thought you knew." Bill Engvall has a joke called 'Vicodinland', an amusing account of his time on Vicodin after his hernia. In the television series Six Feet Under, Ruth's sister, Sarah, experiences withdrawal symptoms while trying to break her Vicodin addiction. During Season 2 of the television series Rescue Me, Franco gets hooked on Vicodin. ECW wrestlers Rob Van Dam and Sabu were arrested in possession of the drug. Vicodin is mentioned throughout Chuck Palahniuk's novel Invisible Monsters with multiple characters addicted to the drug. In Episode 220 of the television series Alias, Marcus Dixon admits to taking Vicodin. In the electro-pop song "Champagne" by Amanda Lepore, the lyrics include "I drink Champagne like Marilyn and use it to wash down my Vicodin" The song "Emma" by punk band Alkaline Trio includes the lyric "We washed it down the drain, with one silver bullet and two Vicodin." It is also the theme of their song "Take Lots With Alcohol" Both NFL star Brett Favre and radio personality Rush Limbaugh gained additional notoriety for admitting addiction to the drug. The song "Painkillers" by Everlast includes the lines "And ever night I think I might never rock the mic again /'Cause my brain's fucked up on Percocet and Vicodin / Might as well be heroin pulsin' through my veins." [edit] See also Hydrocodone compound [edit] External links DEA Scheduling Information Erowid Hydrocodone (Vicodin) Vault Link page to external chemical sources. Analgesics (N02A, N02B) edit N02A Opioids: Buprenorphine · Butorphanol · Dextropropoxyphene · Dihydrocodeine · Fentanyl · Diamorphine (Heroin) · Hydromorphone· Morphine · Nalbuphine · Oxycodone · Pentazocine · Pethidine (Meperidine) · Tramadol N02BA Salicylic acid and derivatives: Acetylsalicylic Acid (Aspirin) · Diflunisal · Ethenzamide N02BB Pyrazolones Aminophenazone · Metamizole · Phenazone N02BE Anilides Paracetamol (acetaminophen) · Phenacetin · Others Ziconotide · Tetrahydrocannabinol BUY HYDROCODONE NOW!!! Hydrocodone is an effective antitussive (anti-cough) agent, and as an opiate it is also an effective analgesic for mild to moderate pain control. Five mg of hydrocodone is equivalent to 30 mg of codeine when administered orally. Early comparisons concluded that hydrocodone and morphine were equipotent for pain control in humans. However, it is now considered that a dose of 15 mg (1/4 gr) of hydrocodone is equivalent to 10 mg (1/6 gr) of morphine. Hydrocodone is considered to be morphine-like in all respects. The hydrocodone is a narcotic analgesic that acts in the central nervous system to relieve pain. If hydrocodone is used for a long time, it may become habit-forming (causing mental orphysical dependence). Physical dependence may lead to withdrawal side effects when you stop taking the medicine. Since hydrocodone and ibuprofen combination is only used for short-term (10 days or less) relief of pain, physical dependence will probably not occur. Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) used in this combination to relieve inflammation, swelling, and pain. hydrocodone and phenylephrine Drug information Generic Name: hydrocodone and phenylephrine (high droe KOE dohn and fen ill EH frin) Brand Names: Lortuss HC, Nalex-DH What is the most important information I should know about hydrocodone and phenylephrine? • Use caution when driving, operating machinery, or performing other hazardous activities. Hydrocodone and phenylephrine may cause dizziness or drowsiness. If you experience dizziness or drowsiness, avoid these activities. • Use alcohol cautiously. Alcohol may increase drowsiness and dizziness while taking hydrocodone and phenylephrine. • Hydrocodone and phenylephrine may increase the effects of other drugs that cause drowsiness, including antidepressants, alcohol, antihistamines, sedatives (used to treat insomnia), pain relievers, anxiety medicines, seizure medicines, and muscle relaxants. Tell your doctor about all medicines that you are taking, and do not take any other medicine without first talking to your doctor. • Hydrocodone is habit forming. It is possible become physically and/ or psychologically dependent on the medication. Do not take more than the prescribed amount of medication or take it for longer than is directed by your doctor. Withdrawal effects may occur if hydrocodone and phenylephrine is stopped suddenly after several weeks of continuous use. Your doctor may recommend a gradual reduction in dose. What is hydrocodone and phenylephrine? • Hydrocodone is a narcotic. It is a pain reliever and a cough suppressant. • Phenylephrine is a decongestant. It works by constricting (shrinking) blood vessels (veins and arteries) in the body. Constriction of blood vessels in the sinuses and nose decreases congestion. • Hydrocodone and phenylephrine is used to treat cough and nasal congestion associated with the common cold, sinus infections, the flu, and bronchitis. • Hydrocodone and phenylephrine may also be used for purposes other than those listed in this medication guide. What should I discuss with my healthcare provider before taking hydrocodone and phenylephrine? • Do not take hydrocodone and phenylephrine if you have taken a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), phenelzine (Nardil), tranylcypromine (Parnate), or selegiline (Eldepryl) in the last 14 days. A dangerous drug interaction could occur, leading to serious side effects. • Before taking hydrocodone and phenylephrine, tell your doctor if you have · epilepsy or another seizure disorder; · been diagnosed with sleep apnea (periods of not breathing during sleep); · thyroid problems; · asthma; · a head injury; · Addison's disease; · diabetes; · glaucoma; · bladder problems or difficulty urinating; · an enlarged prostate; · high blood pressure, irregular heartbeats, or any type of heart disease; · kidney problems; or · liver problems. • You may not be able to take hydrocodone and phenylephrine, or you may require a dosage adjustment or special monitoring during treatment if you have any of the conditions listed above. • Hydrocodone and phenylephrine is in the FDA pregnancy category C. This means that it is not known whether hydrocodone and phenylephrine will be harmful to an unborn baby. Do not take hydrocodone and phenylephrine without first talking to your doctor if you are pregnant or could become pregnant during treatment. • Hydrocodone and phenylephrine passes into breast milk and may be harmful to a nursing baby. Do not take hydrocodone and phenylephrine without first talking to your doctor if you are breast-feeding a baby. • If you are over 65 years of age, you may be more likely to experience side effects from hydrocodone and phenylephrine. Your doctor may prescribe a lower dose of this medication. How should I take hydrocodone and phenylephrine? • Take hydrocodone and phenylephrine exactly as directed by your doctor. If you do not understand the directions on your prescription bottle, ask your pharmacist, nurse, or doctor to explain the instructions to you. • Hydrocodone and phenylephrine can be taken with or without food. • Take the oral tablets and capsules with a full glass of water. • To ensure that you get a correct dose, measure the liquid form of hydrocodone and phenylephrine with a special dose-measuring spoon or cup, not with a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist where you can get one. • Do not take more of this medication or take it for longer than is recommended. If your symptoms do not improve, or if they worsen, talk to your doctor. • Hydrocodone is habit forming. It is possible become physically and/ or psychologically dependent on the medication. Do not take more than the prescribed amount of medication or take it for longer than is directed by your doctor. Withdrawal effects may occur if hydrocodone and phenylephrine is stopped suddenly after several weeks of continuous use. Your doctor may recommend a gradual reduction in dose. • Store hydrocodone and phenylephrine at room temperature away from moisture and heat. What happens if I miss a dose? • Take the missed dose as soon as you remember. However, if it is almost time for the next dose, skip the missed dose and take only the next regularly scheduled dose. Do not take a double dose of this medication. What happens if I overdose? • Seek emergency medical attention if an overdose is suspected. • Symptoms of a hydrocodone and phenylephrine overdose may include extreme drowsiness, dizziness, headache, seizures, dry mouth, cold and clammy skin, flushing, nausea, vomiting, difficult or decreased breathing, and unconsciousness. What should I avoid while taking hydrocodone and phenylephrine? • Use caution when driving, operating machinery, or performing other hazardous activities. Hydrocodone and phenylephrine may cause dizziness or drowsiness. If you experience dizziness or drowsiness, avoid these activities. • Use alcohol cautiously. Alcohol may increase drowsiness and dizziness while taking hydrocodone and phenylephrine. • Hydrocodone and phenylephrine may increase the effects of other drugs that cause drowsiness, including antidepressants, alcohol, antihistamines, sedatives (used to treat insomnia), pain relievers, anxiety medicines, seizure medicines, and muscle relaxants. Tell your doctor about all medicines that you are taking, and do not take any other medicine without first talking to your doctor. • Do not take other over-the-counter cough, cold, allergy, diet, pain, or sleep medications while taking hydrocodone and phenylephrine without first talking to your pharmacist or doctor. Other medications may also contain hydrocodone, phenylephrine, or other similar drugs, and you may accidentally take too much of these medicines. What are the possible side effects of hydrocodone and phenylephrine? • If you experience any of the following serious side effects, stop taking hydrocodone and phenylephrine and seek emergency medical attention or contact your doctor immediately: · a rare but serious allergic reaction (difficulty breathing; closing of the throat; swelling of the lips, tongue, or face; or hives); or · confusion, hallucinations, or unusual behavior. • Other, less serious side effects may be more likely to occur. Continue to take hydrocodone and phenylephrine and talk to your doctor if you experience · dizziness, drowsiness, or sleepiness; · restlessness or irritability; · blurred vision; · constipation; · dry mouth; · nausea, vomiting, or decreased appetite; · muscle twitches; · sweating; · itching; or · decreased urination. • Hydrocodone is habit forming. It is possible become physically and/ or psychologically dependent on the medication. Do not take more than the prescribed amount of medication or take it for longer than is directed by your doctor. Withdrawal effects may occur if hydrocodone and phenylephrine is stopped suddenly after several weeks of continuous use. Your doctor may recommend a gradual reduction in dose. • Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome. What other drugs will affect hydrocodone and phenylephrine? • Do not take hydrocodone and phenylephrine if you have taken a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), phenelzine (Nardil), tranylcypromine (Parnate), or selegiline (Eldepryl) in the last 14 days. A dangerous drug interaction could occur, leading to serious side effects. • Hydrocodone and phenylephrine may increase the effects of other drugs that cause drowsiness, including antidepressants, alcohol, sedatives (used to treat insomnia), pain relievers, anxiety medicines, and muscle relaxants. Tell your doctor about all medicines that you are taking, and do not take any medicine unless your doctor approves. • Do not take other over-the-counter cough, cold, allergy, diet, pain, or sleep medications while taking hydrocodone and phenylephrine without first talking to your pharmacist or doctor. Other medications may also contain hydrocodone, phenylephrine, or other similar drugs, and you may accidentally take too much of these medicines. • Drugs other than those listed here may also interact with hydrocodone and phenylephrine. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines, including vitamins, minerals, and herbal products. Where can I get more information? • Your pharmacist has more information about hydrocodone and phenylephrine written for health professionals that you may read. -------------------------------------------------------------------------------- • 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 • Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/ or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. 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. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist. guaifenesin and hydrocodone Drug information Generic Name: guaifenesin and hydrocodone (gwye FEH ne sin and high droe KOE dohn ) Brand Names: Atuss HX, Co-Tussin, Codiclear DH, Codotuss, Cotuss V, Entuss, Fentuss Expectorant, G-Tuss, Gua HC, Hycoclar Tuss, Hycoclear, Hycosin Expectorant, Hycotuss Expectorant, Hydrotuss, Kwelcof, Medcodin, Pneumotussin 2.5, Propatuss Expectorant, Tusso-DF, Vicoclear, Vicodin Tuss, Vicotuss, Vitussin Expectorant, Vortex What is the most important information I should know about guaifenesin and hydrocodone? • Use caution when driving, operating machinery, or performing other hazardous activities. Guaifenesin and hydrocodone may cause dizziness or drowsiness. If you experience dizziness or drowsiness, avoid these activities. • Use alcohol cautiously. Alcohol may increase drowsiness and dizziness while taking guaifenesin and hydrocodone. • Guaifenesin and hydrocodone may increase the effects of other drugs that cause drowsiness, including antidepressants, alcohol, antihistamines, sedatives (used to treat insomnia), pain relievers, anxiety medicines, seizure medicines, and muscle relaxants. Tell your doctor about all medicines that you are taking, and do not take any other medicine without first talking to your doctor. • Hydrocodone is habit forming. It is possible to become physically and/ or psychologically dependent on the medication. Do not take more than the prescribed amount of medication or take it for longer than is directed by your doctor. Withdrawal effects may occur if guaifenesin and hydrocodone is stopped suddenly after several weeks of continuous use. Your doctor may recommend a gradual reduction in dose. What is guaifenesin and hydrocodone? • Guaifenesin is an expectorant. Guaifenesin loosens phlegm and increases the lubrication of the lungs allowing for a productive cough and decreased chest congestion. • Hydrocodone is a narcotic. It is a pain reliever and a cough suppressant. • Guaifenesin and hydrocodone is used to treat cough and nasal congestion associated with the common cold, allergies and infections. • Guaifenesin and hydrocodone may also be used for purposes other than those listed in this medication guide. What should I discuss with my healthcare provider before taking guaifenesin and hydrocodone? • Hydrocodone is habit forming and should only be used under close supervision by patients with past or current alcohol or drug addiction. • Before taking this medication, tell your doctor if you have · kidney disease; · liver disease; · asthma; · urinary retention; · an enlarged prostate; · hypothyroidism; · seizures or epilepsy; · gallbladder disease; · a head injury; or · Addison's Disease. • You may not be able to take guaifenesin and hydrocodone, or you may require a dosage adjustment or special monitoring during treatment if you have any of the conditions listed above. • Guaifenesin and hydrocodone is in the FDA pregnancy category C. This means that it is not known whether guaifenesin and hydrocodone will be harmful to an unborn baby. Do not take guaifenesin and hydrocodone without first talking to your doctor if you are pregnant or could become pregnant during treatment. • Guaifenesin and hydrocodone passes into breast milk and may be harmful to a nursing baby. Do not take guaifenesin and hydrocodone without first talking to your doctor if you are breast-feeding a baby. • If you are over 65 years of age, you may be more likely to experience side effects from guaifenesin and hydrocodone. Your doctor may prescribe a lower dose of this medication. How should I take guaifenesin and hydrocodone? • Take guaifenesin and hydrocodone exactly as directed by your doctor. If you do not understand the directions on your prescription bottle, ask your pharmacist, nurse, or doctor to explain the instructions to you. • Guaifenesin and hydrocodone can be taken with or without food. • Take the oral tablets and capsules with a full glass of water. • To ensure that you get a correct dose, measure the liquid form of guaifenesin and hydrocodone with a special dose-measuring spoon or cup, not with a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist where you can get one. • Do not take more of this medication or take it for longer than is recommended. If your symptoms do not improve, or if they worsen, talk to your doctor. • Hydrocodone is habit forming. It is possible to become physically and/ or psychologically dependent on the medication. Do not take more than the prescribed amount of medication or take it for longer than is directed by your doctor. Withdrawal effects may occur if guaifenesin and hydrocodone is stopped suddenly after several weeks of continuous use. Your doctor may recommend a gradual reduction in dose. • Store guaifenesin and hydrocodone at room temperature away from moisture and heat. What happens if I miss a dose? • Take the missed dose as soon as you remember. However, if it is almost time for the next dose, skip the missed dose and take only the next regularly scheduled dose. Do not take a double dose of this medication. What happens if I overdose? • Seek emergency medical attention if an overdose is suspected. • Symptoms of a guaifenesin and hydrocodone overdose may include extreme drowsiness, dizziness, headache, seizures, dry mouth, cold and clammy skin, flushing, nausea, vomiting, difficult or decreased breathing, and unconsciousness. What should I avoid while taking guaifenesin and hydrocodone? • Use caution when driving, operating machinery, or performing other hazardous activities. Guaifenesin and hydrocodone may cause dizziness or drowsiness. If you experience dizziness or drowsiness, avoid these activities. • Use alcohol cautiously. Alcohol may increase drowsiness and dizziness while taking guaifenesin and hydrocodone. • Guaifenesin and hydrocodone may increase the effects of other drugs that cause drowsiness, including antidepressants, alcohol, antihistamines, sedatives (used to treat insomnia), pain relievers, anxiety medicines, seizure medicines, and muscle relaxants. Tell your doctor about all medicines that you are taking, and do not take any other medicine without first talking to your doctor. • Do not take other over-the-counter cough, cold, allergy, diet, pain, or sleep medications while taking guaifenesin and hydrocodone without first talking to your pharmacist or doctor. Other medications may also contain hydrocodone, guaifenesin or other similar drugs, and you may accidentally take too much of these medicines. What are the possible side effects of guaifenesin and hydrocodone? • If you experience any of the following serious side effects, stop taking guaifenesin and hydrocodone and seek emergency medical attention or contact your doctor immediately: · a rare but serious allergic reaction (difficulty breathing; closing of the throat; swelling of the lips, tongue, or face; or hives); or · confusion, hallucinations, or unusual behavior. • Other, less serious side effects may be more likely to occur. Continue to take guaifenesin and hydrocodone and talk to your doctor if you experience · dizziness, drowsiness, or sleepiness; · restlessness or irritability; · blurred vision; · constipation; · dry mouth; · nausea, vomiting, or decreased appetite; · muscle twitches; · sweating; · itching; or · decreased urination. • Hydrocodone is habit forming. It is possible to become physically and/ or psychologically dependent on the medication. Do not take more than the prescribed amount of medication or take it for longer than is directed by your doctor. Withdrawal effects may occur if guaifenesin and hydrocodone is stopped suddenly after several weeks of continuous use. Your doctor may recommend a gradual reduction in dose. • Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome. What other drugs will affect guaifenesin and hydrocodone? • Guaifenesin and hydrocodone may increase the effects of other drugs that cause drowsiness, including antidepressants, alcohol, sedatives (used to treat insomnia), pain relievers, anxiety medicines, and muscle relaxants. Tell your doctor about all medicines that you are taking, and do not take any medicine unless your doctor approves. • Do not take other over-the-counter cough, cold, allergy, diet, pain, or sleep medications while taking guaifenesin and hydrocodone without first talking to your pharmacist or doctor. Other medications may also contain hydrocodone, guaifenesin, or other similar drugs, and you may accidentally take too much of these medicines. • Drugs other than those listed here may also interact with guaifenesin and hydrocodone. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines, including vitamins, minerals, and herbal products. Where can I get more information? • Your pharmacist has more information about guaifenesin and hydrocodone written for health professionals that you may read. -------------------------------------------------------------------------------- • 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 • Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/ or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. 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. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist. guaifenesin and hydrocodone Drug information Generic Name: guaifenesin and hydrocodone (gwye FEH ne sin and high droe KOE dohn ) Brand Names: Atuss HX, Co-Tussin, Codiclear DH, Codotuss, Cotuss V, Entuss, Fentuss Expectorant, G-Tuss, Gua HC, Hycoclar Tuss, Hycoclear, Hycosin Expectorant, Hycotuss Expectorant, Hydrotuss, Kwelcof, Medcodin, Pneumotussin 2.5, Propatuss Expectorant, Tusso-DF, Vicoclear, Vicodin Tuss, Vicotuss, Vitussin Expectorant, Vortex What is the most important information I should know about guaifenesin and hydrocodone? • Use caution when driving, operating machinery, or performing other hazardous activities. Guaifenesin and hydrocodone may cause dizziness or drowsiness. If you experience dizziness or drowsiness, avoid these activities. • Use alcohol cautiously. Alcohol may increase drowsiness and dizziness while taking guaifenesin and hydrocodone. • Guaifenesin and hydrocodone may increase the effects of other drugs that cause drowsiness, including antidepressants, alcohol, antihistamines, sedatives (used to treat insomnia), pain relievers, anxiety medicines, seizure medicines, and muscle relaxants. Tell your doctor about all medicines that you are taking, and do not take any other medicine without first talking to your doctor. • Hydrocodone is habit forming. It is possible to become physically and/ or psychologically dependent on the medication. Do not take more than the prescribed amount of medication or take it for longer than is directed by your doctor. Withdrawal effects may occur if guaifenesin and hydrocodone is stopped suddenly after several weeks of continuous use. Your doctor may recommend a gradual reduction in dose. What is guaifenesin and hydrocodone? • Guaifenesin is an expectorant. Guaifenesin loosens phlegm and increases the lubrication of the lungs allowing for a productive cough and decreased chest congestion. • Hydrocodone is a narcotic. It is a pain reliever and a cough suppressant. • Guaifenesin and hydrocodone is used to treat cough and nasal congestion associated with the common cold, allergies and infections. • Guaifenesin and hydrocodone may also be used for purposes other than those listed in this medication guide. What should I discuss with my healthcare provider before taking guaifenesin and hydrocodone? • Hydrocodone is habit forming and should only be used under close supervision by patients with past or current alcohol or drug addiction. • Before taking this medication, tell your doctor if you have · kidney disease; · liver disease; · asthma; · urinary retention; · an enlarged prostate; · hypothyroidism; · seizures or epilepsy; · gallbladder disease; · a head injury; or · Addison's Disease. • You may not be able to take guaifenesin and hydrocodone, or you may require a dosage adjustment or special monitoring during treatment if you have any of the conditions listed above. • Guaifenesin and hydrocodone is in the FDA pregnancy category C. This means that it is not known whether guaifenesin and hydrocodone will be harmful to an unborn baby. Do not take guaifenesin and hydrocodone without first talking to your doctor if you are pregnant or could become pregnant during treatment. • Guaifenesin and hydrocodone passes into breast milk and may be harmful to a nursing baby. Do not take guaifenesin and hydrocodone without first talking to your doctor if you are breast-feeding a baby. • If you are over 65 years of age, you may be more likely to experience side effects from guaifenesin and hydrocodone. Your doctor may prescribe a lower dose of this medication. How should I take guaifenesin and hydrocodone? • Take guaifenesin and hydrocodone exactly as directed by your doctor. If you do not understand the directions on your prescription bottle, ask your pharmacist, nurse, or doctor to explain the instructions to you. • Guaifenesin and hydrocodone can be taken with or without food. • Take the oral tablets and capsules with a full glass of water. • To ensure that you get a correct dose, measure the liquid form of guaifenesin and hydrocodone with a special dose-measuring spoon or cup, not with a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist where you can get one. • Do not take more of this medication or take it for longer than is recommended. If your symptoms do not improve, or if they worsen, talk to your doctor. • Hydrocodone is habit forming. It is possible to become physically and/ or psychologically dependent on the medication. Do not take more than the prescribed amount of medication or take it for longer than is directed by your doctor. Withdrawal effects may occur if guaifenesin and hydrocodone is stopped suddenly after several weeks of continuous use. Your doctor may recommend a gradual reduction in dose. • Store guaifenesin and hydrocodone at room temperature away from moisture and heat. What happens if I miss a dose? • Take the missed dose as soon as you remember. However, if it is almost time for the next dose, skip the missed dose and take only the next regularly scheduled dose. Do not take a double dose of this medication. What happens if I overdose? • Seek emergency medical attention if an overdose is suspected. • Symptoms of a guaifenesin and hydrocodone overdose may include extreme drowsiness, dizziness, headache, seizures, dry mouth, cold and clammy skin, flushing, nausea, vomiting, difficult or decreased breathing, and unconsciousness. What should I avoid while taking guaifenesin and hydrocodone? • Use caution when driving, operating machinery, or performing other hazardous activities. Guaifenesin and hydrocodone may cause dizziness or drowsiness. If you experience dizziness or drowsiness, avoid these activities. • Use alcohol cautiously. Alcohol may increase drowsiness and dizziness while taking guaifenesin and hydrocodone. • Guaifenesin and hydrocodone may increase the effects of other drugs that cause drowsiness, including antidepressants, alcohol, antihistamines, sedatives (used to treat insomnia), pain relievers, anxiety medicines, seizure medicines, and muscle relaxants. Tell your doctor about all medicines that you are taking, and do not take any other medicine without first talking to your doctor. • Do not take other over-the-counter cough, cold, allergy, diet, pain, or sleep medications while taking guaifenesin and hydrocodone without first talking to your pharmacist or doctor. Other medications may also contain hydrocodone, guaifenesin or other similar drugs, and you may accidentally take too much of these medicines. What are the possible side effects of guaifenesin and hydrocodone? • If you experience any of the following serious side effects, stop taking guaifenesin and hydrocodone and seek emergency medical attention or contact your doctor immediately: · a rare but serious allergic reaction (difficulty breathing; closing of the throat; swelling of the lips, tongue, or face; or hives); or · confusion, hallucinations, or unusual behavior. • Other, less serious side effects may be more likely to occur. Continue to take guaifenesin and hydrocodone and talk to your doctor if you experience · dizziness, drowsiness, or sleepiness; · restlessness or irritability; · blurred vision; · constipation; · dry mouth; · nausea, vomiting, or decreased appetite; · muscle twitches; · sweating; · itching; or · decreased urination. • Hydrocodone is habit forming. It is possible to become physically and/ or psychologically dependent on the medication. Do not take more than the prescribed amount of medication or take it for longer than is directed by your doctor. Withdrawal effects may occur if guaifenesin and hydrocodone is stopped suddenly after several weeks of continuous use. Your doctor may recommend a gradual reduction in dose. • Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome. What other drugs will affect guaifenesin and hydrocodone? • Guaifenesin and hydrocodone may increase the effects of other drugs that cause drowsiness, including antidepressants, alcohol, sedatives (used to treat insomnia), pain relievers, anxiety medicines, and muscle relaxants. Tell your doctor about all medicines that you are taking, and do not take any medicine unless your doctor approves. • Do not take other over-the-counter cough, cold, allergy, diet, pain, or sleep medications while taking guaifenesin and hydrocodone without first talking to your pharmacist or doctor. Other medications may also contain hydrocodone, guaifenesin, or other similar drugs, and you may accidentally take too much of these medicines. • Drugs other than those listed here may also interact with guaifenesin and hydrocodone. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines, including vitamins, minerals, and herbal products. Where can I get more information? • Your pharmacist has more information about guaifenesin and hydrocodone written for health professionals that you may read. -------------------------------------------------------------------------------- • 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 • Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/ or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. 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. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist. Narcotics are able to bring about many bodily effects beyond the notorious addictive euphoria. Other effects the medical profession has been interested in include: analgesia, anti-diarrheal effects, cardiovascular effects, and cough suppression. Hydrocodone represents a narcotic developed to accentuate the cough suppression effect. It is somewhat more effective in this regard than codeine (another famous narcotic with strong cough suppression effects). Cough suppression by narcotics is effected by direct action on the cough centers of the brain. Hydrocodone also tends to dry respiratory secretions, a desirable effect in benign minor infections (see below). This effect is further accentuated with the addition of a substance called "homatropine;" however, one of the chief reasons why homatropine is added is to prevent abuse of hydrocodone's narcotic effects. Should someone attempt to consume more than a recommended dose of hydrocodone (and homatropine) some very unpleasant side effects of homatropine will prevent gross overconsumption. HOW THIS MEDICATION IS USED Some typical situations where cough suppression with hydrocodone would be helpful include: Kennel Cough (a usually minor infection leading to bronchitis) Collapsing Trachea (where the windpipe becomes flimsy) "Old Dog" Bronchitis (a natural part of aging in dogs involves excess mucus production in the lung) Heart Enlargement (where the right chambers of the heart become so large that they actually pinch off the main airways as the heart beats) These are all conditions where minor secretions or actual tissues are pressing on the lung's airways and stimulating cough. Coughs that benefit from suppression are typically "dry" and "hacking," often described as sounding "as though something is stuck in the throat." The effect of hydrocodone in the dog is believed to last approximately 6-12 hours. It is typically dosed at four times a day usage or less (as needed). SIDE EFFECTS The chief side effects of hydrocodone use include: Drowsiness or tranquilization Drying of respiratory secretions Constipation (if hyrdocodone is given chronically) Upset stomach Notify your veterinarian if any of these side effects appear to be causing patient discomfort. INTERACTIONS WITH OTHER DRUGS Serious side effect have been reported involving interactions between anipryl/L-deprenyl (treatment for "senility" in dogs as well as for Cushing's disease in dogs) and demerol (another narcotic). Based on this, the recommendation to avoid the use of anipryl/L-deprenyl with any narcotics has been proposed; a different cough suppressant should be sought in such cases. It is best not to mix Hydrocodone with other tranquilizers or with antihistamines. CONCERNS AND CAUTIONS Cough suppression is not appropriate in the event of pneumonia. In pneumonia, there is excessive pus and mucus accumulation in the lung and this material must be coughed up. Suppressing the cough and drying the secretions will hinder the body's removal of this septic material. Narcotic cough suppressants should be avoided in cases involving obstructive diarrheas or toxic diarrheas (such as canine parvovirus infection). The narcotic will improve the intestinal tone which will assist in the absorption of water from the bowel and will improve stool consistency; however, it will also facilitate toxic absorption as well. In such situations, other forms of diarrhea treatment would be more appropriate. Hydrocodone diversion and abuse has been escalating in recent years. In 2005, hydrocodone was the most frequently encountered opioid pharmaceutical in drug evidence submitted to the National Forensic Laboratory Information System (NFLIS) with 19,893 exhibits; the System to Retrieve Investigational Drug Evidence (STRIDE) analyzed 590 exhibits in 2005. In the Drug Abuse Warning Network (DAWN) hydroconde combination products were associated with more emergency room visits than any other pharmaceutical opioid with an estimated 42,491 emergency room visits. Poison control data, medical examiners’ reports, and treatment center data all indicate that the abuse of hydrocodone is associated with significant public health risks, including a substantial number of deaths. The DEA is currently reviewing a petition to increase the regulatory controls on hydrocodone combination products from Schedule III to Schedule II of the Controlled Substances Act (CSA). Licit Uses: Hydrocodone is an antitussive (cough suppressant) and analgesic agent for the treatment of moderate to moderately severe pain. Studies indicate that hydrocodone is as effective, or more effective, than codeine for cough suppression and nearly equipotent to morphine for pain relief. Hydrocodone is the most frequently prescribed opiate in the United States with over 124 million prescriptions for hydrocodone-containing products dispensed in 2005. There are several hundred brand name and generic hydrocodone products marketed. All are combination products and the most frequently prescribed combination is hydrocodone and acetaminophen (Vicodin®, Lortab®). Examples of other combination products include those containing aspirin (Lortab ASA®), ibuprofen (Vicoprofen®) and antihistamines (Hycomine®). Chemistry/Pharmacology: Hydrocodone [4,5?-epoxy-3-methoxy-17-methyl-morphinan-6-one tartrate (1:1) hydrate (2:5), dihydrocodeinone] is a semi-synthetic opioid most closely related to codeine in structure and morphine in producing opiate-like effects. The first report that hydrocodone produces euphoria and habituation symptoms was published in 1923. The first report of hydrocodone dependence and addiction was published in 1961. Illicit Uses: Hydrocodone is abused for its opioid effects. Widespread diversion via bogus call-in prescriptions, altered prescriptions, theft and illicit purchases from Internet sources are made easier by the present controls placed on hydrocodone products. Hydrocodone pills are the most frequently encountered dosage form in illicit traffic with 5, 7.5 and 10 mg doses of hydrocodone being most common. Hydrocodone is generally abused orally, often in combination with alcohol. As with most opiates, abuse of hydrocodone is associated with tolerance, dependence, and, possibly, addiction. The co-formulation with acetaminophen carries an additional risk of liver toxicity when high, acute doses are consumed. Data suggests that some individuals who abuse very high doses of acetaminophen-containing hydrocodone products may be spared this liver toxicity if they have been chronically taking these products and have escalated their dose slowly over a long period of time. User Population: Every age group has been affected by the relative ease of hydrocodone availability and the perceived safety of these products by medical prescribers. Sometimes viewed as a "white collar" addiction, hydrocodone abuse has increased among all ethnic and economic groups. Of particular concern is the prevalence of illicit use of hydrocodone among school age children. In 2005, the Monitoring the Future Survey (commonly referred to as the high school survey) reported that 2.6%, 5.9% and 9.5% of 8th, 10th, and 12th graders, respectively, reported non-medical use of Vicodin® in the previous year. Illicit Distribution: Hydrocodone has been encountered in tablets, capsules and liquid form in the illicit market. However, tablets containing acetaminophen are the most frequently encountered products. Hydrocodone is not clandestinely produced and diverted pharmaceuticals are the primary source of the drug for abuse purposes. In 2005, over 1,096 capsules, 7,365 grams and 21,794 ml were submitted to STRIDE. Doctor shopping, altered or fraudulent prescriptions, bogus call-in prescriptions, diversion by unscrupulous physicians and pharmacists, and drug theft are major sources of the diverted drug. Control Status: Congress placed hydrocodone (bulk or single entity products) in Schedule II of the CSA and combination products in both Schedule III and V (depending on hydrocodone concentration) when the CSA was enacted in 1970. Hydrocodone bitartrate and acetaminophen is supplied in tablet form for oral administration. Hydrocodone bitartrate is an opioid analgesic and antitussive and occurs as fine, white crystals or as a crystalline powder. It is affected by light. The chemical name is 4,5a-Epoxy-3-methoxy-17-methylmorphinan-6-one tartrate (1:1) hydrate (2:5). It has the following structural formula: In addition, each tablet contains the following inactive ingredients: anhydrous lactose, croscarmellose sodium, crospovidone, magnesium stearate, microcrystalline cellulose, povidone, starch and stearic acid; except the 7.5 mg/325 mg, 10 mg/325 mg and 10 mg/500 mg tablets do not contain anhydrous lactose. The 7.5 mg/325 mg tablets include FD&C Yellow #6 Aluminum Lake; the 7.5 mg/650 mg tablets include FD&C Red #40 Aluminum Lake; the 10 mg/325 mg and 10 mg/750 mg tablets include D&C Yellow #10 Aluminum Lake; the 10 mg/500 mg tablets include FD&C Blue #2 Aluminum Lake; and the 10 mg/650 mg tablets include FD&C Blue #1 Aluminum Lake and D&C Yellow #10 Aluminum Lake. Meets USP Dissolution Test 1.

hydrocodone and phenylephrine Drug information Generic Name: hydrocodone and phenylephrine (high droe KOE dohn and fen ill EH frin) Brand Names: Lortuss HC, Nalex-DH What is the most important information I should know about hydrocodone and phenylephrine? • Use caution when driving, operating machinery, or performing other hazardous activities. Hydrocodone and phenylephrine may cause dizziness or drowsiness. If you experience dizziness or drowsiness, avoid these activities. • Use alcohol cautiously. Alcohol may increase drowsiness and dizziness while taking hydrocodone and phenylephrine. • Hydrocodone and phenylephrine may increase the effects of other drugs that cause drowsiness, including antidepressants, alcohol, antihistamines, sedatives (used to treat insomnia), pain relievers, anxiety medicines, seizure medicines, and muscle relaxants. Tell your doctor about all medicines that you are taking, and do not take any other medicine without first talking to your doctor. • Hydrocodone is habit forming. It is possible become physically and/ or psychologically dependent on the medication. Do not take more than the prescribed amount of medication or take it for longer than is directed by your doctor. Withdrawal effects may occur if hydrocodone and phenylephrine is stopped suddenly after several weeks of continuous use. Your doctor may recommend a gradual reduction in dose. What is hydrocodone and phenylephrine? • Hydrocodone is a narcotic. It is a pain reliever and a cough suppressant. • Phenylephrine is a decongestant. It works by constricting (shrinking) blood vessels (veins and arteries) in the body. Constriction of blood vessels in the sinuses and nose decreases congestion. • Hydrocodone and phenylephrine is used to treat cough and nasal congestion associated with the common cold, sinus infections, the flu, and bronchitis. • Hydrocodone and phenylephrine may also be used for purposes other than those listed in this medication guide. What should I discuss with my healthcare provider before taking hydrocodone and phenylephrine? • Do not take hydrocodone and phenylephrine if you have taken a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), phenelzine (Nardil), tranylcypromine (Parnate), or selegiline (Eldepryl) in the last 14 days. A dangerous drug interaction could occur, leading to serious side effects. • Before taking hydrocodone and phenylephrine, tell your doctor if you have · epilepsy or another seizure disorder; · been diagnosed with sleep apnea (periods of not breathing during sleep); · thyroid problems; · asthma; · a head injury; · Addison's disease; · diabetes; · glaucoma; · bladder problems or difficulty urinating; · an enlarged prostate; · high blood pressure, irregular heartbeats, or any type of heart disease; · kidney problems; or · liver problems. • You may not be able to take hydrocodone and phenylephrine, or you may require a dosage adjustment or special monitoring during treatment if you have any of the conditions listed above. • Hydrocodone and phenylephrine is in the FDA pregnancy category C. This means that it is not known whether hydrocodone and phenylephrine will be harmful to an unborn baby. Do not take hydrocodone and phenylephrine without first talking to your doctor if you are pregnant or could become pregnant during treatment. • Hydrocodone and phenylephrine passes into breast milk and may be harmful to a nursing baby. Do not take hydrocodone and phenylephrine without first talking to your doctor if you are breast-feeding a baby. • If you are over 65 years of age, you may be more likely to experience side effects from hydrocodone and phenylephrine. Your doctor may prescribe a lower dose of this medication. How should I take hydrocodone and phenylephrine? • Take hydrocodone and phenylephrine exactly as directed by your doctor. If you do not understand the directions on your prescription bottle, ask your pharmacist, nurse, or doctor to explain the instructions to you. • Hydrocodone and phenylephrine can be taken with or without food. • Take the oral tablets and capsules with a full glass of water. • To ensure that you get a correct dose, measure the liquid form of hydrocodone and phenylephrine with a special dose-measuring spoon or cup, not with a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist where you can get one. • Do not take more of this medication or take it for longer than is recommended. If your symptoms do not improve, or if they worsen, talk to your doctor. • Hydrocodone is habit forming. It is possible become physically and/ or psychologically dependent on the medication. Do not take more than the prescribed amount of medication or take it for longer than is directed by your doctor. Withdrawal effects may occur if hydrocodone and phenylephrine is stopped suddenly after several weeks of continuous use. Your doctor may recommend a gradual reduction in dose. • Store hydrocodone and phenylephrine at room temperature away from moisture and heat. What happens if I miss a dose? • Take the missed dose as soon as you remember. However, if it is almost time for the next dose, skip the missed dose and take only the next regularly scheduled dose. Do not take a double dose of this medication. What happens if I overdose? • Seek emergency medical attention if an overdose is suspected. • Symptoms of a hydrocodone and phenylephrine overdose may include extreme drowsiness, dizziness, headache, seizures, dry mouth, cold and clammy skin, flushing, nausea, vomiting, difficult or decreased breathing, and unconsciousness. What should I avoid while taking hydrocodone and phenylephrine? • Use caution when driving, operating machinery, or performing other hazardous activities. Hydrocodone and phenylephrine may cause dizziness or drowsiness. If you experience dizziness or drowsiness, avoid these activities. • Use alcohol cautiously. Alcohol may increase drowsiness and dizziness while taking hydrocodone and phenylephrine. • Hydrocodone and phenylephrine may increase the effects of other drugs that cause drowsiness, including antidepressants, alcohol, antihistamines, sedatives (used to treat insomnia), pain relievers, anxiety medicines, seizure medicines, and muscle relaxants. Tell your doctor about all medicines that you are taking, and do not take any other medicine without first talking to your doctor. • Do not take other over-the-counter cough, cold, allergy, diet, pain, or sleep medications while taking hydrocodone and phenylephrine without first talking to your pharmacist or doctor. Other medications may also contain hydrocodone, phenylephrine, or other similar drugs, and you may accidentally take too much of these medicines. What are the possible side effects of hydrocodone and phenylephrine? • If you experience any of the following serious side effects, stop taking hydrocodone and phenylephrine and seek emergency medical attention or contact your doctor immediately: · a rare but serious allergic reaction (difficulty breathing; closing of the throat; swelling of the lips, tongue, or face; or hives); or · confusion, hallucinations, or unusual behavior. • Other, less serious side effects may be more likely to occur. Continue to take hydrocodone and phenylephrine and talk to your doctor if you experience · dizziness, drowsiness, or sleepiness; · restlessness or irritability; · blurred vision; · constipation; · dry mouth; · nausea, vomiting, or decreased appetite; · muscle twitches; · sweating; · itching; or · decreased urination. • Hydrocodone is habit forming. It is possible become physically and/ or psychologically dependent on the medication. Do not take more than the prescribed amount of medication or take it for longer than is directed by your doctor. Withdrawal effects may occur if hydrocodone and phenylephrine is stopped suddenly after several weeks of continuous use. Your doctor may recommend a gradual reduction in dose. • Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome. What other drugs will affect hydrocodone and phenylephrine? • Do not take hydrocodone and phenylephrine if you have taken a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), phenelzine (Nardil), tranylcypromine (Parnate), or selegiline (Eldepryl) in the last 14 days. A dangerous drug interaction could occur, leading to serious side effects. • Hydrocodone and phenylephrine may increase the effects of other drugs that cause drowsiness, including antidepressants, alcohol, sedatives (used to treat insomnia), pain relievers, anxiety medicines, and muscle relaxants. Tell your doctor about all medicines that you are taking, and do not take any medicine unless your doctor approves. • Do not take other over-the-counter cough, cold, allergy, diet, pain, or sleep medications while taking hydrocodone and phenylephrine without first talking to your pharmacist or doctor. Other medications may also contain hydrocodone, phenylephrine, or other similar drugs, and you may accidentally take too much of these medicines. • Drugs other than those listed here may also interact with hydrocodone and phenylephrine. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines, including vitamins, minerals, and herbal products. Where can I get more information? • Your pharmacist has more information about hydrocodone and phenylephrine written for health professionals that you may read. Where to buy hydrocodone Radiopharmaceuticals are radioactive agents. However, when small amounts are used, the radiation your body receives from them is very low and is considered safe. When larger amounts of these agents are given to treat disease, there may be different effects on the body. When radiopharmaceuticals are used to help diagnose medical problems, only small amounts are given to the patient. The radiopharmaceutical then passes through, or is taken up by, an organ of the body (which organ depends on what radiopharmaceutical is used and how it has been given). Then the radioactivity is detected, and pictures are produced, by special imaging equipment. These pictures allow the nuclear medicine doctor to study how the organ is working and to detect cancer or tumors that may be present in the organ. Some radiopharmaceuticals are used in larger amounts to treat certain kinds of cancer and other diseases. In those cases, the radioactive agent is taken up in the cancerous area and destroys the affected tissue. The information that follows applies only to radiopharmaceuticals when used in small amounts to diagnose medical problems. The dosages of radiopharmaceuticals that are used to diagnose medical problems will be different for different patients and depend on the type of test. The amount of radioactivity of a radiopharmaceutical is expressed in units called becquerels or curies. Radiopharmaceutical dosages given may be as small as 0.185 megabecquerels (5 microcuries) or as high as 1295 megabecquerels (35 millicuries). The radiation received from these dosages may be about the same as, or even less than, the radiation received from an x-ray study of the same organ. Radiopharmaceuticals are to be given only by or under the direct supervision of a doctor with specialized training in nuclear medicine. In deciding to use a diagnostic test, any risks of the test must be weighed against the good it will do. This is a decision you and your doctor will make. Also, test results may be affected by other things. For radiopharmaceuticals, the following should be considered: Allergies - If you will be receiving albumin in the form of radioiodinated albumin, technetium Tc 99m albumin aggregated, technetium Tc 99m albumin colloid, or technetium Tc 99m albumin for your test, tell your doctor if you have ever had any unusual or allergic reaction to products containing human serum albumin. Also tell your doctor if you are allergic to any other substance, such as foods, preservatives, or dyes. Pregnancy - Radiopharmaceuticals usually are not recommended for use during pregnancy. This is to avoid exposing the fetus to radiation. Some radiopharmaceuticals may be used for diagnostic tests in pregnant women, but it is necessary to inform your doctor if you are pregnant so the doctor may reduce the radiation dose to the baby. This is especially important with radiopharmaceuticals that contain radioactive iodine, which can go to the baby's thyroid gland and, in high enough amounts, may cause thyroid damage. Be sure you have discussed this with your doctor. Breast-feeding - Some hydrocodone pass into the breast milk and may expose the baby to radiation. If you must receive a radiopharmaceutical, it may be necessary for you to stop breast-feeding for some time after receiving it. Be sure you have discussed this with your doctor. Children - For most radiopharmaceuticals, the amount of radiation used for a diagnostic test is very low and considered safe. However, be sure you have discussed with your doctor the benefit versus the risk of exposing your child to radiation. Older adults - Many medicines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults or if they cause different side effects or problems in older people. Although there is no specific information comparing use of most radiopharmaceuticals in the elderly with use in other age groups, problems would not be expected to occur. However, it is a good idea to check with your doctor if you notice any unusual effects after receiving a radiopharmaceutical. Other medicines - Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are going to receive a radiopharmaceutical, it is especially important that your doctor know if you are taking any other prescription or nonprescription (over-the-counter [OTC]) medicine. In addition, if you will be receiving radioactive iodine (sodium iodide I 123, sodium hydrocodone I 131) or sodium pertechnetate Tc 99m for a thyroid test, it is especially important that your doctor know if you have been taking iodine through other medicine or foods. For example, the results of your test may be affected if: You are taking iodine-containing medicines, including certain multivitamins and cough syrups. You eat large amounts of iodine-containing foods, such as iodized salt, seafood, cabbage, kale, rape (turnip-like vegetable), or turnips. You have had an x-ray test recently for which you were given a special dye that contained iodine. Other medical problems - The presence of other medical problems may affect the use of radiopharmaceuticals. Make sure you tell your doctor if you have any other medical problems. Preparation for This Test The nuclear medicine doctor may have special instructions for you in preparation for your test. For example, before some tests you must fast for several hours, or the results of the test may be affected. For other tests you should drink plenty of liquids. If you do not understand the instructions you receive or if you have not received any instructions, check with the nuclear medicine doctor in advance. Precautions While Using This Medicine There are usually no special precautions to observe for radiopharmaceuticals when they are used in small amounts for diagnosis. Some radiopharmaceuticals may accumulate in your bladder. Therefore, to increase the flow of urine and lessen the amount of radiation to your bladder, your doctor may instruct you to drink plenty of liquids and urinate often after certain tests. For patients receiving radioactive iodine (iodohippurate sodium I 123, iodohippurate sodium I 131, iofetamine I 123, iothalamate I 125, radioiodinated albumin, or radioiodinated iobenguane): Make sure your doctor knows if you are planning to have any future thyroid tests. Even after several weeks, the results of the thyroid test may be affected by the iodine solution that may be given before the radiopharmaceutical. Other medical problems - The presence of other medical problems may affect the use of the beta blockers. Make sure you tell your doctor if you have any other medical problems, especially: hydrocodone, history of (asthma, eczema, hay fever, hives), or Bronchitis or Emphysema - Severity and duration of allergic reactions to other substances may be increased; in addition, beta-blockers can increase trouble in breathing Bradycardia (unusually slow heartbeat) or Heart or blood vessel disease - There is a risk of further decreased heart function; also, if treatment is stopped suddenly, unwanted effects may occur Diabetes mellitus (sugar diabetes) - Beta-blockers may cause hyperglycemia (high blood sugar) and circulation problems; in addition, if your diabetes medicine causes your blood sugar to be too low, beta-blockers may cover up some of the symptoms (fast heartbeat), although they will not cover up other symptoms such as dizziness or sweating Kidney disease or Liver disease - Effects of beta-blockers may be increased because of slower removal from the body Major surgery - May increase risks of problems during surgery. Your doctor may want to stop your treatment with a beta-blocker prior to surgery. Hydrocodone or dihydrocodeinone (marketed as Vicodin, Anexsia, Dicodid, Hycodan, Hycomine, Lorcet, Lortab, Norco, Hydroco, Tussionex, Vicoprofen) is an opioid derived from either of the naturally occurring opiates codeine or thebaine. Hydrocodone is an orally active narcotic analgesic and antitussive. Sales and production of this drug have increased significantly in recent years, as have diversion and illicit use. Hydrocodone is commonly available in tablet, capsule and syrup form. Hydrocodone Bitartrate 10mg/ Acetaminophen 650mgAs a narcotic, hydrocodone relieves pain by binding to opioid receptors in the brain and spinal cord. It may be taken with or without food. When taken with alcohol, it can intensify drowsiness. It may interact with monoamine oxidase inhibitors, as well as other drugs that cause drowsiness. It is in FDA pregnancy category C: its effect on an embryo or fetus is not clearly known and pregnant women should consult their physicians before taking it. Common side effects include dizziness, lightheadedness, nausea, drowsiness, euphoria, vomiting, and constipation. Some less common side effects are allergic reaction, blood disorders, changes in mood, mental fogginess, anxiety, lethargy, difficulty urinating, spasm of the ureter, irregular or depressed respiration and rash. Hydrocodone can be habit-forming , and can lead to physical and psychological addiction. In the U.S., pure hydrocodone and forms containing more than 15 mg per dosage unit are considered Schedule II drugs. Those containing less than or equal to 15 mg per dosage unit in combination with acetaminophen or another non-controlled drug are called hydrocodone compounds and are considered Schedule III drugs. Hydrocodone is typically found in combination with other drugs such as paracetamol (acetaminophen), aspirin, ibuprofen and homatropine methylbromide. The purpose of the non-controlled drugs in combination is often twofold. 1) To provide increased analgesia via drug synergy. 2) To limit the intake of hydrocodone by causing unpleasant and often unsafe side effects at higher than prescribed doses (See Below). In the UK it is listed as a Class A drug under the Misuse of Drugs Act 1971. The presence of acetaminophen in hydrocodone-containing products deters many drug users from taking excessive amounts. However, some users will get around this by extracting a portion of the acetaminophen using hot/cold water, taking advantage of the water-soluble element of the drug. It is not uncommon for addicts to have liver problems from consuming excessive amounts of acetaminophen over a long period of time; taking 10,000 to 15,000 miligrams (10 to 15 grams) of acetaminophen in a period of 24 hours typically results in severe hepatotoxicity, and doses in the range of 15,000-20,000 miligrams a day have been reported as fatal.[1] It is this factor that leads many addicts to use only single entity opiates such as OxyContin. Daily consumption of hydrocodone should not exceed 40 milligrams in patients not tolerant to opiates. However, it clearly states in the 2006 PDR (Physicians Desk Reference) that Norco 10, containing 10 miligrams of hydrocodone and 325 miligrams of APAP (viz., acetaminophen or paracetamol), can be taken at a dosage of up to twelve tablets per day (120 miligrams of hydrocodone). Such high amounts of hydrocodone are only intended for opiate tolerant patients, and titration to such levels must be monitored very carefully. This restriction is only limited by the fact that twelve tablets, each containing 325 miligrams of APAP, puts the patient right below the 24 hour FDA maximum of 4,000 mg of APAP. Some specially compounded products are routinely given to chronic pain patients in doses of up to 180 mg of hydrocodone per day. Tolerance to this drug can increase very rapidly if abused. Because of this, addicts often overdose from taking handfulls of pills, in pursuit of the high they experienced very early on in their hydrocodone use. Symptoms of hydrocodone overdosage include respiratory depression, extreme somnolence, coma, stupor, cold and/or clammy skin, sometimes bradycardia, and hypotension. A severe overdose may involve circulatory collapse, cardiac arrest and/or death. [edit] Alcohol It is not recommended to mix any amount of hydrocodone with any amount of alcohol as doing so could cause health problems. APAP, like alcohol, is metabolized solely by the liver. Therefore the risk of fatal overdose due to hepatotoxicity can occur with significantly lower levels of APAP when mixed with ethanol. This fact is often neither known nor given credence as it does not stop people from mixing them due to the feeling of euphoria it provides. [edit] Commercial medications containing hydrocodone When sold commercially, hydrocodone often is combined with another medication. Those combined with acetaminophen are known by various trademark names, such as Vicodin and Lortab. Hydrocodone also can be combined with aspirin (e.g., Lortab ASA), ibuprofen (e.g., Vicoprofen), and certain antihistamines (e.g., Chemdal HD). Below are some of the commercially available medications containing hydrocodone, listed by manufacturer. Abbott Laboratories [2] Like Quaalude and Valium in the 1970's, Vicodin has become not just a drug but a symbol, and its presence in a lyric or a screenplay can be seen as a comment on the obsessions of the early twenty-first century. Some of the places where the brand name has appeared in popular culture include: In the television series House, Gregory House (played by Hugh Laurie) is a brilliant but difficult doctor who takes massive amounts of Vicodin to manage chronic pain. In the short-lived, controversial television series The Book of Daniel, Aidan Quinn plays an Episcopal priest who is hooked on Vicodin. The song "Company" by Third Eye Blind features the lyric "Mix it up with Vicodin/ 'Cause anything's better than this". The metalcore band Atreyu have a song called "Five Vicodin Chased with a Shot of Clarity". Terra Naomi, the singer-songwriter, recorded a "Vicodin Song" which includes the lyric "I've got Vicodin, do you want to come over?" Several songs by Eminem mention Vicodin. In the song "Feel Good Hit of the Summer" by Queens of the Stone Age, the phrase "Nicotine, Valium, Vicodin, marijuana, ecstasy and alcohol. Cocaine" is repeated over the song. The song "Diary Of A San Fernando Sexx Star" by Butch Walker has the lyric "So you popped a Vicodin and ran away from everyone, and everything you thought you knew." Bill Engvall has a joke called 'Vicodinland', an amusing account of his time on Vicodin after his hernia. In the television series Six Feet Under, Ruth's sister, Sarah, experiences withdrawal symptoms while trying to break her Vicodin addiction. During Season 2 of the television series Rescue Me, Franco gets hooked on Vicodin. ECW wrestlers Rob Van Dam and Sabu were arrested in possession of the drug. Vicodin is mentioned throughout Chuck Palahniuk's novel Invisible Monsters with multiple characters addicted to the drug. In Episode 220 of the television series Alias, Marcus Dixon admits to taking Vicodin. In the electro-pop song "Champagne" by Amanda Lepore, the lyrics include "I drink Champagne like Marilyn and use it to wash down my Vicodin" The song "Emma" by punk band Alkaline Trio includes the lyric "We washed it down the drain, with one silver bullet and two Vicodin." It is also the theme of their song "Take Lots With Alcohol" Both NFL star Brett Favre and radio personality Rush Limbaugh gained additional notoriety for admitting addiction to the drug. The song "Painkillers" by Everlast includes the lines "And ever night I think I might never rock the mic again /'Cause my brain's fucked up on Percocet and Vicodin / Might as well be heroin pulsin' through my veins." rare cases, the use of ibuprofen has caused serious side effects. Contact your doctor immediately if you experience black, bloody or tarry stools abdominal pain bloody vomit blurred vision or other visual problems rash sudden weight gain or swelling. * Do not take other prescription or over-the-counter medications that contain ibuprofen (Motrin, Advil, others) while taking hydrocodone and ibuprofen without first talking to your doctor. * Never take more hydrocodone and ibuprofen than is prescribed for you. If your pain is not being adequately treated, talk to your doctor. * Use caution when driving, operating machinery, or performing other hazardous activities. Hydrocodone and ibuprofen may cause drowsiness or dizziness. If you experience drowsiness or dizziness, avoid these activities. * Do not drink alcohol while taking hydrocodone and ibuprofen. Alcohol may increase drowsiness or dizziness. Alcohol may also