Overview: Hydrocodone/acetaminophen is a combination medicine taken to help treat pain. Common side effects may include constipation, dizziness, drowsiness, headache, and stomach pain. Do not drive or do other activities that require alertness or coordination until you know how hydrocodone/acetaminophen affects you. Call your health care provider right away if your pain increases, you feel more sensitive to pain, or develop pain in other areas of the body while taking hydrocodone/acetaminophen.
Uses
What is hydrocodone/acetaminophen used for?
Hydrocodone/acetaminophen is a combination medicine that is commonly taken for severe pain.
Hydrocodone/acetaminophen may also be used for other conditions as determined by your health care provider.
How does hydrocodone/acetaminophen work (mechanism of action)?
Hydrocodone/acetaminophen works to change how your body feels and responds to pain. Acetaminophen may work by blocking pain signals. Hydrocodone works by binding to and activating specific receptors in your body, resulting in pain relief.
How is hydrocodone/acetaminophen supplied (dosage forms)?
Dosage forms and strengths
- 2.5 mg/325 mg, 5 mg/300 mg, 5 mg/325 mg, 7.5 mg/300 mg, 7.5 mg/325 mg, 10 mg/300 mg, 10 mg/325 mg oral tablets
- 7.5 mg/325 mg per 15 mL, 10 mg/325 mg per 15 mL oral solution
How should I store hydrocodone/acetaminophen?
Hydrocodone/acetaminophen should be stored at room temperature, between 68 F to 77 F (20 C to 25 C). It can be exposed to temperatures between 59 F to 86 F (15 C to 30 C) for shorter periods of time, such as when transporting it. Store in a cool, dry place.
Side Effects
What are the most common side effects of hydrocodone/acetaminophen?
The most common side effects of hydrocodone/acetaminophen are listed below. Tell your health care provider if you have any of these side effects that bother you.
- Constipation (see below)
- Dizziness
- Drowsiness
- Nausea or vomiting
- Headache
- Stomach pain
There may be other side effects of hydrocodone/acetaminophen that are not listed here. Contact your health care provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088. In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.
What are the serious side effects of hydrocodone/acetaminophen?
While less common, the most serious side effects of hydrocodone/acetaminophen are described below, along with what to do if they happen.
Severe Allergic Reactions. Hydrocodone/acetaminophen may cause allergic reactions, which can be serious. Stop taking hydrocodone/acetaminophen and get help right away if you have any of the following symptoms of a serious allergic reaction.
- Breathing problems or wheezing
- Racing heart
- Fever or general ill feeling
- Swollen lymph nodes
- Swelling of the face, lips, mouth, tongue, or throat
- Trouble swallowing or throat tightness
- Itching, skin rash, or pale red bumps on the skin called hives
- Nausea or vomiting
- Dizziness, feeling lightheaded, or fainting
- Stomach cramps
- Joint pain
Risk of Misuse and Addiction. Misusing hydrocodone/acetaminophen can lead to serious side effects like coma or death. Misuse means taking a medicine in a way other than how it was prescribed. Take hydrocodone/acetaminophen exactly as prescribed. Tell your health care provider if you feel that hydrocodone/acetaminophen is not working. Call your health care provider right away or go to the nearest emergency room if you have any of the following serious symptoms.
- Sudden confusion or feeling disoriented
- Feeling paranoid
- Suicidal thoughts or actions
- Seizures
- Trouble breathing
Breathing Problems. Hydrocodone/acetaminophen may cause slow or shallow breathing, especially if you have breathing problems from another condition or take other medicines that can slow your breathing. Tell your health care provider if you develop severe sleepiness or trouble breathing, especially when you start taking hydrocodone/acetaminophen or when your dose is increased. Get emergency help if you have any of the following symptoms.
- Changes in the color of your skin, including a bluish color to your lips and fingernails
- Confusion
- Shortness of breath
- Feeling dizzy, lightheaded, or fainting
- Changes in your heart rate or rhythm, such as a fast, slow, pounding or skipping heartbeat
- Slow or shallow breathing
- Excessive sleepiness or trouble staying awake
Liver Damage. Liver damage, also called hepatotoxicity, can happen when taking hydrocodone/acetaminophen. Call your health care provider right away if you have any of the following symptoms of liver damage.
- Nausea or vomiting
- Stomach or belly pain
- Fever
- Weakness or unusual tiredness
- Itching
- Loss of appetite
- Light-colored poop
- Dark-colored urine (pee)
- Your skin or the whites of your eyes turning yellowish in color (also called jaundice)
Increase in Pain Sensitivity (Hyperalgesia). Hydrocodone/acetaminophen can increase your sensitivity to pain. It can cause things that normally cause pain to feel more painful than usual. Hydrocodone/acetaminophen can also cause allodynia. This happens when things that normally do not cause pain, such as wearing glasses or brushing your hair, become painful. If your pain increases, do not take extra doses of hydrocodone/acetaminophen. This could cause you to overdose or develop other serious side effects. Call your health care provider right away if your pain increases, you feel more sensitive to pain, or develop pain in other areas of the body.
Reduced Adrenal Function. Long-term use of hydrocodone/acetaminophen can cause your body’s adrenal glands to stop making as much cortisol (the stress hormone). This is known as adrenal insufficiency. Adrenal insufficiency can worsen if your body is under stress because of fever, surgery, or trauma. Tell your health care provider if you have any of the following symptoms of adrenal insufficiency.
- Nausea and vomiting
- Weakness, tiredness, or lack of energy
- Low blood pressure
- Loss of appetite
- Dizziness
Low Blood Pressure (Hypotension). Hydrocodone/acetaminophen may cause low blood pressure. If you feel faint or dizzy, lie down. Tell your health care provider right away if you have any of the following symptoms of low blood pressure.
- Dizziness, feeling lightheaded, or fainting
- Confusion
- Feeling weak or tired
Severe Skin Reactions. Hydrocodone/acetaminophen can cause severe skin reactions, such as Stevens-Johnson Syndrome (SJS), Toxic Epidermal Necrolysis (TEN), and acute generalized exanthematous pustulosis (AGEP), that can lead to death if not treated. If you develop a rash, stop hydrocodone/acetaminophen and call your health care provider right away. Get emergency help if you have any of the following symptoms.
- Painful red or purple skin that looks burned and peels off
- Flat red rash or blisters on your skin, mouth, nose, and genitals
- Red, painful, watery eyes
- Pus-filled bumps
Constipation. Some people taking hydrocodone/acetaminophen may develop severe constipation or a blockage of the gut (bowel obstruction). Stop taking hydrocodone/acetaminophen and call your health care provider right away if you have any of the following symptoms of a blockage in your intestines.
- Nausea or vomiting
- Stomach pain or bloating
- Loss of appetite
- Unable to pass gas
Sphincter of Oddi Spasm. The sphincter of Oddi is a muscular valve in your body that controls the flow of bile and digestive juices from the pancreas into the small intestine. When this valve spasms, it may feel like a tight muscle cramp, causing pain and blocking the flow of these juices, which can lead to discomfort and digestive problems. This is more likely to happen if you do not have a gallbladder. Stop taking hydrocodone/acetaminophen and get emergency help if you have new or worse stomach pain or pain in the upper right side of your stomach area that travels to your back or shoulder, with or without nausea and vomiting.
Warnings & Precautions
Who should not use hydrocodone/acetaminophen?
Allergies to Ingredients. People who are allergic to any of the following should not take hydrocodone/acetaminophen.
- Acetaminophen
- Hydrocodone
- Lorcet
- Lortab
- Norco
- Vicodin
- Any of the ingredients in the specific product dispensed
Your pharmacist can tell you all of the ingredients in the specific hydrocodone/acetaminophen products they stock.
Breathing Problems. Hydrocodone/acetaminophen should not be taken if you have respiratory depression (breathing problems), severe asthma, or other lung problems. Taking hydrocodone/acetaminophen can worsen breathing problems or lead to death.
Gut Blockage. Hydrocodone/acetaminophen should not be taken if you have a blockage of your gut (bowel obstruction) or a narrowing of the stomach or intestines. Hydrocodone/acetaminophen can worsen these conditions.
Slowed Gut Movement. Hydrocodone/acetaminophen should not be taken if you have a paralytic ileus. This is when your intestines are unable to move food through them. Hydrocodone/acetaminophen can worsen this.
What should I know about hydrocodone/acetaminophen before using it?
Read and follow the instructions for the product you have. Taking this medicine the wrong way can cause serious side effects.
Do not take hydrocodone/acetaminophen unless it has been prescribed to you by a health care provider. Take it as prescribed.
Do not share hydrocodone/acetaminophen with other people, even if they have the same condition as you. It may harm them.
Keep hydrocodone/acetaminophen out of the reach of children. Hydrocodone/acetaminophen is a controlled substance because it can be misused or lead to dependence. Store this medicine in a safe place to protect it from theft. It is illegal to sell or give away this medicine.
Use an accurate measuring device to measure your dose of liquid hydrocodone/acetaminophen. A household spoon is not an accurate measuring device and may cause you to take the wrong dose. Ask your pharmacist to recommend an appropriate measuring device.
Hydrocodone/acetaminophen contains acetaminophen. Acetaminophen (Tylenol) is a medicine used for pain or fever. It can be found in many medicines that you can buy over-the-counter (OTC). Taking too much acetaminophen can be harmful. To avoid taking too much acetaminophen, talk to your health care provider before you take any other medicine with acetaminophen in it.
Hydrocodone/acetaminophen can affect your alertness or coordination. Do not drive or do other activities that require alertness or coordination until you know how hydrocodone/acetaminophen affects you.
People who are 65 and older can be at greater risk for some side effects from hydrocodone/acetaminophen. Talk to your health care provider about your risks if you are in this age group.
Talk to your health care provider about a medicine called naloxone. Naloxone is a medicine that can be used as an emergency treatment for an opioid overdose, including accidental overdoses.
Long-term use of hydrocodone/acetaminophen may affect your ability to become pregnant or get a partner pregnant. Talk with your health care provider if you have any concerns.
If you have been taking hydrocodone/acetaminophen on a regular basis, do not stop taking it without talking to your health care provider. Stopping too quickly may cause serious side effects. Call your health care provider right away if you have any of the following symptoms.
- Irritability
- High or low energy or low mood
- Feeling restless
- Changes in sleep habits
- Headache
- Nausea
- Dizziness
- Electric-shock like feelings
- Confusion
Throw any unused or expired hydrocodone/acetaminophen by either taking the medicine to a U.S. Drug Enforcement Administration (DEA) collection site or medicine take-back program. If one is not available, you can mix the medicine with cat litter, dirt, or used coffee grounds, place the mixture in a plastic bag, and throw the plastic bag away in the trash can. You can also flush hydrocodone/acetaminophen down the toilet. You can find out more on how to properly dispose of your medicines at www.fda.gov/drugdisposal.
What should I tell my health care provider before using hydrocodone/acetaminophen?
Tell your health care provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if hydrocodone/acetaminophen is right for you.
In particular, make sure that you discuss any of the following.
Substance Use Disorder or Alcohol Use Disorder. Talk to your health care provider if you have ever had a problem with alcohol, prescription medicines, or street drugs or live with someone who has this problem. Hydrocodone/acetaminophen has a risk of being misused.
Other Medicines and Supplements. Hydrocodone/acetaminophen may interact with other medicines and supplements. Before taking hydrocodone/acetaminophen, tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.
Current and Past Health Conditions. Tell your health care provider if you have any of the following.
- Mental health conditions, such as depression
- Head injuries or increased pressure in your skull, history of seizures, or a brain tumor
- Seizures
- Liver, kidney, or adrenal gland problems
- Thyroid problems
- Problems peeing or prostate problems
- Pancreas or gallbladder problems
- Breathing problems, such as asthma or chronic obstructive pulmonary disease (COPD)
- Live with someone who misuses alcohol, street drugs, or prescription medicines
Pregnancy. Hydrocodone/acetaminophen may cause harm to an unborn baby. Tell your health care provider if you are or plan to become pregnant. Your health care provider will advise you if you should take hydrocodone/acetaminophen while you are pregnant or trying to get pregnant. Taking hydrocodone/acetaminophen regularly while you are pregnant can cause withdrawal symptoms in your newborn baby, which can be life-threatening. Tell your health care provider if you took hydrocodone/acetaminophen during your pregnancy, especially near the end of your pregnancy.
Breastfeeding. Hydrocodone/acetaminophen passes into breast milk. Tell your health care provider if you are breastfeeding or plan to breastfeed. Your health care provider will advise you if you should take hydrocodone/acetaminophen while breastfeeding. If you are breastfeeding while taking hydrocodone/acetaminophen, watch your baby for drowsiness and slowed breathing, and get help right away if you notice these things. Do not stop taking hydrocodone/acetaminophen or breastfeeding without telling your health care provider.
Interactions
Does hydrocodone/acetaminophen interact with foods or drinks?
There are no known interactions between hydrocodone/acetaminophen and foods or nonalcoholic drinks.
Do not take any medicines that have alcohol in them or drink alcohol while taking hydrocodone/acetaminophen. The combination of alcohol and hydrocodone/acetaminophen can increase your risk of serious side effects, including death.
Does hydrocodone/acetaminophen interact with other medicines (drug interactions)?
Always tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.
In particular, make sure that you discuss if you are using any of the following before taking hydrocodone/acetaminophen.
- Clarithromycin, erythromycin (Ery-Tab and others), or linezolid, which are medicines used for bacterial infections
- A monoamine oxidase inhibitor (MAOI) within the past two weeks, which is a medicine usually used for depression or Parkinson’s disease
- Fluconazole (Diflucan), itraconazole (Sporanox, Tolsura), ketoconazole, posaconazole (Noxafil), or voriconazole (Vfend), which are medicines used for fungal infections
- A protease inhibitor, such as atazanavir (Reyataz), nelfinavir (Viracept), or ritonavir (Norvir), which is a medicine commonly used to treat HIV
- Rifampin (Rifadin), which is a medicine commonly used to treat an infection called tuberculosis
- Carbamazepine (Carbatrol, Tegretol, and others) or phenytoin (Dilantin, Phenytek, and others), which are medicines to control seizures
- Any medicine that affects serotonin, including selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors (SNRIs), other medicines used for depression, some migraine medicines, and some medicines for nausea and vomiting
- A diuretic, also called a water pill, which is a medicine used to reduce edema (fluid retention) and blood pressure
- An anticholinergic medicine, which includes antihistamines and medicines commonly used for overactive bladder, Parkinson’s disease, or stomach problems
- A mixed agonist/antagonist or partial agonist opioid analgesic, such as buprenorphine (Butrans, Sublocade), butorphanol, nalbuphine, pentazocine, and others, which is a medicine used to treat certain types of pain or opioid use disorder
- Any other medicine that causes dizziness and sleepiness, such as prescription pain medicines (including opioids), sleep medicines, muscle relaxants, or medicines for anxiety (including benzodiazepines)
Many other medicines may alter the blood levels of hydrocodone/acetaminophen. Tell your health care provider about all medicines that you take or have recently taken.
This may not be a complete list of medicines that can interact with hydrocodone/acetaminophen. Always check with your health care provider.
Overdose/Missed Dose
What should I do if I accidentally use too much hydrocodone/acetaminophen?
If you or someone else has taken too much hydrocodone/acetaminophen, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.
What should I do if I miss a dose of hydrocodone/acetaminophen?
Hydrocodone/acetaminophen is meant to be taken only when needed. Take it as your health care provider recommends. Do not take double or extra doses. Do not take more than your prescribed dose. If you have any questions about missed doses, contact your health care provider.