- Hydrocodone Withdrawal – Timeline, Detox Centers and Treatment
- Hydrocodone Withdrawal Symptoms
- About Drug and Alcohol Detox
- Hydrocodone Addiction and Abuse
- Hydrocodone Addiction and Its Effects on the Body
- Immediate Effects of Hydrocodone Misuse and Abuse Include:
- Types of Hydrocodone
- Hydrocodone Addiction Statistics
- Find Help Today
- Vicodin (Hydrocodone Bitartrate and Acetaminophen): Uses, Dosage, Side Effects, Interactions, Warning
- Inducers Of CYP3A4
- Benzodiazepines And Other CNS Depressants
- Serotonergic Drugs
- Monoamine Oxidase Inhibitors (MAOIs)
- Mixed Agonist/Antagonist And Partial Agonist Opioid Analgesics
- Muscle Relaxants
- Anticholinergic Drugs
- Controlled Substance
- Vicodin Uses, Side Effects & Safety Information – Drugs.com
- What is Vicodin?
- Important information
- Before taking this medicine
- How should I take Vicodin?
- What happens if I miss a dose?
- What happens if I overdose?
- What should I avoid while taking Vicodin?
- What other drugs will affect Vicodin?
- Further information
- Related questions
- Vicodin Withdrawal Timeline, Symptoms and Treatment
- Vicodin Withdrawal Symptoms
- Length of Use
- Method of Stopping Use
- Other Methods for Treating Vicodin Addiction
Hydrocodone Withdrawal – Timeline, Detox Centers and Treatment
Hydrocodone is the primary active component of several common prescription painkillers, including the widely available Vicodin.
Hydrocodone products are the most commonly prescribed drugs in America, according to Consumer Reports.
Because of the high potential for diversion and abuse, not to mention addiction liability, hydrocodone products were moved to the more tightly controlled Schedule II Drug Enforcement Administration (DEA) classification after the Food and Drug Administration (FDA) completed a scientific review and requested the change in 2013.
most prescription narcotics, abrupt hydrocodone cessation may herald the onset of withdrawal symptoms, which may include:
- Muscle aches
- Runny nose
- Mood swings
- Drug cravings
Symptoms last 5-7 days, in most cases. Medications and therapy can soothe distress and reduce the risk of drug relapse.
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Prescription opioids are frequently reserved for the management of chronic and/or significantly severe pain; in a dose-dependent manner, their use is also associated with rewarding, euphoric sensations.
The National Institute on Drug Abuse (NIDA) reports that opioid painkiller prescriptions reached 207 million in the United States in 2013, and America consumes practically 100 percent of the world’s hydrocodone.
Hydrocodone is an opioid drug that affects levels of dopamine in the brain.
When an individual takes hydrocodone regularly for a length of time, they may develop tolerance to the drug, and in order to continue to feel its desired effects, more will need to be taken.
Taking increasingly large amounts of hydrocodone may lead to the swift development of physical dependence, however, and ultimately, addiction.
An estimated 2 million Americans struggle with a substance use disorder involving prescription opioids, the American Society of Addiction Medicine (ASAM) reports. One of the effects of significant physiological dependence is the onset of withdrawal symptoms when the drug leaves the system.
Timeline for Withdrawal
Most hydrocodone products, including Norco and Vicodin, are immediate release formulations, with a duration of effects lasting roughly 4-6 hours, the Journal of Pain Research publishes, although there are a few extended-release varieties that last up to 12 hours per dose, which could slightly delay the onset of withdrawal.
Generally speaking, hydrocodone withdrawal will start between 6 and 12 hours after the last dose, depending on which specific drug the dependent individual last took. Opioid withdrawal usually peaks within 72 hours and can last anywhere from a week to a month. Drug cravings and some of the emotional side effects may last longer than a month.
The amount of time an individual took hydrocodone, as well as the average dose and exact formulation of the drug may make a difference in the precise withdrawal timeline and severity.
The longer a drug is taken, the more ly that significant physiological dependence has developed.
Some underlying medical or mental health issues may also change how long withdrawal will last, as the brain works to restore itself to where it was before hydrocodone was introduced.
Hydrocodone Withdrawal Symptoms
Side effects of hydrocodone withdrawal range from mild to moderate to severe and may differ from person to person. Just as the withdrawal timeline can be influenced by the level of dependency the brain exhibits to hydrocodone, so can the intensity and variety of withdrawal symptoms.
Opiate drugs bind to the multiple opioid receptors throughout the brain and central nervous system, and they act to depress certain physiological processes—resulting in a reduction in breathing rate, heart rate, blood pressure, and body temperature.
When someone is dependent on an opioid drug hydrocodone, the sudden removal of it can have distressing consequences as the brain and body work in overdrive to recover. Blood pressure, respiration, body temperature, and heart rate may all spike if hydrocodone use or abuse is stopped suddenly.
It is therefore not recommended to stop taking a hydrocodone product “cold turkey” or without medical supervision and input.
Specific withdrawal symptoms when stopping hydrocodone may include:
- Muscle aches
- Runny nose
- Excessive tearing
- Nausea and abdominal cramps
- Trouble sleeping
- Irregular heart rate
- Difficulties focusing or concentrating
- Mood swings
- Trouble feeling pleasure
- Night sweats
- High blood pressure
- Drug cravings
- Thoughts of suicide
Finding and Evaluating Hydrocodone Detox Centers
In many cases of hydrocodone addiction, medical detox helps keep the individual comfortable as the drug clears from the body. Detox can be performed in either an outpatient or inpatient capacity, with a medical professional monitoring withdrawal progress.
Medical detox is the optimal choice for helping to minimize hydrocodone withdrawal and ensure an individual’s safety and comfort.
Hydrocodone detox programs monitor vital signs and use medications to keep patients comfortable and stable for a period of 5-7 days in most cases.
There are several pharmaceutical options used during medical detox from hydrocodone that reduce withdrawal symptoms and help to prevent relapse in part by lowering the amount and intensity of drug cravings.
Abruptly quitting an opioid hydrocodone may result in the onset of very unpleasant withdrawal symptoms.
If a person develops dependence as a result of chronic prescription use, their doctor may first attempt to slowly taper the doses to minimize the severity of the associated withdrawal syndrome. There are also several medications approved to manage opioid dependence, which include:
- Buprenorphine products Subutex: Buprenorphine is a partial opioid agonist, and by activating opioid receptors, is able to stop withdrawal symptoms from being as intense. As a longer-acting partial agonist drug, buprenorphine has less abuse potential than many of the abused opioids that it is used to treat dependence on. Buprenorphine has a “ceiling” to its effects, so even if someone does try to take more or abuse the drug, it is not as ly to elicit the powerful high they are seeking.
- Buprenorphine and naloxone combination products, such as Suboxone and Zubsolv: In addition to the opioid agonist buprenorphine, these drugs also contain naloxone, which is an opioid antagonist. Opioid antagonists block other opioids from binding to and activating opioid receptors in the brain, rendering them ineffective. The naloxone component can also precipitate, or bring about, rapid withdrawal symptoms when triggered and works as a deterrent for abuse. Naloxone generally remains inactive in these combination buprenorphine products unless the drugs are tampered with and injected.
- Methadone: A long-acting opioid drug, methadone can be substituted for hydrocodone during detox. Dispensed in federally regulated clinics usually once per day, methadone can stay in a person’s system for up to 30 hours, and it can keep withdrawal symptoms and drug cravings to a minimum. It does have the potential for abuse itself, and its use should be closely monitored.
- Naltrexone products such as Vivitrol: naloxone, naltrexone is an opioid antagonist that blocks opioid receptor sites. These drugs are generally used after the initial stages of detox are finished. They help to prevent relapse and deter future opioid abuse.
A hydrocodone detox program first works to stabilize an individual physically, and generally lasts about a week. A comprehensive hydrocodone detox center will ly include both pharmaceuticals and holistic methods to accomplish this.
For instance, a healthy diet plan, exercise program, and structured sleep schedule may all be included at a medical detox center to help the body heal faster, as may meditation, yoga, spa treatments, and/or massage therapy.
Detox is ly to be smoother and go faster if all physical elements are attended to so that the psychological side effects of withdrawal and addiction can be managed as well.
The detox center should be only one part of a more comprehensive substance abuse treatment plan that will also include therapy, counseling, and relapse prevention techniques.
About Drug and Alcohol Detox
- Find Detox Help
- Outpatient Options
Hydrocodone Addiction and Abuse
Hydrocodone is a prescription Opioid painkiller, typically prescribed to treat moderate to severe pain. Un natural Opiates morphine and codeine, hydrocodone is a semi-synthetic opioid.
Generally, doctors may decide to write a hydrocodone (brand name Vicodin®) prescription to treat short-term pain following dental surgery or for injury-related pain. However, due to the addictive nature of Opioids, regular use of hydrocodone can be habit-forming.
Once the body becomes dependent on hydrocodone to feel normal, trying to quit taking them will result in symptoms of withdrawal. To mitigate withdrawal, individuals should treat their hydrocodone addiction through detox and rehab.
In as little as five days of prescribed use, the risk for developing a chronic hydrocodone addiction increases significantly.
Hydrocodone Addiction and Its Effects on the Body
Hydrocodone, other opioids, works by binding to pain receptors (known specifically as mu opioid receptors) in the brain. Once hydrocodone binds to these receptors, pain signals are weakened or blocked entirely. Mu opioid receptors are also responsible for the positive reinforcement aspect of drug-taking.
Feel-good sensations of euphoria produced by opioids are wise introduced here and encourage people to take the drug again. Often, when people try to quit or reduce the amount of hydrocodone they’re taking, they discover how dependent their bodies have become on the painkiller.
After repeated use, opioids’ action in the frontal cortex weaken the individual’s ability to control decision-making and regulate mood.
While hydrocodone is typically taken orally, some who abuse the drug crush the pills and either snort or inject the powder.
Because most people with a hydrocodone addiction begin by misusing a prescription given to them by their doctor, it can be difficult to see the signs of addiction. Prescription drug abuse involves taking pills more often than prescribed, continuing to take them beyond their prescribed timeframe, and taking them in a way other than how they were intended (such as snorting or injecting them).
Addiction is diagnosed on a spectrum from mild to moderate to severe. Some signs of hydrocodone addiction include taking more than intending to and prioritizing drug use over personal or professional responsibilities. As an individual’s tolerance to the effects of hydrocodone builds, people will need higher doses to keep withdrawal symptoms at bay.
Immediate Effects of Hydrocodone Misuse and Abuse Include:
- Blurry vision
- Dry mouth
- Itchy skin
- Nodding in and consciousness
- Pinpoint pupils
- Reduced breathing rate
- Slowed heartbeat
- Slurred speech
- Warm, flushed skin
Long-term abuse of hydrocodone not only changes the way the brain functions but can have lasting effects on mood and thought patterns. People who have abused hydrocodone for a prolonged period of time are ly to suffer insomnia, liver or kidney disease, depression, and anxiety. Some mental disorders, insomnia and depression, can be treated through therapy and medication antidepressants. However, damage done to the liver and kidneys is difficult to reverse, as well as treat.
Taking too much hydrocodone can result in an overdose. When the body is unable to process all of the opioids in its system, breathing and heart rates can plummet. In just a few minutes, someone overdosing on hydrocodone may stop breathing, depriving their brains of oxygen (also known as hypoxia).
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Types of Hydrocodone
In addition to Vicodin, other brand name versions of hydrocodone include Norco® and Lortab®. Each iteration contains hydrocodone and non-opioid pain reliever, acetaminophen. Hydrocodone without acetaminophen is sold under brand name Zohydro®.
Some individuals with a hydrocodone addiction have a specific brand they prefer, despite all opioids having similar effects if taken in large enough quantities (including morphine, codeine, and Heroin).
Researchers say this type of preference has practical and psychological foundations.
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(5mg, 7.5mg, or 10mg combined with 300mg acetaminophen)
What Vicodin looks : white tablets with dosage amount debossed on one side and “VICODIN” (may also have ES or HP) on the other.
Each Vicodin tablet has 300 mg of acetaminophen and comes in three different dosage levels of hydrocodone—5 mg, 7.5 mg and 10 mg. It is generally prescribed for one tablet taken every 4 to 6 hours, though addicts may take much higher doses.
In 2011, up to 131 million Americans were prescribed Vicodin, often in unnecessary strengths and quantity. In 2014, lawmakers recognized the increasing danger of hydrocodone combination products and changed them from Schedule III to Schedule II controlled substances.
Then, the Food and Drug Administration (FDA) announced that all manufacturers cease marketing products with more than 325mg of acetaminophen due to increased risk of liver damage and accidental acetaminophen overdose when taking acetaminophen daily.
Previous formulations included 500 mg to 750 mg of acetaminophen per pill.
(7mg, 10mg combined with 325 mg acetaminophen)
What Norco looks : white tablets with orange specks with “WATSON” debossed on one side and 913 on the other, light orange tablets with “NORCO® 729” on one side and bisected on the other, and yellow tablets with “NORCO 539” debossed on one side and bisected on the other.
Though Vicodin is by far the most common hydrocodone prescription, Norco is still commonly used. It is most often prescribed in two strengths: 7.5 mg or 10 mg of hydrocodone combined with 325 mg of acetaminophen.
Prior to the FDA lowering acceptable levels of acetaminophen in medication, Norco had the least amount of acetaminophen. Subsequently, some addicts chose Norco over other prescription painkillers to avoid the increased risk of consuming too much acetaminophen. Currently however, it has the highest percentage of acetaminophen of the hydrocodone variants.
(5mg, 7.5mg, 10mg combined with 325mg acetaminophen)
What Lortab looks : tablets in multiple colors depending on strength (white with pink, green, or blue specks, or wholly pink) with “ucb” debossed on one side and a number (901, 902, 903, 910) on the other.
Lortab is a brand name version of hydrocodone similar to brands Norco® and Lorcet®.
(10mg, 15mg, 20mg, 30mg, 40mg, 50mg)
What Zohydro looks : white, light green, dark blue, or dark brown capsules with “Z3## [dosage] mg” in black ink.
Zohydro was the first purely hydrocodone medication approved by the FDA in 2013. The agency approved the medication against the advice of its scientific advisory board, which voted 11-2 to deny Zohydro’s approval. The addition of acetaminophen is thought to lower hydrocodone’s risk of abuse, causing many to question the FDA’s decision to approve Zohydro.
Because pure hydrocodone has a higher risk of abuse than found in Vicodin, Norco, and Lortab, it is generally only prescribed for severe pain. This medication is designed to treat individuals with severe, chronic pain who are opioid tolerant and have not found relief with alternate treatment options.
Hydrocodone Addiction Statistics
In 2014, doctors wrote 120 million hydrocodone prescriptions.
pills per patient
After hydrocodone (Vicodin) was moved from a Schedule III to a Schedule II substance, there was a 7 pill per patient prescribing rate increase in the U.S.
In 2015, 12.5 million Americans used hydrocodone in the past year; 2 million were addicted to prescription painkillers.
Find Help Today
If you or someone you love is struggling with addiction to hydrocodone, now is the time to get help. Contact a treatment expert to find out more about what options are available to start a new life free from addiction.
Vicodin (Hydrocodone Bitartrate and Acetaminophen): Uses, Dosage, Side Effects, Interactions, Warning
The concomitant use of hydrocodone bitartrate and acetaminophen tablets and CYP3A4 inhibitors, such as macrolide antibiotics (e.g., erythromycin), azole-antifungal agents (e.g. ketoconazole), and protease inhibitors (e.g.
, ritonavir), can increase the plasma concentration of the hydrocodone from hydrocodone bitartrate and acetaminophen tablets, resulting in increased or prolonged opioid effects.
These effects could be more pronounced with concomitant use of hydrocodone bitartrate and acetaminophen tablets and both CYP3A4 and CYP2D6 inhibitors, particularly when an inhibitor is added after a stable dose of hydrocodone bitartrate and acetaminophen tablets is achieved [see WARNINGS].
After stopping a CYP3A4 inhibitor, as the effects of the inhibitor decline, the hydrocodone plasma concentration will decrease [see CLINICAL PHARMACOLOGY], resulting in decreased opioid efficacy or a withdrawal syndrome in patients who had developed physical dependence to hydrocodone bitartrate and acetaminophen tablets.
If concomitant use is necessary, consider dosage reduction of hydrocodone bitartrate and acetaminophen tablets until stable drug effects are achieved.
Follow patients for respiratory depression and sedation at frequent intervals.
If a CYP3A4 inhibitor is discontinued, consider increasing the hydrocodone bitartrate and acetaminophen tablets dosage until stable drug effects are achieved. Follow for signs or symptoms of opioid withdrawal.
Inducers Of CYP3A4
The concomitant use of hydrocodone bitartrate and acetaminophen tablets and CYP3A4 inducers, such as rifampin, carbamazepine, and phenytoin, can decrease the plasma concentration of hydrocodone [see CLINICAL PHARMACOLOGY], resulting in decreased efficacy or onset of a withdrawal syndrome in patients who have developed physical dependence to hydrocodone [see WARNINGS].
After stopping a CYP3A4 inducer, as the effects of the inducer decline, the hydrocodone plasma concentration will increase [see CLINICAL PHARMACOLOGY], which could increase or prolong both the therapeutic effects and adverse reactions, and may cause serious respiratory depression.
If concomitant use is necessary, consider increasing the hydrocodone bitartrate and acetaminophen tablets dosage until stable drug effects are achieved. Follow the patient for signs and symptoms of opioid withdrawal.
If a CYP3A4 inducer is discontinued, consider hydrocodone bitartrate and acetaminophen tablets dosage reduction and follow for signs of respiratory depression.
Benzodiazepines And Other CNS Depressants
Due to additive pharmacologic effect, the concomitant use of benzodiazepines and other CNS depressants, such as benzodiazepines and other sedative hypnotics, anxiolytics, and tranquilizers, muscle relaxants, general anesthetics, antipsychotics, and other opioids, including alcohol, can increase the risk of hypotension, respiratory depression, profound sedation, coma, and death.
Reserve concomitant prescribing of these drugs for use in patients for whom alternative treatment options are inadequate. Limit dosages and durations to the minimum required. Follow patients closely for signs of respiratory depression and sedation [see WARNINGS].
The concomitant use of opioids with other drugs that affect the serotonergic neurotransmitter system, such as selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors (SNRIs), tricyclic antidepressants (TCAs), triptans, 5-HT3 receptor antagonists, drugs that affect the serotonin neurotransmitter system (e.g., mirtazapine, trazodone, tramadol), and monoamine oxidase (MAO) inhibitors (those intended to treat psychiatric disorders and also others, such as linezolid and intravenous methylene blue), has resulted in serotonin syndrome [see PATIENT INFORMATION].
If concomitant use is warranted, carefully follow the patient, particularly during treatment initiation and dose adjustment. Discontinue hydrocodone bitartrate and acetaminophen tablets if serotonin syndrome is suspected.
Monoamine Oxidase Inhibitors (MAOIs)
The concomitant use of opioids and MAOIs, such as phenelzine, tranylcypromine, or linezolid, may manifest as serotonin syndrome, or opioid toxicity (e.g., respiratory depression, coma) [see WARNINGS].
The use of hydrocodone bitartrate and acetaminophen tablets is not recommended for patients taking MAOIs or within 14 days of stopping such treatment.
If urgent use of an opioid is necessary, use test doses and frequent titration of small doses to treat pain while closely monitoring blood pressure and signs and symptoms of CNS and respiratory depression.
Mixed Agonist/Antagonist And Partial Agonist Opioid Analgesics
The concomitant use of opioids with other opioid analgesics, such as butorphanol, nalbuphine, pentazocine, may reduce the analgesic effect of hydrocodone bitartrate and acetaminophen tablets and/or precipitate withdrawal symptoms.
Advise patient to avoid concomitant use of these drugs.
Hydrocodone bitartrate and acetaminophen tablets may enhance the neuromuscular blocking action of skeletal muscle relaxants and produce an increased degree of respiratory depression.
If concomitant use is warranted, monitor patients for signs of respiratory depression that may be greater than otherwise expected and decrease the dosage of hydrocodone bitartrate and acetaminophen tablets and/or the muscle relaxant as necessary.
Opioids can reduce the efficacy of diuretics by inducing the release of antidiuretic hormone.
If concomitant use is warranted, follow patients for signs of diminished diuresis and/or effects on blood pressure and increase the dosage of the diuretic as needed.
The concomitant use of anticholinergic drugs may increase risk of urinary retention and/or severe constipation, which may lead to paralytic ileus.
If concomitant use is warranted, follow patients for signs and symptoms of urinary retention or reduced gastric motility when hydrocodone bitartrate and acetaminophen tablets are used concomitantly with anticholinergic drugs.
Hydrocodone bitartrate and acetaminophen tablets contain hydrocodone, a Schedule II controlled substance.
Hydrocodone bitartrate and acetaminophen tablets contain hydrocodone, a substance with a high potential for abuse similar to other opioids, including fentanyl, hydromorphone, methadone, morphine, oxycodone, oxymorphone, and tapentadol, can be abused and are subject to misuse, addiction, and criminal diversion [see WARNINGS].
All patients treated with opioids require careful monitoring for signs of abuse and addiction, because use of opioid analgesic products carries the risk of addiction even under appropriate medical use.
Prescription drug abuse is the intentional non-therapeutic use of a prescription drug, even once, for its rewarding psychological or physiological effects.
Drug addiction is a cluster of behavioral, cognitive, and physiological phenomena that develop after repeated substance use and includes a strong desire to take the drug, difficulties in controlling its use, persisting in its use despite harmful consequences, a higher priority given to drug use than to other activities and obligations, increased tolerance, and sometimes a physical withdrawal.
“Drug-seeking” behavior is very common in persons with substance use disorders.
Drug-seeking tactics include emergency calls or visits near the end of office hours, refusal to undergo appropriate examination, testing, or referral, repeated “loss” of prescriptions, tampering with prescriptions and reluctance to provide prior medical records or contact information for other treating healthcare provider(s).
“Doctor shopping” (visiting multiple prescribers to obtain additional prescriptions) is common among drug abusers and people suffering from untreated addiction. Preoccupation with achieving adequate pain relief can be appropriate behavior in a patient with poor pain control.
Abuse and addiction are separate and distinct from physical dependence and tolerance. Health care providers should be aware that addiction may not be accompanied by concurrent tolerance and symptoms of physical dependence in all addicts. In addition, abuse of opioids can occur in the absence of true addiction.
Hydrocodone bitartrate and acetaminophen tablets, other opioids, can be diverted for non-medical use into illicit channels of distribution. Careful record-keeping of prescribing information, including quantity, frequency, and renewal requests, as required by state and federal law, is strongly advised.
Proper assessment of the patient, proper prescribing practices, periodic re-evaluation of therapy, and proper dispensing and storage are appropriate measures that help to limit abuse of opioid drugs.
Risks Specific to Abuse of HydrocodoneBitartrate and Acetaminophen Tablets
Hydrocodone bitartrate and acetaminophen tablets are for oral use only. Hydrocodone bitartrate and acetaminophen tablets pose a risk of overdose and death. The risk is increased with concurrent abuse of hydrocodone bitartrate and acetaminophen tablets with alcohol and other central nervous system depressants.
Parenteral drug abuse is commonly associated with transmission of infectious diseases such as hepatitis and HIV.
Both tolerance and physical dependence can develop during chronic opioid therapy. Tolerance is the need for increasing doses of opioids to maintain a defined effect such as analgesia (in the absence of disease progression or other external factors). Tolerance may occur to both the desired and undesired effects of drugs, and may develop at different rates for different effects.
Physical dependence results in withdrawal symptoms after abrupt discontinuation or a significant dosage reduction of a drug. Withdrawal also may be precipitated through the administration of drugs with opioid antagonist activity (e.g.
, naloxone, nalmefene), mixed agonist/antagonist analgesics (e.g., pentazocine, butorphanol, nalbuphine), or partial agonists (e.g., buprenorphine).
Physical dependence may not occur to a clinically significant degree until after several days to weeks of continued opioid usage.
Hydrocodone bitartrate and acetaminophen tablets should not be abruptly discontinued in a physically dependent patient [see DOSAGE AND ADMINISTRATION]. If hydrocodone bitartrate and acetaminophen tablets are abruptly discontinued in a physically dependent patient, a withdrawal syndrome may occur.
Some or all of the following can characterize this syndrome: restlessness, lacrimation, rhinorrhea, yawning, perspiration, chills, myalgia, and mydriasis.
Other signs and symptoms also may develop, including: irritability, anxiety, backache, joint pain, weakness, abdominal cramps, insomnia, nausea, anorexia, vomiting, diarrhea, or increased blood pressure, respiratory rate, or heart rate.
Infants born to mothers physically dependent on opioids will also be physically dependent and may exhibit respiratory difficulties and withdrawal signs [see PRECAUTIONS; Pregnancy].
Vicodin Uses, Side Effects & Safety Information – Drugs.com
Generic Name: acetaminophen and hydrocodone (a SEET a MIN oh fen and hye droe KOE done)
Brand Names:Hycet, Lorcet, Lortab 10/325, Lortab 5/325, Lortab 7.5/325, Lortab Elixir, Norco, Verdrocet, Vicodin, Xodol
Medically reviewed by Philip Thornton, DipPharm Last updated on Mar 2, 2020.
What is Vicodin?
Vicodin contains a combination of acetaminophen and hydrocodone. Hydrocodone is an opioid pain medication. An opioid is sometimes called a narcotic. Acetaminophen is a less potent pain reliever that increases the effects of hydrocodone.
Vicodin tablets are used for the relief of moderate to moderately severe pain.
Vicodin may also be used for purposes not listed in this medication guide.
Hydrocodone can slow or stop your breathing. Never use this medicine in larger amounts, or for longer than prescribed. Narcotic pain medicine may be habit-forming, even at regular doses. Never share Vicodin with another person, especially someone with a history of drug abuse or addiction. Keep the medication in a place where others cannot get to it.
MISUSE OF NARCOTIC MEDICINE CAN CAUSE ADDICTION, OVERDOSE, OR DEATH, especially in a child or other person using the medicine without a prescription.
Do not use Vicodin if you have used a MAO inhibitor in the past 14 days, such as isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, or tranylcypromine.
Do not take more of Vicodin than is recommended. An overdose of acetaminophen can damage your liver or cause death. Call your doctor at once if you have nausea, pain in your upper stomach, itching, loss of appetite, dark urine, clay-colored stools, or jaundice (yellowing of your skin or eyes).
Stop taking Vicodin and call your doctor right away if you have skin redness or a rash that spreads and causes blistering and peeling.
Before taking this medicine
You should not use Vicodin if you are allergic to acetaminophen (Tylenol) or hydrocodone, or if you have recently used alcohol, sedatives, tranquilizers, or other narcotic medications.
Do not use this medicine if you have taken a MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, phenelzine, rasagiline, selegiline, and tranylcypromine.
Some medicines can interact with hydrocodone and cause a serious condition called serotonin syndrome. Be sure your doctor knows if you also take medicine for depression, mental illness, Parkinson's disease, migraine headaches, serious infections, or prevention of nausea and vomiting. Ask your doctor before making any changes in how or when you take your medications.
You should not use Vicodin if you have:
- severe asthma or breathing problems; or
- a blockage in your stomach or intestines.
To make sure Vicodin is safe for you, tell your doctor if you have ever had:
- breathing problems, sleep apnea;
- liver disease;
- a drug or alcohol addiction;
- kidney disease;
- a head injury or seizures;
- urination problems; or
- problems with your thyroid, pancreas, or gallbladder.
Vicodin is more ly to cause breathing problems in older adults and people who are severely ill, malnourished, or otherwise debilitated.
If you use narcotic medicine while you are pregnant, your baby could become dependent on the drug. This can cause life-threatening withdrawal symptoms in the baby after it is born. Babies born dependent on habit-forming medicine may need medical treatment for several weeks. Tell your doctor if you are pregnant or plan to become pregnant.
Acetaminophen and hydrocodone can pass into breast milk and may harm a nursing baby. You should not breast-feed while using Vicodin.
How should I take Vicodin?
Take Vicodin exactly as prescribed. Follow all directions on your prescription label. Never take this medicine in larger amounts, or for longer than prescribed. An overdose can damage your liver or cause death. Tell your doctor if the medicine seems to stop working as well in relieving your pain.
Hydrocodone may be habit-forming, even at regular doses. Never share Vicodin with another person, especially someone with a history of drug abuse or addiction. MISUSE OF NARCOTIC MEDICINE CAN CAUSE ADDICTION, OVERDOSE, OR DEATH, especially in a child or other person using the medicine without a prescription. Selling or giving away Vicodin is against the law.
If you need surgery or medical tests, tell the doctor ahead of time that you are using this medicine. You may need to stop using the medicine for a short time.
Do not stop using Vicodin suddenly after long-term use, or you could have unpleasant withdrawal symptoms. Ask your doctor how to safely stop using Vicodin.
Store at room temperature away from moisture and heat. Keep track of the amount of medicine used from each new bottle. Hydrocodone is a drug of abuse and you should be aware if anyone is using your medicine improperly or without a prescription.
Always check your bottle to make sure you have received the correct pills (same brand and type) of medicine prescribed by your doctor.
What happens if I miss a dose?
Since Vicodin is taken as needed, you may not be on a dosing schedule. If you are taking the medication regularly, take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not use extra medicine to make up the missed dose.
What happens if I overdose?
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose of acetaminophen and hydrocodone can be fatal.
The first signs of an acetaminophen overdose include loss of appetite, nausea, vomiting, stomach pain, sweating, and confusion or weakness. Later symptoms may include pain in your upper stomach, dark urine, and yellowing of your skin or the whites of your eyes.
Overdose symptoms may also include extreme drowsiness, pinpoint pupils, cold and clammy skin, muscle weakness, fainting, weak pulse, slow heart rate, coma, blue lips, shallow breathing, or no breathing
What should I avoid while taking Vicodin?
Vicodin may impair your thinking or reactions. Avoid driving or operating machinery until you know how Vicodin will affect you. Dizziness or severe drowsiness can cause falls or other accidents.
Ask a doctor or pharmacist before using any other cold, allergy, pain, or sleep medication. Acetaminophen (sometimes abbreviated as APAP) is contained in many combination medicines. Taking certain products together can cause you to get too much acetaminophen which can lead to a fatal overdose. Check the label to see if a medicine contains acetaminophen or APAP.
Avoid drinking alcohol. It may increase your risk of liver damage while taking acetaminophen.
Get emergency medical help if you have signs of an allergic reaction to Vicodin: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
In rare cases, acetaminophen may cause a severe skin reaction that can be fatal. This could occur even if you have taken acetaminophen in the past and had no reaction.
Stop taking Vicodin and call your doctor right away if you have skin redness or a rash that spreads and causes blistering and peeling.
If you have this type of reaction, you should never again take any medicine that contains acetaminophen.
Call your doctor at once if you have:
- noisy breathing, sighing, shallow breathing, breathing that stops during sleep;
- a light-headed feeling, you might pass out;
- confusion, unusual thoughts or behavior;
- seizure (convulsions);
- easy bruising or bleeding;
- infertility, missed menstrual periods;
- impotence, sexual problems, loss of interest in sex;
- liver problems – nausea, upper stomach pain, itching, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes); or
- low cortisol levels – nausea, vomiting, loss of appetite, dizziness, worsening tiredness or weakness.
Seek medical attention right away if you have symptoms of serotonin syndrome, such as: agitation, hallucinations, fever, sweating, shivering, fast heart rate, muscle stiffness, twitching, loss of coordination, nausea, vomiting, or diarrhea.
Common Vicodin side effects include:
- drowsiness, headache;
- upset stomach, constipation;
- blurred vision; or
- dry mouth.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
What other drugs will affect Vicodin?
You may have breathing problems or withdrawal symptoms if you start or stop taking certain other medicines. Tell your doctor if you also use an antibiotic, antifungal medication, heart or blood pressure medication, seizure medication, or medicine to treat HIV or hepatitis C.
Vicodin can interact with many other drugs and cause dangerous side effects or death. Be sure your doctor knows if you also use:
- cold or allergy medicines, bronchodilator asthma/COPD medication, or a diuretic (“water pill”);
- medicines for motion sickness, irritable bowel syndrome, or overactive bladder;
- other narcotic medications – opioid pain medicine or prescription cough medicine;
- a sedative Valium – diazepam, alprazolam, lorazepam, Xanax, Klonopin, Versed, and others;
- drugs that make you sleepy or slow your breathing – a sleeping pill, muscle relaxer, medicine to treat mood disorders or mental illness; or
- drugs that affect serotonin levels in your body – a stimulant, or medicine for depression, Parkinson's disease, migraine headaches, serious infections, or nausea and vomiting.
This list is not complete. Other drugs may interact with acetaminophen and hydrocodone, including prescription and over-the- counter medicines, vitamins, and herbal products. Not all possible interactions are listed here.
Remember, keep this and all other medicines the reach of children, never share your medicines with others, and use Vicodin only for the indication prescribed.
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
Copyright 1996-2020 Cerner Multum, Inc. Version: 16.01.
Vicodin Withdrawal Timeline, Symptoms and Treatment
Vicodin is the brand name combination of hydrocodone and acetaminophen, which is an over-the-counter pain reliever, commonly sold under the brand name Tylenol.
Vicodin typically relieves pain for up to six hours, and medical professionals often prescribe this pain reliever for patientsafter surgery. any opioid pain medication,Vicodin can be addictive, and some patients build a tolerance to it. This means that the individual takes larger dosesof Vicodin or does so compulsively without being able to stop.
Physical dependence means that individuals will experiencewithdrawal symptoms when they stop taking the medication. Un other opioid pain relievers,Vicodin can be especially dangerous for the liver.
Large doses of acetaminophen were found to cause severe allergic reactionsand liver damage in many people, and several people who took over 325 mg of acetaminophen consistently often ended up inthe emergency room due to overdose.
The Food and Drug Administration changed their guidelines on acetaminophen products in2011, especially on the amount of acetaminophen that can be used in prescription painkillers Percocet (oxycodone) andVicodin (hydrocodone). The limit was placed at 325 mg, but individuals taking these painkillers should also be wary of acetaminophenin over-the-counter cold and flu medications, to prevent overdose.
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Vicodin Withdrawal Symptoms
Vicodin withdrawal symptoms are similar to those of other opioid pain medications. Typicalwithdrawal symptoms for Vicodin include:
- Psychological changes, irritability, mood swings, anxiety, and confusion
- Appetite changes, an increased craving for the drug and reduced sensation of hunger
- Physical symptoms, tremors, enlarged pupils, nausea and vomiting, sweating, diarrhea, salivation, shivering or goosebumps,rapid breathing, and muscle aches or cramps
- Sleep disturbances, restlessness, insomnia, or exhaustion
- Symptoms of a cold, a runny nose, fever, sweating, chills, and nasal congestion
Timeline for Withdrawal
The predicted average timeline for Vicodin withdrawal symptoms to end, or significantly dissipate, is 7-10 days. That being said, in some cases, certain symptoms can last for weeks or months, especially psychological symptoms.
many drug addictions, cravings for Vicodin may suddenly occur years after the individual has stopped taking the drug. Vicodin’s half-life is about four hours, so the drug leaves the body completely after about eight hours.
Once the drug begins to leave the body, withdrawal symptoms begin.
Vicodin withdrawal can be a very individual process. While the worst of the withdrawal symptoms most ly end within 1-2 weeks, it is difficult to estimate the timeline accurately for each individual person.
Some people experience a syndrome called PAWS, or post-acute withdrawal syndrome. This condition can last for weeks or months during which the individual suffers other withdrawal symptoms.
This difficult condition makes detox psychologically difficult to endure, and it is difficult to estimate when it will end. Those who experience PAWS are best served in inpatient addiction treatment where 24-hour medical supervision and support is available to aid in relapse prevention.
There are several factors that can affect the amount of time an individual experiences withdrawal symptoms. These factors include:
Length of Use
If a person took the drug for a few weeks as prescribed, withdrawal symptoms will be minimal, if they occur at all. If a person developed a tolerance for the drug or became addicted to the medication, and took it compulsively for years, withdrawal will be more acute.
When a person develops a tolerance for Vicodin, other opioid painkillers, the person must take more to feel the same effects from the drug.
Additionally, the original prescription may have specified a large dose for a particular medical reason.
When the person begins to withdraw from Vicodin, withdrawal symptoms will generally be worse if the body is used to large amounts of the medication, compared to smaller doses.
When a person suffers from Vicodin addiction, rather than just tolerance, the psychological compulsiveness involved in addiction will make withdrawal symptoms worse. The person must overcome the psychological, as well as the physical, need to take the drug. This can also make physical symptoms feel more difficult to endure.
Method of Stopping Use
When a person tries to quit any opioid medication, such as Vicodin, cold turkey without help, the person will ly experience withdrawal symptoms more severely. Medical detox is recommended to make the process more comfortable.
In some instances, replacement medications buprenorphine or methadone may be used to aid the withdrawal process on a longer-term basis. The use of any medication is determined on an individual basis.
Additionally, psychological support from therapists, nurses, and other staff members, can radically help clients during the detox process.
Naloxone, often used under the brand name Narcan, has become prominent in the opioid addiction treatment realm. Many states have passed laws allowing emergency room doctors and emergency services professionals to administer naloxone to people suffering from opioid overdose.
With prescription painkiller abuse and addiction being called an epidemic in the US, more lawmakers are trying to find ways to lower the number of lives lost due to overdose.
Naloxone stops the brain, temporarily, from soaking up the opioid medication by binding to those receptors faster than opioids can.
In current incarnations, however, naloxone is a temporary solution that stops symptoms of overdose for long enough to get the individual to the hospital for treatment. In many cases, naloxone does not stop the overdose, because the medication leaves the body faster than opioids do.
So, if a person suffers an overdose of Vicodin, naloxone can be administered to halt the overdose and get that person to the hospital.
This means that naloxone is not used in clinical settings to address withdrawal symptoms. However, government regulatory agencies are considering this possibility because naloxone has, so far, not shown to have any side effects, and is not addictive.
Other Methods for Treating Vicodin Addiction
If a person struggling with Vicodin addiction enters inpatient detox and rehabilitation, clinicians may use buprenorphine or methadone to ease withdrawal symptoms.
As partial opioid agonists, these medicals essential make the body think it is still getting the opiates it has become accustomed to, preventing withdrawal from kicking in.
Oftentimes, individuals received lowered doses of these medications over time until they are drug-free.
Non-drug therapies exist that can help ease Vicodin withdrawal symptoms. Methods meditation, massage, or acupuncture may help the detox process in various ways.
By helping the person to be relaxed and comfortable through detox, via these complementary therapies, the process can feel more manageable.
In addition, the 24-hour support that is available through medical detox can help the individual to resist the urge to relapse to Vicodin when withdrawal feels tough.