Vicodin is the brand name of a prescription drug that contains two active ingredients – an opioid drug hydrocodone and an analgesic acetaminophen. It is a pain medication that is available legally by prescription and is used to treat severe pain.
However, opioids like hydrocodone (Vicodin) and oxycodone (OxyContin) are also widely misused and abused by millions of people in the United States for non-medical reasons. The US comprises only 4% of the world’s population but uses 99% of the world’s hydrocodone supply. Studies have found that most often Vicodin abuse starts with a legal prescription and not illegal experimentation.
Vicodin abuse can have serious health consequences, including liver failure, slowed or stopped breathing, slowed heart rate, jaundice, seizures, overdose, and death.
Opioid abuse is a major driver of drug overdose deaths in the US in recent years. Overdose deaths related to prescription opioids increased from about 3,500 in 1999 to a peak of 17,000 in 2017 and around 14,000 in 2022.
Please continue reading to learn more about Vicodin (hydrocodone acetaminophen tablets) and the dangers it poses when used without a doctor’s prescription and supervision.
What Exactly Is Vicodin?
Vicodin is the brand name of a prescription pain medication. It contains two active ingredients – hydrocodone and acetaminophen. This combination is available in tablet form and as an oral solution.
Ingredients: What is Vicodin Made Of?
Vicodin contains two active ingredients:
Hydrocodone bitartrate: Hydrocodone is a full opioid agonist that binds to opioid receptors in the central nervous system. It works by blocking pain signals in the brain.
Acetaminophen: Acetaminophen is a widely available over-the-counter analgesic that is sold under the brand name Tylenol and others. The mechanism of action of acetaminophen is not fully understood, but it is believed to inhibit an enzyme called COX and prevent activation of pain pathways in the central nervous system to produce analgesia (pain relief).
Is Vicodin Still Prescribed Today?
Yes, Vicodin (hydrocodone acetaminophen combination) is still prescribed today to manage moderate to severe pain in patients who cannot be managed with other relatively safer pain medicines.
Why Is Vicodin Prescribed? Who Should Take It?
Vicodin (hydrocodone acetaminophen tablet) is prescribed to treat moderate to severe pain that cannot be managed with other pain medications. For example, postsurgical pain, pain related to cancer, and pain from serious injuries and trauma. The combination of hydrocodone and acetaminophen is also used as an antitussive (cough suppressant).
Only people who have a prescription of Vicodin from a healthcare provider should take this pain medicine. Misuse or abuse of this prescription drug carries a serious risk of side effects and health complications, including overdose and death.
How Effective is Vicodin as a Pain Medication? Is Vicodin the Strongest Painkiller?
Vicodin is not the strongest painkiller. However, it is an opioid, and opioids are some of the strongest painkillers available. Opioids are obtained from the poppy plant (for example, morphine) or made in the laboratory (for example, hydrocodone, oxycodone, fentanyl, and others). The illegal drug heroin is also an opioid drug.
The approximate potency (strength) of hydrocodone relative to morphine is about 2/3. Fentanyl, which is responsible for most opioid overdose deaths in the US, is 100 times stronger than morphine.
Vicodin contains two ingredients, hydrocodone and acetaminophen, which have an additive effect. This makes Vicodin very effective in controlling moderate to severe pain.
What Drug is Similar to Vicodin?
Drugs that are similar to Vicodin (hydrocodone and acetaminophen) include Anexsia, Co-Gesic, Lorcet, Lortab, Norco, and others.
What’s The Typical Dosage of Vicodin?
Vicodin tablets are available in the following strengths of hydrocodone/acetaminophen: 5 mg/325 mg, 5 mg/500 mg, 7.5 mg/325 mg, 7.5 mg/500 mg, 7.5 mg/650 mg, 7.5 mg/750 mg, 10 mg/325 mg, 10 mg/500 mg, 10 mg/650 mg, 10 mg/660 mg, 10 mg/750 mg.
Your doctor will adjust the dosage of Vicodin based on the severity of pain and your response (pain control obtained). They will prescribe the lowest dose for the shortest possible time to control pain. The usual adult dosage for Vicodin (hydrocodone bitartrate and acetaminophen) is one to two tablets every 4-6 hours.
How to Properly Use Vicodin?
If you have been prescribed Vicodin, it’s important to take it exactly as instructed by your healthcare provider. Do not take a larger dose or take it more frequently than prescribed without consulting your doctor.
If you are taking the oral solution of hydrocodone/acetaminophen, use a dose measuring device (syringe, dropper, or cup) to measure the exact dose. Do not use a regular household spoon to measure liquid medicine as this can result in incorrect dosing.
Never share your Vicodin tablets with others. Vicodin contains hydrocodone which is a federally controlled substance. It is illegal to sell or share controlled substances.
Do not obtain Vicodin from others (friends and family members) or illegal sources (street dealers). Vicodin from illegal sources may be contaminated with dangerous substances like fentanyl which can result in a fatal opioid overdose.
What Risks Are Associated with Vicodin?
When taken as prescribed, Vicodin can effectively treat moderate to severe pain. However, at higher doses, it can cause serious side effects, including affecting your breathing and heart rate, which can be fatal. In addition, opioids are habit-forming, and misusing or abusing Vicodin can lead to addiction, where changes in your brain chemistry can leave you unable to control opioid use.
Tolerance, Physical Dependence, and Addiction: How Your Body Adapts
Under a doctor’s supervision, many patients with chronic pain can continue to obtain pain relief for weeks, months, and even years on relatively stable doses of opioids. However, recreational opioid users (people who misuse or abuse opioid drugs for non-medical reasons) are at risk of tolerance and addiction.
Tolerance is reduced effectiveness over time. It can result in the need to use increasing doses of an opioid drug to achieve the same level of pain control or euphoria (pleasure).
Physical dependence is the appearance of withdrawal symptoms when an opioid drug is stopped suddenly after chronic (long-term) use. This can lead to drug cravings and compulsive drug use despite harmful consequences, which is called drug addiction. Opioid addiction is a treatable condition and can be overcome with professional addiction treatment.
Potential Drug Interactions
Taking certain medications with Vicodin can increase the risk of serious side effects, including extreme sedation, life-threatening breathing problems, and coma.
Before starting treatment with Vicodin, give your doctor and pharmacist a complete list of prescription drugs, over-the-counter medications, dietary supplements, and herbal products. Your doctor may adjust the dose of your other medications and/or monitor you carefully for side effects if there are known interactions between Vicodin and your other medications.
Seek immediate medical attention if you develop the following signs and symptoms after taking Vicodin: Extreme drowsiness, dizziness, slowed or breathing, or unresponsiveness. Make sure family members know when and how to seek emergency medical care if you cannot do so yourself.
Some of the medications that can interact with Vicodin include:
- CYP3A4 and CYP2D6 inhibitors (ketoconazole, erythromycin, ritonavir).
- CYP3A4 inducers (rifampin, phenytoin, carbamazepine).
- CNS depressants (benzodiazepines).
- Serotonergic agents (antidepressants like SSRIs, SNRIs, and TCAs; migraine medicines like triptans; nausea medicines called 5-HT3 receptor blockers).
- Monoamine oxidase inhibitors (MAOIs).
- Other opioid drugs.
- Muscle relaxants.
- Diuretics (water pills).
- Anticholinergic drugs.
- Alcohol.
- Herbal products like St. John’s Wort and tryptophan.
Drug-Condition Conflicts
Vicodin (hydrocodone acetaminophen tablets) and other opioid drugs may not be safe for people with certain health conditions. Give your health care provider a complete medical history before starting Vicodin treatment. Be sure to mention if you have medical conditions such as:
- Paralytic ileus
- Blockage or narrowing of the intestines
- Urinary problems
- Adrenal insufficiency
- Seizures
- Diabetes
- Lung disease or breathing problems
- Thyroid disease
- Liver disease
- Gallbladder problems
- Pancreas conditions
- Kidney disease
- Pregnant or breastfeeding
Warning Signs: Is Vicodin Safe for Long-Term Use?
When used exactly as prescribed, Vicodin (hydrocodone acetaminophen) can effectively control moderate to severe pain. People can continue taking this medicine to manage chronic pain for weeks, months, or even years at relatively stable doses.
However, this strong painkiller carries several risks with long-term use, especially at high doses, including liver damage, hypersensitivity reactions, respiratory depression, and misuse, abuse, and addiction.
Hepatotoxicity
Vicodin contains acetaminophen which can cause severe liver damage and acute liver failure. There are case reports of patients needing a liver transplant after taking high doses of acetaminophen (doses exceeding 4,000 mg per day). The risk of liver injury is higher in people with preexisting liver disease and those who drink alcohol while taking Vicodin.
If you are taking Vicodin, check the labels of all your other over-the-counter pain medicines. Many OTC pain relievers contain acetaminophen. Taking multiple products together can result in an overdose. Make sure you don’t exceed the recommended maximum dose per day of acetaminophen from all sources (typically 3,500 to 4,000 mg per day).
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+18442884672 Allergic Reactions
Rarely, taking acetaminophen can result in life-threatening allergic reactions, including anaphylaxis (throat closing). Seek emergency medical care if you develop a skin rash, hives, itching, peeling or blistering skin, swelling of the face or throat, or difficulty breathing after taking Vicodin (hydrocodone acetaminophen tablets).
Respiratory Depression
Hydrocodone is an opioid and it can produce respiratory depression (shallow, slowed, or stopped breathing). This effect is dose related and the risk is higher with higher doses of Vicodin.
Head Injury and Increased Intracranial Pressure
The respiratory depressive effects of hydrocodone are worsened in people with head injuries and elevated intracranial pressure (increased pressure inside the skull). The use of narcotics and their adverse effects can also complicate the clinical course of patients with head injuries.
Acute Abdominal Conditions
Narcotics such as hydrocodone should not be used in people with acute abdominal conditions as these drugs can complicate the diagnosis and mask the clinical course in such patients.
Important Precautions Before Taking Vicodin
Give your doctor a complete medical history and a full list of your medications. Tell your health care provider about any history of drug allergies.
Also, tell your doctor if you are pregnant or breastfeeding. Exposure to opioid drugs can have serious health consequences in the unborn baby or breast-fed infant.
If you plan to have children in the future, talk to your doctor about the risks of taking Vicodin (hydrocodone acetaminophen tablets). This drug can lead to decreased fertility in both women and men.
Special Risk Patients: Who Needs Extra Caution?
Tell your doctor if you have a personal or family history of alcohol use disorder or substance use disorder (misuse or abuse of prescription drugs or street drugs). People with a history of substance abuse are at a greater risk of misusing and abusing Vicodin.
Tell your doctor if you have a medical history of lung disease or breathing problems, acute abdominal conditions (narrowing or blockage of the intestines, paralytic ileus), brain tumor, head injury, urinary problems, adrenal insufficiency, diabetes, thyroid conditions, liver disease, kidney disease, pancreas disease, or gallbladder disease.
Avoid drinking alcohol while on Vicodin as it can increase the risk of life-threatening side effects like respiratory depression (slowed or stopped breathing).
Tell all your healthcare providers and laboratory personnel that you are on Vicodin, especially before any surgical procedures, including dental treatments.
Guidance for Patients and Caregivers
Vicodin (hydrocodone acetaminophen tablets) can be habit-forming. Do not take more than the prescribed dose. Do not take more frequent doses than prescribed.
Store Vicodin carefully out of reach of others, especially children. Keep track of your Vicodin tablets so you know if any are missing.
Vicodin can cause side effects like dizziness and drowsiness. Be careful while driving, operating heavy machinery, and doing other potentially hazardous activities until you know how Vicodin affects you.
Vicodin can cause dizziness with changes in position due to low blood pressure. Get out of bed slowly and place your feet on the ground for a few minutes when going from a sitting or lying position to standing.
Vicodin can cause constipation. Talk to your doctor about eating a fiber-rich diet or taking medications to prevent or treat constipation while on this pain medicine.
Vicodin Overdose
A Vicodin overdose can be fatal. Seek emergency medical care for a known or suspected overdose on Vicodin.
Signs and Symptoms
Hydrocodone: Respiratory depression (decreased respiratory rate), shallow or slowed breathing, extreme sleepiness, limp muscles, cold clammy skin, slowed heart rate, low blood pressure, coma, circulatory collapse, cardiac arrest, and death.
Acetaminophen: Nausea, vomiting, stomach pain, stomach cramps, loss of appetite, sweating, and fatigue.
Overdose Treatment
Naloxone is an opioid antagonist. It is a rescue medicine that can rapidly reverse the effects of an opioid overdose and restore normal breathing. It can save the life of a person who has overdosed on Vicodin. Naloxone does not have any effect on a person who does not have opioids in their system, and therefore, can be used for suspected (but not confirmed) Vicodin overdoses.
You can give naloxone by nasal spray (generic naloxone, Narcan, Kloxxado) or injection (subcutaneous, intramuscular, or intravenous injection). A pre-packaged single-dose syringe is available under the brand name Zimhi for intramuscular or subcutaneous injection.
Call 911 immediately after giving naloxone to someone who has overdosed on Vicodin. This rescue medicine works for 30 to 90 minutes only. Some people require multiple doses of the rescue medicine to restore normal breathing. So, it’s important to stay with the person after administering naloxone until emergency medical services arrive.
Emergency medical treatment for a Vicodin overdose consists of cardiorespiratory support. Treatments in the emergency room may include supplemental oxygen, intravenous fluids, vasopressors (to raise blood pressure), and other supportive treatments.
How to Store and Dispose of Vicodin?
Store Vicodin in its original container, tightly closed, and safely out of sight and reach of others, especially children who may accidentally ingest the medicine and suffer fatal consequences. The storage location of Vicodin should not be easily visible or accessible by other people, including people visiting your home.
Store Vicodin tablets at room temperature. Do not store the medicine in a bathroom cabinet where it can be exposed to excess heat and humidity.
Talk to your doctor or pharmacist about proper disposal of Vicodin. The recommendation is to dispose of any unneeded Vicodin through a drug take-back program. If you do not have access to a medicine take-back program, flush any unneeded or expired Vicodin down the toilet.
How Discover Recovery Can Help
Vicodin is a prescription painkiller that is used to manage moderate to severe pain. It contains two active ingredients – hydrocodone which is an opioid drug and acetaminophen which is an analgesic.
Vicodin is one of the most abused prescription drugs in the United States. Many people who start out by taking Vicodin with a doctor’s prescription, go on to misuse and abuse the drug. Taking higher doses or more frequent doses of Vicodin than prescribed, or taking Vicodin obtained from others including illegal sources carries serious risks, including overdose and death.
If you or a loved one has developed a Vicodin addiction, help is available. At Discover Recovery Treatment Center, we have a team of specialists in addiction medicine who can help you overcome your dependence on Vicodin. We use evidence-based treatments, including medically supervised detoxification, intensive inpatient and outpatient psychotherapy, and medication assisted treatment (methadone, buprenorphine, or naltrexone) to manage opioid use disorders.
Take that important step today and call Discover Recovery. Every minute counts, and even a small delay in seeking professional addiction treatment could mean putting a precious life at risk.
