Prescription painkiller Vicodin has two active ingredients—an opioid drug hydrocodone and acetaminophen. It is used to treat severe pain but is widely misused and can lead to addiction. Studies have found that most often, Vicodin abuse starts with a legal prescription and not illegal experimentation.
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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 (pain reliever) 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 the activation of pain pathways in the central nervous system to produce analgesia (pain relief).
Acetaminophen is not considered addictive, but hydrocodone is a highly addictive opioid. Only people who have a prescription for 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.
Why Is Vicodin Prescribed? Who Should Take It?
Vicodin is prescribed to treat moderate to severe pain that cannot be managed with other pain medications. For example, post-surgical 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).
If you’ve been prescribed Vicodin, it’s important to take it exactly as prescribed and not increase the dosage or frequency without consulting your doctor.
How Effective Is Vicodin? Is It the Strongest Painkiller?
Vicodin is not the strongest painkiller. However, it is an opioid, and opioids are some of the most addictive painkillers available. Opioid painkillers are obtained from the poppy plant (for example, morphine) or lab-made to mimic those obtained from the poppy plant (for example, hydrocodone, oxycodone, fentanyl, and others). The illegal drug heroin is also an opioid.
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.
The two ingredients in Vicodin, hydrocodone and acetaminophen, have an additive effect. This makes Vicodin very effective in controlling moderate to severe pain. There are other drugs that are similar to Vicodin, including 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 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 your healthcare provider instructed. 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
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 shallow 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 and other opioid drugs may not be safe for people with certain health conditions. Give your healthcare 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 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.
Liver Toxicity (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.
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+18442884672 If you are taking Vicodin, check the labels of all your other over-the-counter pain medicines. Many over-the-counter 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).
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.
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 healthcare 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. 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. 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.
What to Do During a Vicodin Overdose
A Vicodin overdose can be fatal. Seek emergency medical care for a known or suspected overdose on Vicodin.
Signs of Vicodin overdose include:
- Respiratory depression (decreased respiratory rate)
- Shallow or slowed breathing
- Extreme sleepiness
- Limp muscles
- Cold, clammy skin
- Slowed heart rate
- Low blood pressure
If you see these signs, call 911 immediately. If you have Narcan (naloxone) and know how to administer it, follow the instructions. Additional doses of Narcan my be needed from emergency medical personnel.
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.
Discover Recovery Offers Vicodin Addiction Treatment
If you or a loved one has developed a Vicodin addiction, help is available. At Discover Recovery, 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 or complete our online assessment form.
