Class: Opioid Analgesic/Acetaminophen Combination. C-III
Dosage Forms. Tablet: (Hydrocodone/Acetaminophen) 5 mg/325 mg, 7.5 mg/325 mg, 10 mg/325 mg, 5 mg/500 mg, 7.5 mg/500 mg, 10 mg/500 mg, 7.5 mg/650 mg, 10 mg/650 mg, 7.5 mg/750 mg, 10 mg/750 mg; Capsule: (Hydrocodone/Acetaminophen) 5 mg/500 mg; Solution: (Hydrocodone/Acetaminophen) 10 mg/325 mg/15 mL
Common FDA Label Indication, Dosing, and Titration.
1. Pain, moderate to moderately severe: Adults: 1-2 tab po q4-6h prn; total 24-h dose not to exceed 4000 mg acetaminophen or 15 mL (7.5 mg hydro-codone/500 mg acetaminophen) po q4-6h as needed; total 24-h dose not to exceed 6 doses (90 mL); Children: (2 y and older) average 0.27 mL/kg (7.5 mg hydrocodone/500 mg acetaminophen per 15 mL) or 0.135 mg/kg hydrocodone and 9 mg/kg acetaminophen po q4-6h as needed; max 6 doses/d
Off-Label Uses. None
MOA. Acetaminophen is a central inhibitor of prostaglandin synthesis. Hydrocodone is an opioid analgesic and antitussive with unknown mechanism of action, but it is thought to be related to the presence of opiate receptors in the central nervous system.
Drug Characteristics: Hydrocodone/Acetaminophen
Medication Safety Issues: Hydrocodone/Acetaminophen
Drug Interactions: Hydrocodone/Acetaminophen
Adverse Reactions: Hydrocodone/Acetaminophen
Efficacy Monitoring Parameters. Relief of pain.
Toxicity Monitoring Parameters. Seek medical attention if severe skin rash, excessive drowsiness, decreased breathing, severe constipation, black tarry stools, or yellowing of eyes or skin.
Key Patient Counseling Points. Use a stool softener and/or laxative for preventing constipation with chronic use. May cause drowsiness; avoid driving or other tasks requiring motor coordination. Avoid alcohol and other CNS depressants.
Clinical Pearls. Use caution in elderly, appear more sensitive to the effect. Tolerance and physical dependence may occur with chronic use, avoid abrupt discontinuation. Contains acetaminophen, do not exceed max daily dose (4 g).