Hydrocodone/AcetaminophenHydrocodone Bitartrate/Acetaminophen

About Hydrocodone/Acetaminophen

Hydrocodone acts on opioid receptors in the brain and spinal cord, and acetaminophen adds pain relief that works differently. It is usually taken every 4 to 6 hours as needed, at the lowest dose for the shortest time. Lightheadedness, dizziness, sleepiness, nausea and vomiting are the most frequent side effects, and constipation also occurs.

Its boxed warnings cover addiction even at prescribed doses; slowed or stopped breathing; fatal overdose if a child swallows even one dose; coma or death with benzodiazepines, alcohol or other sedatives; withdrawal in newborns after long use in pregnancy; overdose when drugs that raise hydrocodone levels are added; and the Opioid Analgesic REMS. Another covers the liver: acetaminophen has caused acute liver failure, sometimes needing a transplant or ending in death, mostly above 4,000 mg a day and often with more than one acetaminophen product.

The label says not to take more than 4,000 mg of acetaminophen a day from all sources, to check other labels for acetaminophen or APAP, and to get medical help at once after taking more, even when feeling well. Liver disease and alcohol raise the risk. The FDA limits prescription combinations to 325 mg of acetaminophen per tablet.

The DEA moved hydrocodone combinations to Schedule II in October 2014, so they cannot be refilled, and an unfilled electronic prescription can be transferred only once. Prescribers are asked to discuss naloxone or nalmefene; naloxone 4 mg nasal spray is sold without a prescription.

Taking Hydrocodone/Acetaminophen

How to take it

As prescribed, without going over the label’s daily tablet limit, which is lower for the 7.5 and 10 mg strengths. Measure the liquid in milliliters with a marked oral syringe or cup, never a household spoon. After regular use it is tapered, not stopped suddenly.

If you miss a dose

It is usually taken only as needed. If your prescriber has you take it on a schedule, MedlinePlus says to skip a missed dose and continue your regular schedule.

Storage

At room temperature, away from heat and moisture, in the original container, somewhere others cannot reach. Take unused medicine to a take-back program.

Interactions to know about

Do not take other products containing acetaminophen or APAP. Alcohol adds to the liver risk and, like benzodiazepines, sleep medicines, gabapentin, pregabalin and other sedatives, to its effect on breathing. Erythromycin, ketoconazole and ritonavir raise hydrocodone levels; serotonin-affecting antidepressants can cause serotonin syndrome. Stop and seek care at the first sign of a rash.

This summarizes the official prescribing information. Your prescriber’s and pharmacist’s instructions, and the leaflet that comes with your medicine, take priority.

Why the cash price for Hydrocodone/Acetaminophen differs from pharmacy to pharmacy

The 325 mg tablets have many makers, so quotes differ mainly by fee, markup and quantity; the 300 mg tablets and the liquids have fewer makers and may need to be ordered.

Schedule II drugs are ordered on a special DEA form from wholesalers that must flag unusual orders and can set their own ordering thresholds, so a pharmacy short of stock may fill only part of a prescription or turn it away.

Ways to pay less for Hydrocodone/Acetaminophen without insurance

• Confirm stock before the prescription is sent, since an unfilled electronic prescription can be transferred only once.
• Ask for a partial fill if you may not need every tablet; where state law allows, the rest can be collected within 30 days of the date written.
• If a liquid or a 300 mg tablet is prescribed, ask the prescriber whether a 325 mg tablet would suit you.
• Upload the prescription to Script Unlock so licensed pharmacies can quote their cash price. You pay the pharmacy directly.

Questions to ask your pharmacist about Hydrocodone/Acetaminophen

1. 1.How much acetaminophen am I taking a day at this dose?
2. 2.Which over-the-counter products contain acetaminophen?
3. 3.Is my strength in stock, and can you fill the full quantity?
4. 4.Is it safe with my sleep, anxiety or nerve-pain medicines?
5. 5.Can I buy naloxone here, and how is it used?

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