Hydrocodone/paracetamol
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|---|---|
| Hydrocodone | Opioid Analgesic |
| Paracetamol | Anilide Analgesic |
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| Routes of administration | Oral |
| Legal status | |
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Vicodin is a trademarked brand narcotic analgesic product containing hydrocodone and paracetamol (acetaminophen). It is usually found in tablet form with either the names Vicodin, Vicodin ES, or Vicodin HP imprinted on one side. Analgesics with the same chemical composition and a similar physical appearance are found under many other trade names, including Anexsia, Anolor DH5, Bancap HC, Dolacet, Lorcet, Lortab, and Norco. The hydrocodone/paracetamol drug formula is also available under generic brands. The paracetamol in the formula increases the effects of the hydrocodone. Hydrocodone also comes in a combination with ibuprofen, available under the trade name Vicoprofen.
Ingredients
Vicodin is made as a mixture fo hydrocodone and paracetamol. Paracetamol is also called acetaminophen, commonly known as Tylenol, which acts as an analgesic/antipyretic. Hydrocodone is a mixture of the opiate Codeine and the opiate alkaloid Thebaine. Codeine acts as an antitussive, antidiarrheal and analgesic, while the thebaine is added for its stimulatory effects.
- Vicodin contains 500 mg paracetamol and 5 mg hydrocodone
- Vicodin ES contains 750 mg paracetamol and 7.5 mg hydrocodone
- Vicodin HP contains 660 mg paracetamol and 10 mg hydrocodone
Non-active ingredients included in each pill as well: colloidal silicon dioxide, starch, croscarmellose sodium, dibasic calcium phosphate, magnesium stearate, microcrystalline cellulose, povidone, and stearic acid. [1]
Regulation and scheduling
In the United States, Vicodin production is regulated in part by the Controlled Substances Act of 1970. This guarantees that all manufacturing, importing, possession, and distribution of drugs is to be overseen and regulated by the federal government.
In the U.S. Hydrocodone is a Schedule III drug. Other drugs on this list include anabolic steroids, dihydrocodeine, dronabinol, ergine, ketamine, paregoric, and Xyrem; codeine and hydrocodone are also Schedule III but only when compounded with paracetamol or with an NSAID. Schedule III drugs are classified by the U.S. government as potentially causing moderate or low physical dependence or a high psychological dependence if abused. There is a high inclination for abuse of this drug.
Manufacture
The principal constituent of Vicodin, hydrocodone, has the same basic structure as morphine but is metabolized by different enzymes. There are two(three) variations of Vicodin, with different amounts of hydrocodone / paracetamol (acetaminophen) in each. Hydrocodone is a strong drug which has similar effects as morphine, because of this, the pills are made with much less hydrocodone than paracetamol. The theory of using the mix comes from the idea that these drugs alleviate pain using different mechanisms and also that the adverse side effects of each separte drug are reduced by using reduced dosages of both drugs in order to get the same analgesic effect. [2] Both hydrocodone and acetaminophen are white crystalline powders, which are then manufactured into pill form. Manufacturers of hydrocodone (generic or otherwise) include Abbott Laboratories (makers of trademark Vicodin), Amerisource Health Services Corp, Cardinal Health, Drx Pharmaceutical Consultants Inc, Eckerd Corp, Hospira Inc, Knoll Laboratories Div Knoll Pharmaceutical Co, Mallinckrodt Pharm. Quality Care, Pdrx Pharmaceuticals Inc, Physicians Total Care Inc, Rx Pak Div of Mckesson Corp, Sandhills Packaging Inc, and Watson Pharmaceuticals.
Pharmacokinetics
Besides the activity of hydrocodone and acetaminophen on their own, there is observed a factor of analgesia related to the two substances in tandem which is not altogether understood, but this independent synergy has been observed to be related to the inhibition of prostaglandins. The pharmacokinetics of a mixed drug such as Vicodin depends on the kinetics of the drugs that comprise it. We will look at the two main constituents separately, hydrocodone and paracetamol. Hydrocodone: acts at mu opioid recepors. [3] Hydrocodone must be metabolized to its active state, hydromorphone. This metabolism occurs by the activity of cytochrome P450 2D6. Cytochrome 3A4 forms the active substrate norhydrocodone. Cytochromes are a form of hemoprotiens found in the cells of all living organisms and are involved primarily with electron transport. The half life of hydrocodone is approximately 3.8 hrs. Paracetamol:this drug is fuckin awesome and if you consume about ten you will feel fuckin great
Indications
Vicodin, like other opioid analgesics, is used to manage pain. It is most commonly prescribed for relief of moderate to moderately severe pain of acute, chronic, or post-operative types. It can also be used to treat severe cough.
Pregnancy
This drug is classified under pregnancy category C. Although not enough research has been done to deem this drug safe for pregnant women, if the positive effects outweigh the possible negatives, then it can be taken. If taken in the time before delivery, it may give rise to respiratory depression in the baby. Mothers who use any opioids regularly during pregnancy run the risk of their babies being substance dependent and therefore going through withdrawal symptoms after birth. Withdrawal symptoms include: excessive crying, vomiting, irritability, tremors and fever. Nursing mothers should not use this drug as paracetamol is transferred through breast milk and it is unknown if hydrocodone is.[4]
Side effects
Side effects for Vicodin are most commonly upset stomach, nausea, and altered mental status (eg. dizziness, light headedness). Other more rare side effects include allergic reaction, seizures, clammy skin, severe weakness, dizziness, hyperventilation, unconsciousness, jaundice (yellowing of eyes or skin), unusual fatigue, bleeding, bruising, stomach pain[5], constipation, dry mouth, decreased appetite, muscle twitches, sweating, hot flashes, itching, tinnitus, hearing loss, decreased urination, and increased sex drive. Vicodin also has depressant effects on the central nervous system. However, some of the less mundane effects can be desirable effects that are sought after by some. Those effects include euphoria and drowsiness, as well as slowing of the pulse. Unlike NSAIDs, Paracetamol does not cause ulcers. However, severe liver damage can occur in patients consuming more than 4 grams of paracetamol per day.[citation needed]
References in pop culture
- The TV show House M.D. features the main character, Dr. Gregory House, taking Vicodin often to control the pain in his operated leg. His addiction to the drug is a source of controversy on the show. In the episode Detox, Dr. House experiences severe withdrawal symptoms. His addiction has also lead Detective Michael Tritter to sue him for illegal prescriptions in the episodes Fools for Love to Words and Deeds.
- The TV show Two and a Half Men also featured Vicodin in an episode when the main character, Charlie Harper, got into a fight. He also spelled Vicodin as "Vicoden" and remarked, "That's the thing about Vicodin, I don't care."
References
- ^ http://www.rxlist.com/vicodin-drug.htm
- ^ Beaver W.T., and McMillan D. Methodological considerations in the evaluation of analgesic combinations: Acetaminophen (paracetamol) and hydrocodone in postpartum pain. Br. J. Clin. Pharmac. (1980), 10, 215S-223S
- ^ Zacny, J.P., Gutierrez, S. and Bolbolan, S.A. (2004) Profiling the subjective, psychomotor, and physiological effects of a hydrocodone/acetaminophen product in recreational drug users. Drug and Alcohol Dependence. 78 243-252
- ^ http://www.drugs.com/pro/vicodin-hp.html
- ^ Drugs.com (March 24, 2008). "Vicodin". Cerner Multum, Inc. Retrieved 2008-06-09.
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