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Uses

Medical

Hydrocodone/paracetamol medication is used to relieve moderate to severe pain. It contains an opioid (narcotic) pain reliever (hydrocodone) and a non-opioid pain reliever (acetaminophen). Hydrocodone works in the brain to change how your body feels and responds to pain. Acetaminophen can also reduce a fever. Hydrocodone is an opioid pain medication, sometimes called a narcotic. Acetaminophen (paracetamol) is a less potent pain reliever that increases the effects of hydrocodone. Together acetaminophen and hydrocodone is a combination medicine used to relieve moderate to severe pain.

Recreational

It’s believed that hydrocodone works like other opioids, in that when it’s taken it binds to opioid receptors, which are located throughout the central nervous system. It doesn’t stop pain from occurring, but it does raise a person’s tolerance for pain, and it changes how they sense pain. At a normal dose, when hydrocodone is used for legitimate pain, a person won’t feel much of a high, but a high is possible when people take larger doses, or they abuse the drug. When used recreationally, hydrocodone produces effects very similar to morphine, heroin, and oxycodone. Intensity is slightly lower than morphine or heroin because these two drugs are generally administered intravenously. Contrary to popular belief, hydrocodone is actually a very addictive drug when misused. When used under medical settings exactly as prescibed, most users of hydrocodone do not become addicted to the drug. But many other people can go doctor shopping to obtain this drug and use it for their own recreational use.

Important Warnings

Use with central nervous system (CNS) depressants

Taking opioids with CNS depressants, such as benzodiazepines or alcohol, may result in excessive sedation, slow breathing, coma, and death.

May cause liver failure

taking too much acetaminophen can cause liver failure. Sometimes, this results in the need for liver transplant, or death. Most reported cases of liver injury have occurred when a person took more than 4,000 mg of acetaminophen per day, usually together with more than one product containing acetaminophen.

May cause addiction, abuse, and misuse

Taking this drug increases your risk of opioid (narcotic) addiction, abuse, and misuse. This could lead to overdose and death.

Drug interactions

Hydrocodone and acetaminophen are broken down by your liver. If you take these drugs with another drug that can affect your liver, hydrocodone and acetaminophen could build up in your body and cause more breathing problems and other side effects.

Severe allergic reaction

Which may include:

• trouble breathing
• swelling of your face, throat, and mouth
• rash
• itching
• vomiting

Side Effects

Most common

• noisy breathing, sighing, shallow breathing;
• a slow heart rate or weak pulse;
• pain or burning when you urinate;
• confusion, tremors, severe drowsiness;
• a light-headed feeling, like you might pass out; or
• low cortisol levels--nausea, vomiting, loss of appetite, dizziness, worsening tiredness or weakness.

Hepatotoxicity

Acute

Despite wide scale use for many decades, hydrocodone by itself has not been convincingly linked to instances of clinically apparent acute liver injury.  However, when combined with acetaminophen, hydrocodone combinations have become a common cause of acetaminophen acute liver injury.  The typical history is of a patient who began taking more than the prescribed number of pills over several days, attempting to achieve more of an opiate effect and leading secondarily and unintentionally to an overdose of acetaminophen.  Because of the potential for hepatotoxicity, the FDA has warned against the use of opioid combinations in which the dose of acetaminophen is greater than 325 mg per tablet.

Chronic

Poisoning is a potential risk factor.

Withdraw

Symptoms generally include, insomnia, shakes, chills, anxiety, fatigue, nausea, vomiting, restless leg syndrome, and goosebumps. Withdrawal symptoms begin shortly before the next dosing time, and continue for 72 hours, increasing in intensity, then after the 72 hour peak, the symptoms drastically recede.