Talk:Hydrocodone

Untitled

This page should not be used as a reference. Please use the main article page instead.

Heresay

I removed the following block of text.

"Tolerance to this drug can increase very rapidly if abused. Because of this, addicts often overdose from taking handfulls of pills, in pursuit of the high they experienced very early on in their hydrocodone use."

There are two big problems with this. First, tolerance is not dependent on whether a drug is used as directed or used recreationaly. Tolerence will increase with any long term use. Second, claiming that addicts (condescending) often overdose because they do not calculate how many mg's they are consuming is ridicules for a few reasons. 1. it's easy to divide the dosage needed by the size of the pills to reach the correct number of pills. 2. Taking hand fulls of pills is a lethal dose no matter how tolerent a user is. A hand full could easily have 50 pills in it even with the lowest dosage that is 250mg a lethal dose for all but the the most long term user. Who ever added this also failed to cite a source. Because of all this I could not allow it to remain in the article for even a day waiting for a source. Tomorrow I will replace it with sourced accurate information of acetaminophen and hydrocodone overs dose's. Foolishben 07:24, 28 November 2006 (UTC)

You can feel likehaving sex when taking three. --24.143.14.88 09:15, 27 December 2006 (UTC)

dude youre an idiot. An Angry Platypus 03:08, 19 October 2007 (UTC)

If you've never taken it before. If you're tolerant it can take sometimes even 10 pills to get that same feeling. --Brad219 06:31, 9 April 2007 (UTC)

Tolerance only develops if you want to get higher and higher. If you maintain your dose, the initial feeling of contentment will stay with you for years. But most people are tempted to take more to get a bigger sense of euphoria thus developing a tolerance. Dose maintenance is important, it works and you can enjoy the mild euphoric effects for many years, however if you do get tempted to increase the euphoric effects by taking more, you will quickly fall into a circle that will lead to tolerance.

That's not the way tolerance works. It doesn't matter how little you're taking; if you're taking it regularly (i.e. daily, or even less often) you'll develop a tolerance. You won't develop it as fast as if you were taking higher doses, but it will still happen. --Galaxiaad 02:58, 11 August 2007 (UTC)

i was taking these things for 5 years and never upped my dose and always got that same great feeling, then one day i decided to start taking more at a time, thats when the tollerance developed. —Preceding unsigned comment added by 76.161.201.30 (talk) 20:55, 3 June 2008 (UTC)

Galax is right. An Angry Platypus 03:08, 19 October 2007 (UTC)

Uncited Fact

I believe drug-related articles should only contain facts cited to specific, reliable sources. Thus, I removed the reference to pharmacological equivalence in the opening paragraph. I also removed the second (and empty) External Links section. --Impaciente 05:24, 11 May 2006 (UTC)

What is the chemical and international names please ?

In the USA the brand name is "Lortab" and it's distributed (by prescription) in 500mg tablets. I suspect other doses are available but 500mg are the only ones I've seen. Worked wonders for my toothache! Zerbey 20:37, 22 Sep 2004 (UTC)

The original and most common brand name is Vicodin in the US. Also, tylox is the brand name for percocet, not hydrocodone. Someone might want to check the other brand names to see if they're correct.

500mg, that's insane and quite misleading. The pills come in many different combinations of hydrocodone-bitartrate and acetaminophen sometimes upto 10mg and 650mg respectively (Lorcet) [1], and medically speaking it isn't right to add the two numbers together.

I suspect that's the case here (I did doublecheck the bottle, though) so the mistake lies with my pharmacist. I suspect 500mg of pure Hydrocodone would be fatal. Zerbey 21:17, 4 Apr 2005 (UTC)

here in the US I got some generic from Watson labs (WATSON 387) ... it's 7.5 hydrocodone bitartrate and 750 acetaminophen 208.59.171.97 17:24, 7 July 2006 (UTC)

Yes, that's correct. The smaller number indicates the dose of opioid, in this case hydrocodone, while the larger number represents the dose of the co-drug, in this case, acetaminophen. Lorcet, Lortab, and Vicodin are brand names, all having the same generic active ingredient, the opioid hydrocodone. For example, a prescription for Lortab 5/500mg tablets would represent pills containing 5mg of hydrocodone and 500mg of acetaminophen each. A similar methodology is followed for dosing of other opioid compound drugs, such as Percocet (oxycodone/APAP), which is available in 5/325mg, 10/325mg, and other formulations.

The drug's salt (e.g., bitartrate, hydrochloride, etc.) is listed for the sake of completeness, but should have little or no impact on the consumer of the medication. It primarily represents the true form of the compound as it has been synthesized for consumption and relates to the drug's in vivo solubility and bioavailability.

What are schedules ?

The schedules refer to the class of "controlled" substance, I believe.

It's schedule II in the US just like all strong opiods

I think it's schedule III in small doses when mixed with acetaminophen? checking 208.59.171.97 17:24, 7 July 2006 (UTC)

NO! proproxyphene, hydrocodone and codeine are schedule III. fentanyl, oxycodone, hydromorphone, oxymorphone, morphine, and the like are schedule II.

Proproxyphene in the form of Darvocet (100 of propoxyphene and 650 milligrams of APAP) is actually in Schedule IV status.

hydrocodone is a schedule II substance when packaged alone. However, it is schedule III when combined with another analgesic such as APAP(paracetamol) or acetyl salicylic acid (aspirin).Wcbradley and under 15 milligrams of hydrocodone 17:14, 4 March 2007 (UTC)

Additionally, a dose of hydrocodone (one pill) must be under 15 milligrams and contain the above mentioned non-narcotic analgesics to be placed in the Schedule III category. Anything over 15 milligrams (with or without an added non-opioid)is placed in C-II. It should be noted there is currently no pharmaceutical manufacturer in the United States making hydrocodone tablets with over 15 milligrams of the medicine in it. A physician, however, can write a prescription for a pharmacist to compound hydrocodone tablets with more than 15 milligrams and without the added non-opioid analgesic.

Right. The word "schedule" refers to the US Controlled Substance Act, a policy that calls for careful regulation of drugs with potential abuse. Schedule I drugs are those with no known medicinal value, and includes "street" drugs such as heroin, GHB, Ecstasy, LSD, and others. Schedule II refers to drugs with high abuse potential but with a known medicinal value. Schedule II drugs include the potent, but addictive, opioids such as fentanyl (Duragesic, Actiq), hydromorphone (Dilaudid), morphine (Avinza, MS Contin), oxycodone (OxyContin, Percocet, Percodan); cocaine; methylphenidate (Ritalin); and others, including cocaine (sometimes used in nasal and occular surgery to dilate blood vessels and to numb the area for an operation). Schedule III drugs are those with less abuse potential than those in Schedules I and II, but can still lead to dependence in spite of their medicinal value. Drugs in Schedule III include anabolic steroids, ketamine, paregoric (a opium-derived camphorated tincture), and others. The pattern continues in Schedules IV and V. C-IV are typically drugs in the benzodiazopene category (alprazolam, diazapem, lorazepam and others, plus weaker opioids drugs). C-V's include opioids, such as codeine in the form of cough suppresants (Robitussin-AC), anti-diarrheals (low dose tincture of opoium) and pain medicines in low doses (codeine). Additionally, the new anti-convulsant, Lyrica (pregabalin), which is typically used to treat chronic pain caused by fibromyalgia, diabetic neuropathy pain, spinal cord injury and other forms of chronic pain. It is unique in so much as similar drugs in its class are not typically placed under control substance status.

Deadly dose

Anybody knows what is the deadly dose of Vicodin? 500mg might be a deadly dose.

Vicodin is paired with acetaminophen to maximize the results of the Hydrocodone-Bitartrate, The Vicodin is sold in many ratios, http://www.rxlist.com/cgi/generic/hydrocod.htm. My prescription for example said 500mg Vicodin - but that is rather 500mg of acetaminophren and 5mg of hydrocodone. It is slightly misleading. Undoubtably your heart would stop and you would probalby be very sick to your stomach before that would happen. The acetaminophen is toxic when combined with alcohol in your liver. Though I don't really know why. I wouldn't mind this article being converted to a stub, it doesn't contain much information on the types, ratios, or even that they always contain acetaminophren.--x1987x 20:52, 3 Apr 2005 (UTC)

No pharmacist would label your prescription as 500mg hydrocodone. anyone who thinks that hydrocodone comes in such high doses does not know how to read a pill bottle. generic and brand name hydrocodone preparations alike ALWAYS say, for example "HYDROCODONE/APAP 5/500". this refers to there being 5 milligrams of hydrocodone and 500 milligrams of acetaminophen/paracetamol. There are many other dosages such as 5/325, 7.5/500, 7.5/650, 7.5/325, 10/650, 10/500, and 10/325. I have also heard of, but never encountered 2.5/325 tablets.Wcbradley 17:20, 4 March 2007 (UTC)

Thank you for your suggestion regarding [[: regarding [[:{{{1}}}]]]]! When you feel an article needs improvement, please feel free to make whatever changes you feel are needed. Wikipedia is a wiki, so anyone can edit almost any article by simply following the Edit this page link at the top. You don't even need to log in! (Although there are some reasons why you might like to…) The Wikipedia community encourages you to be bold. Don't worry too much about making honest mistakes—they're likely to be found and corrected quickly. If you're not sure how editing works, check out how to edit a page, or use the sandbox to try out your editing skills. New contributors are always welcome. JFW | T@lk 23:46, 31 Mar 2005 (UTC)

Hyrdrocodone (Lortab; Lorcet) comes in 5, 7.5 and 10 mg oral dosages. The 500 mg that you mention is the amount of acetamenophen in combination with the hydrocodone. A 500 mg dose of Lortab would, I'm sure, be deadly to anyone, even the most tolerant addict. Generally the dosages are 5mg/500 mg; 7.5mg/500 mg or 10mg/500 mg in Lortab. The difference with Lorcet is that the mg of acetaminophen is higher, generally 650 mg or 1000 mg. I have been taking Lortab 7.5 for just over 3 years for a chronic pain condition (4 doses per day). At times, I have had to take 2 pills instead of 1, which meant I had to skip a dose later that day or the next. I am tolerant to the medication now so do not get the euphoric effect, even if I take 2 at a time. However, I am quite certain that if I took 66 2/3 7.5 mg pills (the equivilant of 500 mg), I would die.

My only source for this information is my personal experience and what I read on the prescription bottles and the paperwork that comes with my prescriptions. I used to used CVS pharmacy, but now use Fred's. Both places are very good about answering questions about the medications I have to take - believe me, I've annoyed the heck out of the pharmacists - I have OCD and I ask millions of questions about everything.

There is no single "deadly dose" which can fit everyone; someone who takes a very high daily dosage to deal with high pain levels would be much harder to kill with hydrocodone than somebody who is totally intolerant. It is quite safe to say that 500mg of hydrocodone would be fatal for anyone, though. Your lungs would shut down quickly. Also, please sign your comments with four tildes (~). Rarr 04:35, 5 March 2007 (UTC)

With all due respect to the above poster, it is not inconceivable for a person to have a tolerance that would allow them to take 500 milligrams of hydrocodone. I have been on OxyContin and another oxycodone medication for over four years for a chronic pain condition. At one point, I was taking 400 milligrams of OxyContin a day, with an additional 150mg of OxyIR, which comes to 550 milligrams. As any person with some knowledge of opioids would tell you, oxycodone is about 2-3 times stronger than hydrocodone. So, yes, a person who has little to no tolerance to narcotics would certainly die of respiratory arrest on 500 milligrams of hydrocodone. But if someone who had a high tolerance to opioids, they could easily take that much hydrocodone. What would kill them, however, is taking that much hydrocodone in a form such as Lortab, Vicodin or Norco, which also has Tylenol in it. These drugs have from 325 to over 700 milligrams of paracetemol in them. Most sources say a person should not take over 4,000 milligrams of it in a 24 hour period. So, in order to consume 500 milligrams of hydrocodone for anyone taking something like Norco (325mg of APAP), they would also ingest 16,250 milligrams of APAP, which would cause permanent damage to the liver. So if someone could safely ingest 500 milligrams of hydrocodone due to their tolerance, they would have to do so with a form that contained little to no paracetemol to safely do it.

With all due respect to the above poster, you are wrong. The strongest dose of Hydrocodone manufactured legally in the U.S. is 10mg/pill. In order to ingest 500mg of Hydrocodone a person would have to take at least 50 pills (that is at the strongest dosage of pill)-regardless of their habit, do you seriously think someone would live through that? To even suggest that a person could remain conscious long enough and not throw up at that level of intake is slightly exasperating. Furthermore this article has nothing to do with OxyContin, in any of it's forms, we are discussing Hydrocodone, which is a completely different chemical. Have you ever held 50 10mg Hydrocodone pills-upon doing so it becomes blatantly obvious that it is a dosage reserved for trying to put down large farm animals. As a person who has extensive experience in the matter of Hydrocodone abuse (you should just peek at my record) I can say with complete certainty that if I had ever taken 500mg of Hydrocodone I would have died. To even say that your body wouldn't reject that level of intake over the course of a day-roughly 1/3 a mg of Hydrocodone a minute is absurd. Anyone who has dealt with this drug to any serious extent will tell you the same thing-it is inconceivable. If you still think that you could handle 500mg of Hydrocodone you should go take 250mg and try to respond to my statements in this article. I strongly believe when you realize that you can no longer function with any reasonable ability you will wish you were physically able to withdraw your above said statements. —Preceding unsigned comment added by Kamclimber (talk • contribs) 03:59, 2 April 2008 (UTC)

I think you also need to think about oxycotin being time released. Sure you can take 400 mg, but you aren't getting it all at once. However, your body can indeed build a strong tolerance to them. I have severe chronic pain, and can work while taking up to 20 mg every 5 hours and my performance output is still very high. More so if I didn't take anything due to the pain obviously. However, my fiance cannot function soberly at 5 mg. Some people can handle doses that doctors would say are medically impossible, but then again, those people end up having severe problems when they stop or get older. (Not sure how to sign? This is my first edit. Thanks!) —Preceding unsigned comment added by 72.94.111.220 (talk) 18:03, 27 September 2008 (UTC)

I am pointing out a mistake in a comment above. Propoxyphene is not a "Schedule III" medication. Propoxyphene/APAP is a Schedule IV medication. It's too bad pharmacists don't write these pages. —Preceding unsigned comment added by 137.99.157.3 (talk) 22:33, 21 January 2009 (UTC)

So fix it? Wikipedia is specifically designed so that anyone can fix mistakes. This looks like an on-going debate...please find us an authoritative source so we can get it correct and cite a reference instead of lots people just asserting various thoughts. DMacks (talk) 23:25, 21 January 2009 (UTC)

Comparison of oral codeine and oral hydrocodone

The article currently states that : "The typical therapeutic dose of 5 mg to 10 mg is pharmacologically equivalent to 200 to 400 mg of oral codeine." This is total nonsense. The general rule of thumb is that hydrocodone is 6 times more potent than codeine on a per milligram basis, when taken orally. While some people would argue that 8 times more potent is closer to the mark, there is absolutely no way that hydrocodone is 40 times more potent.

Right you are. For example, a Norco 5/325 (5 mg hydrocodone) is pretty much equivilant to a Tylenol # 3 (30 mg codeine). Changed article to reflect this.Osmodiar 18:03, 22 November 2005 (UTC)

Hydrocodone/apap pills can be extracted to be made into pure liquid hydrocodone, or at least semi pure, or at least enough for you to be able to take 500mg of hydrocodone from 50 10mg hydro pills. I've come close, sadly. —Preceding unsigned comment added by 12.208.148.105 (talk) 04:04, 18 December 2008 (UTC)

Vicoprofen

It may be worth noting that hydrocodone (I don't know how much; probably the typical therapeutic dose) is paired with 200 mg of ibuprofen under the name "Vicoprofen."

Vicoprofen has 7.5 milligrams of hydrocodone it. This is the only dose of the drug currently available.

Side Effects

Does any one know if 7.5/750 dosage every six hours is harmful to your liver if you already have chirrosis? -Unsigned1

It is very likely that the higher doses of Hydrocodone (such as the 7.5/750 dosage you mentioned) are harmful, even with occasional use, to your liver if it is already compromised. Because the liver is your bodies filter, and because Cirrhosis of the liver means scar tissue has compromised your bodies filter, you should consult a physician and consider taking another pain medication that does not contain Hydrocodone or Acetaminophen.

I agree, but the logic here needs to be clarified. Acetaminophen (paracetamol) is an effective antipyretic drug found in both over-the-counter and prescription drugs. The generally agreed upon maximum dose of acetaminophen is 4 grams in those with normal liver function. Unfortunately, clearance of acetaminophen involves a toxic metabolite, NAPQI, that can cause significant damage to the liver if it is allowed to accumulate. Any substance (e.g., alcohol) or condition (e.g., cirrhosis) that compromises hepatic function should prompt you to consult your physician before continuing to ingest large amounts of any drug that are metabolized by the liver. In patients with severe liver dysfunction, drugs that are normally cleared by the liver may need to be dose-adjusted downward to parallel the decrease in liver function. In some cases, these drugs must be avoided entirely, but that decision should be left to the prescribing physician.

Normaly when a person has liver damage, doctors prescribe Morphine, Oxycodone or some kind of non-Acetaminophen opiod; or a supostiory which bypasses the liver.

- See notes below, but most opioids (just like acetaminophen) are metabolized by the liver. This means that the liver's overall function is important when considering what dose is appropriate; usually, the poorer the liver function, the lower the daily maximum dose.

- Also, suppositories containing medications, as a general rule, DO NOT bypass the liver. Unless they are specifically designed to act locally within the large bowel, drugs contained within the suppository will diffuse across the colonic wall, into the venous system, and travel to the liver via the portal vein. A prime example is acetaminophen, often given as a suppository (per rectum, or "PR") to infants or young children who are unable to take medication by mouth. This would be an exercise in futility if the medicine just sat there in the large intestine and did nothing, but it doesn't. It diffuses into the venous circulation, travels to the liver, and eventually works its way around the body to effect its action on prostaglandin synthesis.

Hydrocodone itself does not interact with your liver - it bonds with and is disposed of by opioid receivers throughout your body. 2250mg or 2.25g of acetaminophen is well within safe limits even for somebody with cirrhosis of the liver, though you may want to talk to your doctor about giving you a light dose of Oxycontin instead of any Hydrocodone preparation - oxy is more potent, but it is also time release. You'll save time - only need one or two pills a day - and money, since you don't take as many oxys. -Unsigned2

Your statement above is wrong. Hydrocodone acts on mu-opioid receptors in the brain, spinal cord, and gut, but it is almost completely metabolized by the liver. To say that it does not interact with the liver, then, would be incorrect. - Unsigned3

I may be wrong, but the person that mentioned that hydrocodone does not interact with your liver may have meant that, unlike aceitaminophen, it does not cause damage to the organ, even in high doses. Opiates and opioids are relatively easy for the liver to process. Many people think that opioids are dangerous to organs like the liver and kidneys, when it is really when these drugs are combined with aceitaminophen, aspirin or ibuprofen that damage can be caused.

OxyContin also has no acetaminophen or any other active chemical besides oxycodone, meaning it's perfectly safe for even the most booze-afflicted liver. 7.5 is not even a high dose of hydrocodone, so I have no idea what the above responders are talking about. I'm not sure just how old this question is, since it's also unsigned, but I hope I'm doing some good for whoever sees this. Rarr 22:36, 24 April 2006 (UTC)*

Again, please check your facts, because what the above user said is wrong. I am a physician and wanted to point out that oxycodone, like many opioids, is metabolized extensively by the cytochrome P450 system in the liver. While the drug acts on mu-opioid receptors in the CNS and gut, it is metabolized by the liver and later excreted. If the liver becomes diseased or damaged, as in cirrhosis, the organ is less able to produce the necessary enzymes to metabolize the drug to an inactive, excretable form. In cases of end-stage liver disease, any drug metabolized by the liver should be evaluated for dose-adjustment; that is, the dose should be decreased to a level commensurate with the decrease in hepatic function in an effort to prevent build-up of the drug (or its active metabolite) to dangerous or even toxic levels.

To say that oxycodone is "perfectly safe for even the most booze-afflicted liver" is absolutely false. Refer to Clinical Pharmacology or another drug database to confirm that metabolism occurs in the liver. -Unsigned3

• If you're hoping to do some good for whoever sees this and help the page, thanks, but please recheck some of your facts and "cite resources".I listed a few below. (Volcano1776 19:45, 21 July 2006 (UTC))

http://www.healthboards.com/boards/showthread.php?t=269816&highlight=percocet [url]http://www.ohsu.edu/ahec/pain/part2sect3.pdf[/url] http://www.drugtalk.com/hydrocodone/?p=16 http://www.medscape.com/viewarticle/409025_6 http://www.healthboards.com/boards/showthread.php?t=192457&highlight=vicodin http://www.denisonia.com/policeDept/heroin.asp http://www.rxmed.com/b.main/b2.pharmaceutical/b2.1.monographs/CPS-%20Monographs/CPS-%20(General%20Monographs-%20H)/HYCODAN.html http://www.netwellness.org/question.cfm/25961.h

(Volcano1776 19:45, 21 July 2006 (UTC))

I'd like to clarify for the record that most of the chunk of text above my signature isn't mine; just the last paragraph. The rest was contributed by several people who didn't sign, so I've denoted that. All of the erroneous facts were in those people's contributions. Sorry for the misunderstanding, and your references are still quite valid. Rarr 08:49, 23 December 2006 (UTC)

Vicodin Half Life in Chart

Is the 408 hours really 4-8 hours (4 to 8 hours)?

yes

How long is Vicodin (hydrocodone) detectable by urine or blood testing?

In urine testing, approx. 48 hours.

I don't understand much about medication, but the other night a friend of mine gave me a Lortab. She told me it was Tylenol. I believed it because I was drunk. The next day, I woke up with hives & asked what she gave me. I am still breaking out with hives & itching because I am allergic to Hydrocodone. How long will it stay in my system so I know when to expect the hives to go away? 68.203.133.37 06:26, 2 April 2007 (UTC)CF

The hydrocodone will flush from your system by the end of tomorrow, but you will probably stop breaking out by the end of today, since most of it will be in your kidneys by then. Rarr 10:21, 2 April 2007 (UTC)

Water extraction

What is this "hot water/cold water" extraction process mentioned in the article? Roland Deschain

• Maybe one of us will add to that. But not right now.--Kalmia 06:15, 20 July 2006 (UTC)

HELLO! made several changes in wording to article as it pertains to extraction. Someone gave instructions to filter OUT the hydrocodone. Since opioids have a HIGHER solubility in cold water, the ADJUNCTS would precipitate out first when cooling. This would have users ingesting the precipitate, i.e. acetaminophen. Changed it.67.97.153.253 20:27, 7 September 2007 (UTC)

Suggested merge

I'm suggesting that Vicodin be merged into this article. Most (possibly all) other brand-name medications I've looked up here have redirected to their generic name (this may be different for meds that aren't available generically yet—I haven't checked). The vicodin article contains mostly information that is redundant to this one (contraindications, side effects, overdose, use during pregnancy, etc.) There is enough unique info or expanded explanations that someone may think are more informative, however, that I do not feel comfortable doing a simple redirect from there to here. If you support, oppose, or simply want to comment on this proposition, please feel free to do so here. --Icarus 14:10, 21 June 2006 (UTC)

• Yes, it used to be a redirect. What was the reason for the change? --Kalmia 03:56, 22 June 2006 (UTC)
• Def merge it. --Ncosmob 17:44, 23 June 2006 (UTC)
• Percocet goes to Oxycodone. Merge --Drierp 19:41, 27 June 2006 (UTC)
• Agreed. Merge gracefully and we'll have a meatier article here. Rarr 06:34, 30 June 2006 (UTC)
• Agreed. Vicodin is a brand name for Hydrocodone/APAP Yendor 16:27, 13 July 2006 (UTC)
• Agreed. I would put all forms of generic Hydrocode (short acting) in a single article and then work to create side articles if needed. --Chrispounds 11:35, 15 September 2006 (UTC)
• Suggest redirect. I see no useful information in the Vicodin article that is not already contained in this article. Also, there is no need to have a seperate article for Vicodin since it is mentioned here in the text and in a nifty chart :) Markovich292 01:18, 29 November 2006 (UTC)
• Agreed. There is NO reason for this to have its own article. Thoerner 15:59, 16 August 2007 (UTC)

Well, someone copied the Vicodin pop culture references to here a while ago, changes are still being made to both pages, and there seems to be consensus, so I'm adding the "merge in progress" template there till the merge is finished. --Galaxiaad 18:21, 25 July 2006 (UTC)

• Disagree No to merging. As with Adderall, Dexedrine, and Benzedrine for amphetamine (same drugs) and Desoxyn for methamphetamine, this is no different.

I agree wholeheartedly. This is no different. Those should be, too. However, this is not the place to suggest that Adderall, Dexedrine, Benzedrine and emphetamine be merged, or Dexosyn and methamphetamine be merged. Those suggestions should be made on their pages. The guidelines on this sort of thing should be followed. 69.181.120.218 06:21, 12 August 2006 (UTC)

Instead of merging I suggest an expansion of the "Vicodin" article, including notes about the APAP content in Vicodin formulations and the problems APAP causes in recreational use. -- John Cho 04:38, 27 July 2006 (UTC)

Vicodin should be merged with this article - just because Adderall et all is not part of amphetamine doesn't mean there is any reason to make the same choice here. Adderall and Dexedrine contain nearly duplicate information as that of amphetamine - there is a section in each with information relevant to the brand that could be taken and added to amphetamine, but most of the rest is very similar. Benzedrine is almost entirely cultural references, again easy to merge. We should do the right thing here and provide an example to the other articles. Rarr 07:58, 27 July 2006 (UTC)

I see the merit in having separate articles for culturally significant drugs (is Benzedrine even prescribed anymore? Either way I think someone searching for it on Wikipedia would probably not be primarily looking for chemical/pharmacological information, and if they were they could click through to amphetamine) but that would create problems in deciding what's culturally significant. That combined with the redundancy of the articles and the naming guideline for drug-related articles make me think it's still best to merge. --Galaxiaad 13:48, 27 July 2006 (UTC)

Uh, the Adderall, Dexedrine, and Benzedrine articles for amphetamine all document the differences between the certain forms of amphetamine (Adderall being racemic dextro/laevo, Dexedrine being dextro-amphetamine racemate, and Benzedrine being dextrolaevo-ampphetamine.) This is similar to Vicodin in that it is hydrocodone in an APAP package to make it Schedule III under the DEA. As I stated, document these differences in the Vicodin article instead of merging. --John Cho 21:04, 27 July 2006 (UTC)

It isn't similar. Vicodin is hydrocodone HCI (all hydrocodone preparations that are commercially available are hydrocodone HCI, I believe) combined with acetaminophen/APAP. The two drugs don't have any specific interactions and the DEA's arbitrary scheduling has nothing to do with the inclusion of acetaminophen. Other pills containing hydrocodone may be pure hydrocodone or hydrocodone and ibuprofen. Less than 15mg hydrocodone per pill is Schedule III, 15+ is Schedule II - the DEA doesn't care whether there is acetaminophen there or not. You could argue that because Adderall, Dexedrine, and Benzedrine are all different amphetamine forms, they deserve their own article. Fair enough I suppose, they are measureably different. Vicodin is just a brand name for hydrocodone, which has no such chemical diversity. Every bit of information in Vicodin could easily be placed into Hydrocodone without distracting the focus of the article. Rarr 22:12, 27 July 2006 (UTC)

Vicodin contains hydrocodone bitartrate, not the hydrochloride salt. But anyway, like I stated, the article can be improved upon. --John Cho 23:51, 27 July 2006 (UTC)

Correct me if I'm wrong, but I think racemic is the same thing as dextro/levo, so Adderall and Benzedrine are exactly the same drug (though probably different salts). (With regard to the APAP, as far as I can tell it's just added to discourage abuse (and therefore relevant to its scheduling), as who really needs APAP when they've got a narcotic analgesic? Heh. But I don't feel like that's really relevant to this merge discussion.)

Let me try to better articulate why I think these articles (and those of the forms of amphetamine) should be merged. For one, Vicodin is not the only hydrocodone/APAP preparation. Lorcet and Lortab are two other common ones. Hydrocodone is also available combined with aspirin, ibuprofen, chlorpheniramine, phenyltoloxamine, homatropine, guaifenesin, phenylephrine, etc., etc. (source: http://www.drugs.com/alpha/h5.html and subpages) (and as far as I can tell there's no hydrocodone-only preparation, at least in the U.S. and Canada). It would be unwieldy and highly redundant to have articles for each commercially available combination of drugs. People can always look up the drugs individually. Different combinations/isomers/salts may be different in effect, but so are immediate release and extended release forms of the same drug (not just in how long the effect lasts, either— bupropion extended release was created to reduce the incidence of seizures from ingesting so much at once), and they're always in the same article (furthermore, Vicodin is available with various amounts and ratios of hydrocodone and APAP, each of which will clearly have a different effect, but a page for each would be ridiculous). We can redirect the names of each form to the INN's page and detail the differences there. I really strongly feel this is the only consistent, sane way to have prescription drug articles. --Galaxiaad 01:08, 28 July 2006 (UTC)

You are wrong. Adderall is d/l-amphetamine racemic while Benzedrine is dl-amphetamine (a racemic racemate.) They all are different and (especially the difference between racemic amphetamine and dextro-amphetamine) each article gives the specifics for their differences. --John Cho 01:19, 28 July 2006 (UTC)

i'd like a merge please as it's a brand—Preceding unsigned comment added by 172.189.67.13 (talk)

I don't think so. Vicodin is a mixture of two base drugs, so we can't merge Vicodin with this one as we have to merge Vicodin with the article for Acetaminophen as well, and think about those drugs that are combination of 3 or more chemiclas, then we have to "tri"-plicate or "more"-plicate their info into the articles of their components but we won't as we will avoid this whole "plicate" process with just one article. Therefore we have to keep Vicodin on its own. Any drug combination has to have its own page, because its pharmacology although similar is still different from the one of the drugs the drug combination is made from and the purpose of the article is to explain why. -- Boris 12:51, 15 September 2006 (UTC)

By that argument, we'd need to create Lortab (which is currently just a redirect to this article) as well, and every other brand name of every drug combination. It's sufficient to mention that hydrocodone is often combined with acetaminophen as Vicodin and Lortab, rather than maintaining separate, redundant articles. Hydrocodone is the main active ingredient and so it takes precedence. Rarr 07:40, 25 November 2006 (UTC)

This Topic should be merged since the actual substance is called Hydrocodone, and as stated earlier Vicoden is a trade name used by a praticular manufacturer.

While I generally would be in favor of this... due to television shows like House and popular knowledge place Vicodin as a known brand name, with it's own unique trivia and information about appearances in popular culture and otherwise. Other brand names that have become common have their own supplementary articles, like Tylenol and Excedrin... while Vicodin might not enjoy the incredible recognition of Tylenol, it is still recognized as it's brand than "hydrocodone" - David DIBattiste 13:12, 2 January 2007 (UTC)

If we kept separate pages for every well-known drug brand, we would have a lot of needless clutter. Xanax and Valium are well-known too, but they link to alprazolam and diazepam, their active ingredients. The same policy should apply here. Rarr 05:03, 3 January 2007 (UTC)

Xanad and Valium *are* alprazolam and diazepam. Vicodin is not hydrocodone. Hydrocodone is the strongest active ingredient but it is not the only one. Additionally, benzodiazepines are relaxants, sedatives, and anticonvulsants, not painkillers, and as such are not mixed with paracetamol/acetaminophen/apap. Additionally, the results of abusing them are less prominent. In the United States, hydrocodone alone is Schedule II, diazepam alone is Schedule IV. When you add the apap to hydrocodone and make the combo that is Vicodin, it becomes Schedule III. I realize that the Vicodin article is somewhat less than spectacular and not so good as the hydrocodone article itself, though personally I believe the best course would be expansion of the Vicodin article, as they are different. David DIBattiste 01:14, 4 January 2007 (UTC)

I'm afraid you're mistaken on several points. Benzodiazepines are very commonly abused (just look at the many users of, say, Valium in the past few decades), and while like any drug you can use them responsibly, it's insulting to say that the results of abusing them are 'less prominent'. The DEA scheduling system doesn't only look at abuse potential; benzos are schedule IV because they are used very commonly as, say, anti-anxiety medicines. The DEA system is sometimes influenced by politics as well; why else would marijuana be schedule I? Hydrocodone in doses 15mg or less is Schedule III; the acetaminophen has NOTHING to do with the scheduling of the drug. This is a very common misconception but it is simply false. The main ingredient in Vicodin is hydrocodone; it's already mentioned in this article many times that most hydrocodone preparations contain acetaminophen, ibuprofen, or other common painkillers. People can go to those articles all they want for information on them. In fact, it seems to me that our article already mentions really important information about the risks of acetaminophen overdose; possibly the point you were making when you mentioned the schedules? Lortab is the same mix of hydrocodone and acetaminophen, just in slightly different proportions. Do you want to make a separate article for every brand name and load them full of almost-identical information copied from this article? Vicodin does not have so much more name recognition than Lortab, and yet you want to treat it like it's special. Rarr 04:21, 4 January 2007 (UTC)

I didn't mean to say they were not abused, I know that they are. I meant to say they are substantially less lethal than narcotics, and less physically addictive. Secondly, of course the scheduling system is influenced by politics, how could it not be - it's run by a government agency. Schedule I is for substances found to have potential reason for abuse that have no legally accepted medical use. Schedules below have accepted use, but are still abuseable as defined by law, which falls under the jurisdiction of politics. However, I do agree that hydrocodone, while not the only active ingredient, is the main ingredient in Vicodin and it's effects obviously outweigh acetaminophen or ibuprofen, else everyone would be taking Tylenol and Motrin for all forms of pain. Additionally... you're right. There is no equivalent page for Percocet (oxycodone/apap) which, while with oxycodone instead of hydrocodone, is in many ways the same as this. As such, I no longer dispute the merge/redirect. David DiBattiste 20:41, 6 January 2007 (UTC)

Another un-attributable bit of trivia to vote keeping Vicodin separate: Supposedly, the original trade name was created by someone with the knowledge that the sythesized version was 6 times more powerful than the "natural" codeine it was replacing, thus VI (6) - codin (codeine). Even though the drug is a combination of hydrocodone and acetaminophen, the trade name came from the opiate side only. Maybe the trade name has enough additional lore behind it to make for an article with a reference rather than merging. Balanced against this is whatever obligation one might imaginably have to ensure that people who search for Vicodin don't get just the fanciful part (TV shows, movie stars, naming trivia) and overlook the important health information contained in the link page to hydrocodone.12.76.172.10 09:20, 9 March 2007 (UTC)

One bit of trivia is not enough to justify an entire article. That could be fit into the hydrocodone article, if you can find a source. I doubt that it's true, though; hydrocodone is more than six times as powerful as codeine. Rarr 11:33, 9 March 2007 (UTC)

AGREE with a merge. OxyContin does not have a separate article, as it is included with the overall oxycodone entry. I agree with that, as well, but it would not bother me to see it have a separate article, since it is a time-released drug and, therefore, seems more pertinent to have a separate entry. Vicodin and Lortab are essentially the same thing. It'd be like making two different entries for Brand A chocolate chip cookies and Brand B chocolate chip cookies. A chocolate chip cookie is a chocolate chip cookie, for all pratical purposes, except for the packaging. Vicodin has the same active ingredients as Lortab. Only real difference is the amount of Tylenol in it and the brand name. If you have a separate article for Vicodin, there should be one for Vicoprofen since it has ibuprofen as secondary pain medicine, making it stand out more than Vicodin and Lortab. Using this logic, there should be a separate article for every brand name drug that has more than one equivalent.

Merge with Hydrocodone, though it probably needs it's own section in the article. —Preceding unsigned comment added by Wakandas black panther (talk • contribs) 03:52, 5 September 2007 (UTC)

DISAGREE Do not merge. This is a compound preparation; it contains two active ingredients therefore merging with the article on hydrocodone is not appropriate since it may imply that this is the sole active ingredient. This risks people ignoring the paracetamol (acetaminophen) content; and being tempted to take an excessive quantity WITHOUT realising they risk liver damage after the opiate effect has worn off. A link to the pages for each generic component is more appropriate. Examples cited above such as Dexedrin are not relevent since this is a brand name for a simple preparation containing only ONE active ingredient; in such a case it IS appropriate to simply re-direct/merge to/with a page for the generic component (dexamphetamine / dexamfetamine)--Matt (talk) 01:42, 30 November 2007 (UTC)

DO NOT MERGE! Vicodin is not Hydrocodone. It is a combination of Hydrocodone and acetaminophen. Indications for prescribing Vicodin are different to those for Hydrocodone. By reading some of the above comments, it appears most people are assuming that Vicodin = hydrocodone. This is not correct. They are not the same drug and do not have identical indications for prescription. ++Arx Fortis (talk) 16:48, 10 February 2008 (UTC)

I no longer support a merge. When the original discussion about this took place, Vicodin was a pretty pathetic article that was more or less a rewrite of Hydrocodone. That has since changed. Rarr (talk) 22:06, 11 March 2008 (UTC)

MERGE!! I am very sorry to have to inform you but Vicodin is the "brand" name of hydrocodone-bitartrate 5mg-7.5mg/500mg acetaminophen, and the indications are the same. I would love to hear what indications are different! You make a statement but support it with nothing but opinion, and not an educated one. Acetaminophen was added to hydrocodone not so much for it's analgesic effects, but to make the compound toxic for those who would "abuse" it! How totally ludicrous! To prevent someone possibly "abusing" hydrocodone, they turned it into a virtual poison that toxifies the liver, as acetaminophen is highly toxic when more than ten grams are taken at one time, and when taken as prescribed over a long period of time, liver dammage is reported in study after study. So to stop someone from getting "high" they have made immediate death a possibility, and have made probable liver dammage a near certainty for those who use it as prescribed for a prolonged period.--GetRplyr (talk) 08:17, 9 August 2008 (UTC)

Hydrocondone Extraction

I noticed that thjis article talks about acrticing acempethine from hydrocondone I think that they should add how to extract it in the article. —Preceding unsigned comment added by 66.168.211.173 (talk)

unless wikipedia would have a problem with that, i would be glad to add it —Preceding unsigned comment added by Wcbradley (talk • contribs)

I think it's fine in terms of legal liability to explain it, but it needs to be in a tone appropriate for an encyclopedia, and shouldn't take up more of the article than its notability merits. Personally I think it isn't notable enough to write in this article, when there is already a link in that part of the article to cold water extraction which explains the process. In general Wikipedia doesn't include how-tos (see Wikipedia:What_wikipedia_is_not#Wikipedia_is_not_an_indiscriminate_collection_of_information), and though I think the article on CWE is OK because it documents something that people do and isn't in a "here's how to do this at home, kids!" tone, I don't really think it should be in the article about hydrocodone. Other opinions? --Galaxiaad 23:20, 9 September 2006 (UTC)

Agreed. We already have an article on cold water extraction, and there's enough redundancy surrounding this article that more would be bad for the article. Rarr 00:47, 12 September 2006 (UTC)

Disagree. Though the potential academic usefulness of this information cannot be denied; there is high potential for this information to be abused to extract the opiate content for subsequent non-prescribed administration. A chemist or pharmacist should be aware of how this may be achieved; While and encyclopedia could mention it is possible, the specific methodology should not be shown. I regard this as very much akin to entering information on synthesising explosives etc. People that need to know how to do it, should already know; or be in the process of learning it at university, from lectures and labs - NOT from the internet. It would be irresponsible to put such information on a site as well known as wiki.--Matt (talk) 01:54, 30 November 2007 (UTC)

Disgree. An encyclopedia is to be an unbiased source of information, not a place to restrict what could be useful information because it doen't fit in with youre particular sense of morals. Acetamenophen was put into the hydrocodone compound not so much as an analgesic, but to make the compound toxic to those who might wish to use it for something other than pain relief. So although it might not coincide with your views of what is right and wrong, the information on extraction could potentialy save some lives. Just because someone has a certain education in one field or another does not mean that they should be the only ones with certain information. Because they were educated in a certain field does not make them morally superior to anyone who does not have the same educational background. If a chemist or pharmacist wants to extract the hydrocodone from a compound so he might use it safely for himself (some would say "abuse") is that person granted the privelage to safely use hydrocodone because he went to school and obtained technical "know how", and the person that doesn't share that knowledge toxifies himself and winds up very ill or worse? I'm sorry, but I truly beleive in the U.S. Constitution as it was written, and as it was intended to be used. Unless you commit an act against a person and/or his property there is no crime. If you don't wish to do this or that, then don't do it, but don't assume some false sense of moral superiority over those who don't share your views, and censor what they should and should not have access to.--GetRplyr (talk) 07:15, 9 August 2008 (UTC)

When is hydrocodone therapy indicated?

I couldn't find out from the article how it's detemined that the patient's pain needs more than Ultram or Tylenol #3 but less than Percocet. Is there a rule of thumb? For what kind of pain is hydrocodone indicated? DAC1956 17:06, 15 December 2006 (UTC)

Just based on memory, it's usually indicated for moderate to severe pain, especially if the pain is not chronic; oxycodone is usually the choice for severe chronic pain. I could probably find a source if we needed it for the article. Rarr 08:52, 23 December 2006 (UTC)

Unfortunately, many doctors are reluctant to write schedule II or III drugs, even when they are legitimately needed (broken bone, serious muscle injury, post surgical pain, et cetera). They feel that non-steroidal anti-inflammatories are safer and don't run the risk of addiction, even though they can cause serious side-effects to the gastro-intestinal system and allergic reactions such as hives and swelling of the throat. Several drugs in the COX-2 inhibitor class (Celebrex, Vioxx, Robaxin) have been linked to cardiovascular damage, as well. And some doctors who will write opioids will only write a very limited number of the drugs, which will not adequately reduce pain for the patient. Obviously, these doctors are attempting to limit their liability if there are problems with the patient when they are taking the drug. Most studies on the proper use of opioids for moderate to severe pain, be it acute or chronic conditions, show little to no risk for addiction. Many doctors simply don't want to admit that if a patient has legitimate pain, there's only a limited liability for the patient to get addicted to the drug. And even if a patient has a prior history of drug or alcohol abuse, this does not preclude them from opioid treatment. A doctor must simply be dilligent in monitoring their use of the drug with periodic urine testing and pill counts to make sure the patient is not overusing their monthly supply.

You are correct in stating that doctors are concerned about liability issues (malpractice), however, that is not the reason they do not prescribe schedule II or III narcotics. There actually is very little liability they need to worry about if they are responsible in writing prescriptions. What they do fear is the government ie: DEA, and what the government has done to responsible practitioners in the recent past, and becoming the target of their scrutiny. The last thing a doctor wants is to be brought before what is the equivalent of a witch trial at Salem or the board inquisitors during the Spanish Inquisition. A doctor does not have the freedom to practice medicine in this country anymore. His policies are mandated by those who have no medical degrees of any kind. A doctor practices in fear of losing everything he has worked for, and so he has compromised himself and his oath in an effort to simply be left alone.--GetRplyr (talk) 08:48, 9 August 2008 (UTC)

Link to buy opiates

Someone posted a link claiming to lead to a site where people can buy illegal opioids (I'm not sure if the link actually does that, since I didn't click on it). I'm not sure how to remove it, since it doesn't seem to appear on the Edit Article page. —The preceding unsigned comment was added by 169.229.98.193 (talk) 11:37, 17 December 2006 (UTC).

Thanks for helping out with Wikipedia! But I think you must either be viewing a cached version of the page (we do get spam from less-than-legit online pharmacies, but it is usually reverted quickly-- just hit reload in your browser to load the newest version of the page) or you're talking about "Links to external chemical sources". It's a Wikipedia page similar to Wikipedia:Book sources, and can be found at Wikipedia:Chemical sources. (You couldn't find a link because a Wikipedia template is used to put it on the page.) I'm not entirely clear on what the page is for, but it seems to have links to sites with information on chemicals and links to supply houses that sell them. It's not meant for regular people (non-chemists) to buy drugs without a prescription, and I assure you it would be impossible for an average Joe to buy such a chemical from a chemical supply house (barring fraud, but I digress). I hope this helps, and I apologize if it sounded condescending. That wasn't my intention. --Galaxiaad 15:45, 17 December 2006 (UTC)

Hydrocodone

This drug is not available in pure form. You can get it with tylenol or aspirin or antihistamines, but not all by itself. Why?

This is codienes weaker brother.

Oxycode is superior.

69.121.68.125 12:59, 4 April 2007 (UTC)

Hydrocodone in fact is available by itself, it is just rarely prescribed that way because pure hydrocodone has a higher abuse potential. Also, this is codeine's much stronger brother, not weaker. Codeine is at least 4x weaker. Finally, yes, oxycodone is stronger than hydrocodone. Rarr 04:32, 6 May 2007 (UTC)

Codiene isn't actually weaker it just is metabolized faster and/or less of the drug actually becomes morphine. —Preceding unsigned comment added by 207.126.230.225 (talk) 01:32, 14 September 2007 (UTC)

Hydrocodone is available by itself it is a Schedule II drug instead of the Schedule III combo with APAP. However, here in the states I suppose the FDA or doctors figure if a Schedule II drug is going to be written they might as well go with Oxycodone. If you have ever heard of a compounding pharmacy they are pharmacies that take pure forms of drugs and make them into whatever the Dr. prescribes. It would be possible to get a script for 15mg of hydro here in the U.S. but as I said, it's pointless. As for codeine not being weaker...it is in fact weaker on a mg to mg basis and on an analgesic basis. Jpk314 (talk) 09:40, 2 February 2009 (UTC)

-Why don't they start making preparations of solely Hydrocodone in larger doses, like Roxicodone or Oxycontin? If its less potent, then why don't they make an extended-release form of just the active ingredient or an IR version with no APAP? The FDA voted to stop the manufacture and distribution of opiate painkillers containing APAP (Percocet and Vicodin brand names), so that seems like a reasonable solution. —Preceding unsigned comment added by 204.52.215.151 (talk) 01:28, 13 June 2010 (UTC)

Limbaugh

Rush Limbaugh was addicted to OxyContin, not Vicodin. Removed that part of the article and will put it in the Wikipedia article on that drug.

Actually, Rush was using both drugs before he admitted to his addiction in late 2003.

It was never revealed by Rush which drugs he was abusing. His housekeeper (who he was obtaining the oxy from) revealed that he was taking OxyContin. He himself never admitted to which drugs he was taking. Probably from all his years of "anti-drug" ranting. Either way, if we're going to talk about every famous person addicted to narcotics that's going to be a loooong list. Not a fan of Rush, but this has no place in an article about the pharmacopoeia of hydrocodone. (Jpk314 (talk) 18:41, 28 April 2009 (UTC))

Popular Culture

Could someone add the song "Five Vicodin Chased With A Shot" by the band Atreyu as a song featuring the article topic 222.155.141.152 08:20, 19 June 2007 (UTC)Tom

(i) If the name Vicodin is generally considered to be part of the popular culture of the US, then this article should have a Popular Culture section.

(ii) If the song and band are also considered part of USPC, then please feel free and be bold enough to add the entry yourself - remember, it's your wiki. Mike 09:44, 29 June 2007 (UTC)

Heroin surrogate?

Does it alleviate heroin or other opiete withdrawal syndromes?--Cancun771 19:03, 25 June 2007 (UTC)

Yes- As an opiate, hydrocodone (ie lortab, lorcet, vicodin) will address the same receptors as heroin. The problem may be with the acetaminophen or ibuprophen in these drugs. Though it would vary from person to person, I believe that street heroin dosage equivalents tend to be larger than a typical prescription dosage for hydrocodone. To alleviate withdrawal, you need at least 3/4 of your usual equivalent dosage. You would possibly overdose yourself with these additional compounds before adressing the withdrawals. Cold water extraction and filtration may save your liver. Four grams of tylenol is the upper dosage limit per day. If your tablets contain 500mg (1/2 gram) of tylenol- the most you can safely take is eight a day, and I'd not continue that dosage for too long. There ARE opiate agonist/antagonist drugs that are meant to adress pain and will not help withdrawal, will worsen withdrawal, because they block the opiate receptors. These include tramadol or ultram, nubain, stadol etc... and would not adress withdrawal symptoms. If you indeed are in opiate withdrawals and wish to end your addiction, there are non-opioid drugs that can help, or will hit the same receptors, though you will feel some discomfort. These are benadryl, promethazine, lorazepam, and vistaril, and ibuprophen may help muscle and bone pain of withdrawal. Often, a blood pressure medication, clonidine, is prescribed as well. Methadone is an option also, though it has more severe withdrawals than heroin itself, and seems to eventually cause more sufferring than it prevents. If you intend to withdraw and detox, a physician may be willing to prescribe a combination of these or other meds to help you.

A new drug used to treat opiate/opioid addiction is called Suboxone (buprenorphine/naloxone sublingual tablets). Suboxone is a partial opioid agonist/antagonist that reduces withdrawal symptoms because of its high affinity for opioid receptors in the body. It is taken sublingaully in either a 2 or 8 milligram form, with 0.5 mg of naloxone in the 2mg formulation and 2 mg in the 8mg tablet. The naloxone is in the drug to prevent users from intravenous use, although the efficacy of the naloxone to prevent IV use has not been proven. Many IV drug users report the naloxone does not cause withdrawal. Subutex is also a buprenorphine product in a 2 or 8 mg formulation. It does not, however, contain the naloxone. Suboxone/Subutex is the first drug approved for opioid addiction treatment in a doctor's office. Prior to this, most addicts had to go to a methadone clinic on a daily basis, with some able to get a weekly take-home prescription after several months or a year of continued adherance to the program. Unfortunately, methadone clinics are highly stigmatized and many communities fight to keep them out of their municipalites, making their presence few and far between. The new legislation that allows doctors to treat up to 100 patients with substance abuse with buprenorphine makes it much easier for a person to find adequate treatment for their disease. For a doctor to legally dispense buprenorphine, they must take an 8 hour course on the proper use of the medication and how to refer patients to a mental health professional. While it is not mandatory for a doctor to refer a patient to counseling, the use of the drug along with counseling improves the chance for recovery. —Preceding unsigned comment added by 74.192.200.252 (talk • contribs) 01:03, 4 July 2007

In the future, please sign your comments with four tildes (~). Rarr 05:02, 6 July 2007 (UTC)

Removal of "Extraction" section

There was a discussion on the Science RefDesk about appropriateness of this material. DMacks 06:19, 10 September 2007 (UTC)

I deleted it. It's unsourced. WP:NOT. --DHeyward 06:41, 10 September 2007 (UTC)

Clinical information

Hi everyone, I'm new to the world of wikipedia editing, and I know some of this info is contained in the Vicodin article, so I thought I would throw this out here before I went ahead and did anything. I'm a 4th year doctor of pharmacy student with a particular interest in pain management & pain relief research. As such, I would be happy to apply my knowledge and multiple credible sources to the expansion of this article. I would like to add sections to provide details about the pharmacokinetic/dynamic properties, indications, side effects, etc, etc of this drug to provide more structure and ease of use to the article. I don't plan on making it absurdly technical, and also plan to condense any redundancies I create w/o removing other important information. I'd like people's opinions on whether or not this is appropriate for how pharmacology articles are preferred to be written. So what's everyone think? Regards, Ohnoitsthefuzz 04:38, 27 September 2007 (UTC)

If you're still out there...feel free to do so. Pharmacy students and pharmacists are definitely welcome; we don't have enough of them editing pharmacological articles. Rarr (talk) 22:14, 11 March 2008 (UTC)

Needs Improvement

This article doesn't match the 'standard' template used for many medications. Specifically, there is no section on the Mechanism of Action or the Pharmacokinetics. For example: While hydrocodone is regularly compared to codeine, I can't tell from this article if hydrocodone is a 'prodrug' (it is converted to morphine or some other active opiate by the liver) or if it acts directly. This may be a simple matter, but the article seems to fail to address this point. Further, there is a lot of discussion about abuse and dependence...probably more than is warranted (even with a drug that is probably abused quite a bit).

Lastly, while it might be important to address the fact that hydrocodone is used in certain common compounds (vicodin, lortab, norco, vicoprofin, and their generic equivalents), these compounds should *not* be re-directed to this article. They are unique (different compounds) and only *contain* hydrocodone. Redirecting them here would be as absurd as redirecting them to 'acetaminophen' / 'paracetemol' / 'tylenol'.

Just my opinion, though! —Preceding unsigned comment added by 198.36.95.10 (talk) 12:05, 27 September 2007 (UTC)

Good points! Regarding the redirections, is hydrocodone the main component (by activity)? Maybe we should redirect specifically to the "Commercial medications containing hydrocodone" section, since that's where they are discussed as combination therapies. Otherwise we could spawn that all off into a new Hydrocodone combination drugs or somesuch, but I don't know if there's enough to say about them other than what we have already (but if it's at least a distinct topic, maybe a new page is good). DMacks 13:13, 27 September 2007 (UTC)

Re: OCULAR EFFECTS - —Preceding unsigned comment added by 216.177.239.53 (talk) 17:56, 19 December 2007 (UTC)

These articles all need more information on secondary ocular effects. From acute/chronic corneal drying to accommodative paresis and extra-ocular muscle effects, many drugs have their impact on patients' vision. I will begin adding this info as I can.

Charles in Portland, Oregon, USA

Citate about the Invention of Vicodin

The correct reference for this, as far as I can tell, is Mannich, C. et al., Arch. Pharm. “Ueber zwei neue Reduktionsprodukte des Kodeins,” V. 258, pp. 295-316, Selbatverlag des Deutschen Apotheker-Vereins, Berlin, (1920).Abstract, DOI. (google 'Mannich Hydrocodone' for more, including the 1925 German patent). However, I can't access this directly, I can only see other papers, patents referring back to this as a method for synthesising hydrocodone. So it might be better to say 'synthesised' rather than 'invented' for 1920, the compound may have been known about earlier but this was the first industrial process (again, as far as I can tell.) --Bazzargh (talk) 22:51, 7 January 2008 (UTC)

Thats Carl Mannich btw --Bazzargh (talk) 23:12, 7 January 2008 (UTC)

this doctor who was treating me awhile back gave me a prescription is about a year old, I didn't have the money then now i have it can i still use the prescription to purchased my medicine. —Preceding unsigned comment added by 76.222.255.37 (talk) 07:45, 13 January 2008 (UTC)

Is 'Commercial medications containing hydrocodone' really needed?

This section seems rather irrelevant to the article, does it not? There are hundreds if not thousands of pharmaceutical companies worldwide producing hydrocodone. Listing each one that makes a hydrocodone/APAP does not really have anything to do with the drug at hand. I'm going to remove it for this reason, and due to the fact none of it is cited. tyx (talk) 20:31, 7 February 2008 (UTC)

While I could agree that the laundry-list of manufacturers/products isn't needed, general information about formulations of the drug is quite appropriate to include, especially if there's some practical benefit beyond arbitrary marketting choices. I'll revive that part, but tag the rationale for it with {{cn}} and hopefully this scientific component can be supported/expanded as necessary. DMacks (talk) 21:15, 7 February 2008 (UTC) However, that info is already covered elsewhere in the article, so we don't need it here. DMacks (talk) 21:16, 7 February 2008 (UTC)

• some of the info does belong, such as the description of how it is has other medications added to it. Naming all the manufacturers, however, doesn't since it is a generic drug. PHARMBOY (TALK) 14:08, 10 February 2008 (UTC)

• I for one used this section every once in a while. I have bottles of pain medication with only 2-3-4 pills in them (of varying strengths and so forth) and would look on here to verify what I was taking. I had been using Google to look this information up; but once I saw it on here, I used it like I said, every once in a while. Now obviously we can't list all the manufacturers and so forth because it is a generic, but I believe that the most common sources and strengths of this medication were listed and very nicely might I add. All that being said I would like to have it added back considering search on Google (or any search engine for that matter) gives you a ton of results; some with pop-ups that don't have or show the desired results. NkryptD 11:42, 2 March 2008 (UTC) —Preceding unsigned comment added by 69.139.116.205 (talk)

• I agree that this list was a useful reference - I would very much like to see it return to the article. Perhaps it should go in its own section, though? —Preceding unsigned comment added by 66.30.24.157 (talk) 01:16, 11 March 2008 (UTC)

Overdose Concerns

Just for future reference, "tramadal" is actually tramadol, and is not in any way considered a NSAID like sulindac. Although mixing different chemicals within the body may cause serious bodily harm or death, the accuracy of what one is to watch out for is of the highest importance. Ethersnipher (talk) 16:48, 10 February 2008 (UTC)

I don't think so!

"The presence of acetaminophen in hydrocodone-containing products deters many drug users from taking excessive amounts" I don't think someone realizes the extent of the addiciton associated with this medication. Weather its the Lortab or ES's with the different level of aceto neither one deters any addict from abusing the meds. Most dont use cold water extraction. I have done research and know of people taking in excess of 25 Vicodin ES's a day for long periods, some years. Addicts have no concept about ruining thier liver. NONE! Now maybe that will keep them from injecting it but certainly you don't hear an addict say "I can't take no more today, I have reached the 4g aceto limit" LOL yeah right. Lets keep it real. I also have a problem with this notion that Oxycontin is more addictive. No its not if you take it as prescribed and its less toxic. Its more addictive for addicts/abusers sure... They are taking more at higher doses... breaking that time release. Now if a Oxy abuser didnt have access to it and had only ES's they would take the same mg for mg not even concerned about the liver problems. in thats sense they are both equally as addictive. Ok, I got of base here a little. Just my thoughts... —Preceding unsigned comment added by 68.61.109.8 (talk) 11:24, 11 March 2008 (UTC)

Oxycodone is pharmacologically more potent than hydrocodone; this results in a higher potential for dependence. Even people who are prescribed to it are likely to become *dependent*; taking it as prescribed doesn't get rid of the potential for dependence. It is also not less toxic than hydrocodone; they are of a similar, pretty low toxicity by themselves. In combination with acetaminophen, of course, is an entirely different matter. Also, these people taking 25 pills a day for years...that's absolutely ludicrous. Acetaminophen overdose would be obvious and deadly unless treated after even one day of 25 hydrocodone/acetaminophen pills, as well as in the case of the guy trying to take an Oxycontin-equivalent dose of Vicodin. In addition, you are generalizing "addicts"; please don't do so unless you can show that *all* people addicted to hydrocodone don't understand the hepatotoxicity of acetaminophen. Anyway, from my own research I've found that most hydrocodone users really don't take it in the kind of heavy, heavy doses that other opiate users do. Admittedly, I'm drawing pretty heavily on erowid here, and the people on erowid tend to be more educated than your average drug user. Rarr (talk) 21:41, 11 March 2008 (UTC)

Cold Water Extraction Again

Since this was already removed twice after discussion (#Hydrocondone_Extraction, #Removal_of_.22Extraction.22_section), I'm going to go ahead and remove the latest re-insertion (still with no references!) of CWE. Please discuss here before adding it again. Bazzargh (talk) 15:23, 28 March 2008 (UTC)

Hearing loss associated with hydrocodone use.

Apparently opiates, in particular the -codones, can cause long term hearing loss in long periods of use.[2] [3]. Nagelfar (talk) 08:08, 7 September 2008 (UTC)

pharmacology, SAR of hydrocodone

A pharmacology section showing the special structural relationship to codeine might be worthwhile for this article. Something that goes into details like how the hydroxide group (position 6) on the codeine molecule is replaced by the more greatly oxidized carbonyl group, which first makes it codeinone, which by itself is actually only one third the potency of codeine. While a second process makes the double bond between positions 6 & 7 reduced to a single bond by catalytic hydrogenation which by itself results in making dihydrocodeine (DHC) which is only modestly more powerful by itself than codeine. These two structures alone have no great activity or increased potency, but the structures together (dihydrocodeine & codeinone) become dihydrocodeinone or Hydrocodone, which is significantly more potent than codeine, and unlike codeine which is a prodrug, it is active by itself. 4.255.55.241 (talk) 03:51, 13 November 2008 (UTC)

Tusscodin Retard?

The brand name of nicocodeine hydrochloride is really Tusscodin Retard? 4.242.192.128 (talk) 22:17, 13 November 2008 (UTC)

FDA DESI Hydrocodone Cough Preparation Review

The recently added section to this article is very poorly written. I did some work on it, but it needs more. It sounds like it was written by somebody who was very unhappy that they could not get the medication they wanted - hardly the NPOV style appropriate for encyclopedia entry. It is in dire need of citations. Anybody else have thoughts on this? Bhimaji (talk) 04:29, 24 November 2008 (UTC)

Hydrocodone an American drug?

It would be helpful if a suitable expert editor could comment on hydrocodone use internationally. I know it's widely used in the US, but I've never known anybody have it prescribed here in the UK, and it seems rarely used generally outside America. Oxycodone is another stranger here. I'm not a health professional, but AFAIK people in Britain are given codeine / dihydrocodeine / morphine depending on the level of analgesia required, sometimes in combination with non-opioid analgesics. --80.176.142.11 (talk) 23:25, 18 May 2009 (UTC)

My Dr today tried to tell me Hydrocodone is called Dihydrocodeine in the UK, I told him and gave him information to proove him wrong since Dihydrocodeine is roughly 4.5times weaker than Hydrocodone.

Hydrocodone is a Class A drug under the Misuse of Drugs Act 1971 and is Schdule II under the regulations meaning it is a legally prescribable drug. However, it is very rear they use it, just like in the United States they use Demerol often in the UK that drug is only used by women in labor.

Oxycodone is a legal drug in the UK all Dr's and GP's can prescribe it. It comes in the form of Oxycontin (Slow/ Modified Release) or Oxynorm (Immediate Release). They just dont like to prescribe what they called next level opiates (those stronger than Dihydrocodeine and Tramadol).

Tramadol Hydrochloride is branded Ultram in the United States. (Upadated July 10th 2009, Chronic Pain sufferer from Rheumatoid Arthritis and former London NHS employee)

You are quite correct that hydrocodone and dihydrocodeine are different drugs, though like all the opiods they are related. If your doctor was a pain specialist and didn't understand the difference between them that is rather worrying. Dihydrocodeine doesn't seem widely used in the US and this may explain (though not excuse) the ignorance if the doctor was American. --Ef80 (talk) 15:15, 9 October 2009 (UTC)

Big typo and poor quality link

Under the pharmacology section there is this: "However other studies have shown hydrocodone to be anywhere from half as potent to oxycodone (1.5× the potency of morphine) to only 66.6~% the potency of oxycodone (equipotent to morphine)" It says oxycodone twice and gives different information, also it says From 50% to only 66%. WTF? I think someone was editing while partaking in the article's topic. Also the link for that info goes to a forum where there is only two posts and they do not cover the data in any way. This should be removed. —Preceding unsigned comment added by 12.166.11.143 (talk) 02:05, 7 October 2009 (UTC)

It's not Wikipedia's business to carry water for the U.S. War on Drugs, is it?

Almost every paragraph references hydrocodone's similarities with morphine, its potential for misuse, the danger of the side effects (with not even vague mention of the ODDS of any side effect, e.g. "common" or "rare") and various ways it is regulated. All of these subjects are mentioned several times each, which is redundant -- but the more disturbing implication is that the redundancy of these particular facts seems deliberate.

To be more blunt -- dude, I GET IT. Do the various ways to say "ZOMG IT'S A DANGEROUS DRUG R BAD" need to be mentioned so often? Of course not. I was prescribed hydrocodone so I came here to learn about it and the information is certainly useful, but the article is annoyingly political. Is it really necessary in a general reference article to mention that, "in tests conducted on rhesus monkeys, the analgesic potency of hydrocodone was actually found to be higher than that of morphine"?? There are plenty of useful facts in the article and I don't suggest removing the "it's a dangerous recreational drug" bits entirely, but as formatted it reads like FDA propaganda, especially compared to Wiki articles on medications that aren't so politically feared. All mention of its recreational use, control, etc. could be stripped out of non-related sections and compiled into a single section.

Thanks for your consideration, Wiki staff

24.95.90.102 (talk) 19:47, 18 February 2011 (UTC)

either or both?

"Hydrocodone or dihydrocodeinone is a semi-synthetic opioid derived from either of two naturally occurring opiates—codeine and thebaine."Serialjoepsycho (talk) 07:20, 23 April 2011 (UTC)

Controversy regarding paracetemol hybrid.

I recall there was a big backlash in the medical community about including paracetemol to discourage recreational use by causing liver damage if people took too much; it was compared to putting cyanide in beer as a means to make sure people don't get drunk. Sadly, I cannot find my old notes on this issue for sources, but I'd really encourage editors of this page to seek that information and add it. I'd do it myself, but having been a user since year 0 I no longer contribute figuratively to wikipedia due to ethical issues with the management (power tripping admins). So please, from an academic point of view, I do actively encourage editors to bring that element to light. Pmorphsab (talk) 04:21, 2 August 2011 (UTC)

Availability in Germany and Belgium

Hello there.. I think hydrocodone preparations are (no longer) available in both Belgium and Germany. The Belgian and German equivalents to the American PDR do not list any drugs containing hydrocodone, neither as a stand-alone ingredient nor as a combination with a second analgesic drug (paracetamol, ibuprofen,...). Unless someone protests, I would modify the sections on hydrocodone availability in these countries. C.d.rose (talk) 19:24, 10 August 2011 (UTC)

Oops, I edited the part about availability in Belgium, but I forgot to log in before. So, the last edit changing the section on Regulation was done by me. C.d.rose (talk) 21:15, 11 August 2011 (UTC)

Needs qualified attention: "100-200 µg/L in abusers and 0.1-2.0 mg/L in cases of acute fatal overdosage"

100-200 micrograms *IS* 0.1-0.2 mg, so... Someone who knows which of the two figures is wrong please edit. PS and yeah, while it's well-known that abusers often tolerate far over opiate-naive patients' fatal overdose levels, it's highly unlikely that non-abusers would fatally overdose, plus abusers' blood levels are somewhat limited by the combination NSAIDs, which can cause fatal overdoses on their own and at lower levels.