Vicodin

Medically Reviewed By University of Illinois Chicago Drug Information Group
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Vicodin at a glance

Key highlights to know about Vicodin are:

  • Vicodin is a combination of two medications: hydrocodone (an opioid pain medication) and acetaminophen (a non-opioid pain medication). Vicodin is used to treat severe pain when other pain medicines do not work.
  • Vicodin is available as tablets that are administered by mouth to treat pain.
  • Vicodin is available as a generic medication, called hydrocodone/acetaminophen.
  • Avoid alcohol if you are taking Vicodin. Use of products with alcohol while taking Vicodin can increase your risk of overdose and death.
  • Vicodin is a Schedule-II controlled substance. Vicodin may be habit-forming (addictive). Do not share Vicodin with others.
  • When you are first prescribed Vicodin, your dose is increased, or if you take too much Vicodin, you may be at risk for an opioid overdose. Talk to your healthcare provider about naloxone, an emergency treatment of opioid overdose.
  • The generic version of Vicodin is typically a moderate-cost drug, defined as costing between $30-$100/month.

Important safety warnings for Vicodin

Users of Vicodin should be aware of these safety warnings:

  • Severe asthma, trouble breathing, or other lung problems warning: Do not take Vicodin.
  • Bowel blockage or narrowing of your stomach or intestines warning: Do not take Vicodin.
  • Allergy to hydrocodone or acetaminophen warning: Do not take Vicodin.
  • Opioid overdose warning: Do not take more Vicodin than you were prescribed. If you take too much, call 911 or get emergency help. Taking too much Vicodin may result in problems with breathing that could lead to death. You may also be at risk for an opioid overdose when first starting Vicodin or if your dose is increased. Naloxone is an emergency treatment for an opioid overdose. Ask your healthcare provider or a pharmacist about obtaining naloxone.
  • Risk of addiction warning: Vicodin contains hydrocodone, an opioid medicine. Opioids are controlled substances and Vicodin may be habit-forming. Do not take more Vicodin than prescribed. If you are still experiencing pain while taking your prescribed dose of Vicodin, talk to your healthcare provider.
  • Slow or shallow breathing warning: Use of Vicodin may cause you to experience serious slow or shallow breathing, called respiratory depression, which may lead to death. If you experience respiratory depression, seek emergency help.
  • Adrenal insufficiency warning: Use of Vicodin for a prolonged period may result in a lack of certain steroids in the body, causing a condition called adrenal insufficiency. Let your healthcare professional know if you experience symptoms including nausea, vomiting, loss of appetite, fatigue, weakness, dizziness, and low blood pressure.
  • Low blood pressure warning: Use of Vicodin may cause low blood pressure. If you experience lightheadedness when sitting or standing up, or if you faint, please let your healthcare professional know.
  • Effects on the liver warning: Vicodin contains a combination of hydrocodone and acetaminophen. In higher doses (usually more than 4000 mg per day), acetaminophen can harm your liver and even cause liver failure. Look to see if other medications you take also contain acetaminophen (also called Tylenol or APAP). Seek medical help if you take more than 4000 mg acetaminophen per day.
  • Serious skin reactions warning: A rare side effect of acetaminophen is serious skin reactions. Talk to a healthcare provider immediately if you experience a skin rash.
  • Do not share your medicine warning: Giving someone else your Vicodin is against the law. If someone (especially a child) accidentally ingests your medication, seek emergency help. They could experience severe side effects or death.
  • Infertility warning: Use of Vicodin for a prolonged period may reduce fertility in men and women.

Talk with your doctor about these warnings in the context of your individual treatment plan and medical history.

What Vicodin treats

This medication is used to treat:

  • Severe pain that is not relieved with other pain medicines or if you cannot take another pain medicine.

Doctors sometimes prescribe medications for different uses. Ask your doctor or pharmacist for information about other uses of this medication.

How it works

Vicodin is a prescription medicine that contains a combination of two pain-relieving drugs: hydrocodone and acetaminophen. Hydrocodone is an opioid medication (a narcotic), and is a controlled substance.  Acetaminophen, also known as Tylenol, is a common medicine used to relieve pain. Although the exact way Vicodin works to relieve pain is not completely understood, both components of Vicodin (hydrocodone and acetaminophen) work in different ways to relieve pain.

Vicodin is available as tablets that are taken by mouth as needed for pain. Vicodin is currently not available as a brand-name drug. Vicodin is available as a generic medication called hydrocodone/acetaminophen.

Side effects of Vicodin

Vicodin side effects are possible and may go away with continued use. Serious side effects are rare.

Common side effects

The more common side effects that occur with Vicodin include:

  • Constipation
  • Nausea
  • Sleepiness
  • Vomiting
  • Tiredness
  • Headache
  • Dizziness
  • Abdominal pain

Serious side effects

Call your doctor right away if you have serious side effects. Seek emergency care (call 911) if you experience life-threatening symptoms, such as difficulty breathing; chest pain; loss of consciousness; sudden vision changes; or swelling of the face, mouth, tongue or throat.

Serious side effects and their symptoms can include the following:

  • Serious breathing problems. Symptoms can include:
    • Trouble breathing or shortness of breath
    • Drowsiness with slowed breathing
    • Feeling faint
  • Allergic reactions. Symptoms can include:
    • Swelling of your face, tongue or throat
    • Skin rash
  • Fast heartbeat
  • Chest pain
  • Extreme drowsiness
  • Low blood pressure. Symptoms can include:
    • Lightheadedness when changing positions
    • Feeling faint
  • Liver injury. Symptoms can include:
    • Yellowing of the skin or the white part of the eye
    • Severe nausea or vomiting
    • Upper right abdominal pain
  • Agitation
  • High body temperature
  • Trouble walking
  • Stiff muscles
  • Mental changes, such as confusion

Other side effects are possible. Talk to your doctor or pharmacist if you have any side effect that bothers you or that does not go away. Talk to your doctor about naloxone, a medication that can treat an opioid overdose.

Costs of Vicodin

Without insurance, Vicodin is typically a moderate-cost drug, defined as costing between $30-$100/month. You can check the out-of-pocket cash pay price for Vicodin on prescription drug discount websites.

With insurance, prices can vary considerably. Individual health plans may have preferred drugs with better pricing. If the price of Vicodin on your health plan is too expensive, ask your doctor or pharmacist if there is an equivalent drug you can substitute.  

How Vicodin may interact with other medicines

Vicodin may interact with other prescription and over-the-counter medications, vitamins, or herbal supplements you may be taking. To help avoid harmful interactions, your doctor should manage all of your medications carefully. Be sure to tell your doctor about all medications, vitamins, or herbal supplements you are taking. To find out how this drug might interact with something else you are taking, talk to your doctor or pharmacist.

This is not a complete list of drugs that may interact with Vicodin. However, examples of drugs that may interact with Vicodin include:

Drugs that inhibit drug removal

Drugs that inhibit your body’s ability to remove Vicodin can result in higher levels of Vicodin in the body. This may result in side effects related to Vicodin. Your healthcare provider may decrease your dose of Vicodin if they plan to prescribe you one of these medicines. If you take one of these medicines with Vicodin, talk to your doctor before stopping these medicines, because your healthcare provider may change your Vicodin dose:

  • Macrolide antibiotics, such as erythromycin (EryPed 200, Ery-Tab, Erythrocin Stearate Filmtab)
  • Azole-antifungal drugs, such as ketoconazole (Nizoral), itraconazole (Onmel, Sporanox, Sporanox PulsePak, Tolsura), voriconazole (VFEND)
  • Protease inhibitors, such as ritonavir (Norvir, Norvir Soft Gelatin)

Drugs that increase your body’s ability to eliminate Vicodin can result in lower levels of Vicodin in the body. This may result in your pain not being treated as well as before. Your healthcare provider may increase your dose of Vicodin if they plan to prescribe you one of these medicines. If you take one of these medications with Vicodin, talk to your doctor before stopping these medicines, because they may change your Vicodin dose:

  • Rifampin (Rifadin, Rifadin IV, Rimactane)
  • Carbamazepine (Carbatrol, Epitol, Equetro, Tegretol, Tegretol XR)
  • Phenytoin (Dilantin, Phenytek)

Drugs that depress the central nervous system

Drugs that depress the central nervous system (brain) like Vicodin may result in side effects, such as slow or shallow breathing, low blood pressure, tiredness, coma, or death. Your healthcare provider will monitor you for side effects if they prescribe you one of these medicines. They may also recommend a drug called naloxone which treats opioid overdose.

  • Benzodiazepines
  • Other opioid medications
  • Muscle relaxants
  • Certain drugs that help you sleep
  • Drugs that help treat anxiety
  • Drugs called antipsychotics that treat mood disorders
  • Alcohol

Drugs that work on serotonin

Drugs that work on the neurotransmitter called serotonin may result in a condition called serotonin syndrome when taken with Vicodin. These medications may be used for multiple reasons, but are often used to treat mood disorders. Talk to your pharmacist or doctor if you are not sure if you are taking one of these medications. Examples of drugs that work on serotonin include:

  • Certain drugs for depression or anxiety
    • Selective serotonin reuptake inhibitors (SSRIs)
    • Serotonin and norepinephrine reuptake inhibitors (SNRIs)
    • Tricyclic antidepressants (TCAs)
  • Certain drugs for migraines known as triptans
  • Certain antinausea drugs known as 5-HT3 receptor antagonists
  • Certain drugs used for sleep
    • Mirtazapine (Remeron, Remeron SolTab),
    • Tramadol (ConZip, Qdolo, Ultram, Ultram ER)
    • Trazodone (Desyrel, Desyrel Dividose, Oleptro)
    • Certain muscle relaxants (cyclobenzaprine, metaxalone)

Drugs called monoamine oxidase inhibitors (MAOIs)

Drugs referred to as MAOIs should not be used with Vicodin. MAOIs are used for multiple reasons, but they are common to treat mood disorders and depression. Use of Vicodin with MAOIs may cause a life-threatening side effect called serotonin syndrome. Wait at least two weeks after stopping an MAOI to start Vicodin. Talk to your pharmacist or doctor if you are not sure if you are taking an MAOI. Examples of MAOIs include:

  • Isocarboxazid (Marplan)
  • Linezolid (Zyvox)
  • Methylene blue (Provayblue, Urolene Blue)
  • Phenelzine (Nardil)
  • Selegiline (Eldepryl, Zelapar)

Drugs that work similar to Vicodin

Drugs that work similar to Vicodin but also inhibit the effects of opioids (called “mixed agonist/antagonist” or “partial agonist” opioid medications) may reduce the pain-relieving ability of Vicodin. This may cause symptoms of opioid withdrawal. Examples of these drugs include:

  • Butorphanol
  • Pentazocine (Talwin)
  • Nalbuphine (Nubain)

Drugs that are called diuretics

Drugs called diuretics work by increasing the amount of fluid removed from your body. Vicodin may reduce how well diuretics work. Your healthcare provider may monitor your blood pressure while taking both Vicodin and diuretics. Examples of diuretics include:

  • Bumetanide (Bumex)
  • Chlorthalidone (Hygroton, Thalitone)
  • Furosemide (Lasix)
  • Hydrochlorothiazide (Microzide, Esidrix)

Drugs that are called anticholinergic drugs

Drugs called anticholinergic drugs may prevent you from urinating or may cause severe constipation when used with Vicodin. Anticholinergic drugs are used for many reasons, such as overactive bladder and Parkinson’s disease. Your healthcare provider may monitor you for side effects. Examples of anticholinergic drugs include:

  • Drugs for treating overactive bladder:
    • Fesoterodine (Toviaz)
    • Oxybutynin (Ditropan XL)
    • Solifenacin (VESIcare, VESIcare LS)
    • Tolterodine (Detrol, Detrol LA)

Disclaimer: Since drugs interact differently in each person, this information is not guaranteed to include all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbal supplements, and over-the-counter drugs that you are taking.

Other Vicodin alerts

This drug comes with several alerts and warnings:

Warnings for other groups

  • For children: This drug has not been studied in children.
  • For elderly patients: Being aged 65 years or older may increase your risk of side effects related to Vicodin. If you are 65 years or older, your healthcare provider will monitor for side effects.
  • Liver disease: Liver disease may affect how the drug is removed from your body. If you have liver disease, your healthcare provider may start with a lower dose and monitor for side effects.
  • Kidney disease: Kidney disease may affect how the drug is removed from your body. If you have kidney disease, your healthcare provider may start with a lower dose and monitor for side effects.
  • History of head injuries, brain tumors, conditions that increase pressure on your brain, or seizures: Talk to your healthcare provider before starting Vicodin. Use of Vicodin may increase your risk of severe side effects.
  • Driving and operating heavy machinery: Do not drive or operate heavy machinery until you are familiar with the effects of Vicodin and know how you will react to its use.

Call your doctor right away if you have serious side effects. Seek emergency care (call 911) if you experience life-threatening symptoms, such as difficulty breathing; chest pain; loss of consciousness; sudden vision changes; or swelling of the face, mouth, tongue or throat.

For pregnant and breastfeeding women

Can I take Vicodin when pregnant?

Vicodin can cause harm to an unborn baby. Inform your healthcare provider if you are pregnant. Vicodin should only be used in pregnancy if the benefits outweigh the risks. Using Vicodin during pregnancy for a prolonged period can cause withdrawal symptoms in the newborn baby. This condition can be life-threatening to the newborn. Inform your healthcare provider if you used Vicodin while pregnant.

Can I take Vicodin when breastfeeding?

Vicodin passes into breast milk. Breastfeeding while taking Vicodin may increase sleepiness and breathing problems in infants. Talk to your doctor if you are thinking of breastfeeding while taking Vicodin.

How and when to take Vicodin

Vicodin is supplied as a tablet that is taken by mouth. Use the lowest dose for the shortest period to treat your pain. Your dose and how often you take Vicodin will depend on:

  • Your pain severity
  • How you respond to treatment
  • Previous experience with pain medicine
  • Risk factors for addition, abuse and misuse

Because of the risk of opioid overdose, talk to your healthcare provider about naloxone. Naloxone is an emergency treatment for opioid overdose.

Drug forms and strengths

  • Tablets (expressed as mg hydrocodone/mg acetaminophen)
    • 5 mg/300 mg
    • 7.5 mg/300 mg
    • 10 mg/300 mg

Dosage for pain

Adult dosage (age ≥ 18 years)

  • Typical dosage (5 mg/300 mg): one or two tablets every 4 to 6 hours as needed for pain. The total daily dosage should not exceed eight tablets per day.
  • Typical dosage (7.5 mg/300 mg or 10 mg/300 mg): one tablet every 4 to 6 hours as needed for pain. The total daily dosage should not exceed six tablets per day.

If you miss a dose of Vicodin

If you miss a dose, take your regular dose at the next usual time if needed. Do not take more than your prescribed dose.

If you take too much Vicodin

If you take too much Vicodin, you have a higher risk of having overdose symptoms. If you think you’ve taken too much of this drug, call 911 or seek emergency help. Serious or life-threatening breathing problems may occur if you take too much Vicodin. Taking too much Vicodin can lead to death. Talk to your healthcare provider about naloxone in case you experience an overdose. Naloxone is an emergency treatment of opioid overdose.  After naloxone is given, you must get emergency help right away.  

Symptoms of an overdose may include:

  • Narrowed or widened pupils
  • Difficulty breathing or slow or shallow breathing
  • Slowed or stopped heartbeat
  • Skin that is cold, clammy or blue
  • Excessive sleepiness
  • Unresponsiveness or inability to wake up
  • Seizures

Seek emergency care (call 911) if you experience life-threatening symptoms, such as difficulty breathing; chest pain; loss of consciousness; sudden vision changes; or swelling of the face, mouth, tongue or throat.

Helpful tips when taking Vicodin

Keep these considerations in mind if your doctor prescribes Vicodin for you.

General

  • Taking too much Vicodin can increase your risk of life-threatening breathing problems. Take the lowest dose possible to treat your pain. Talk to your healthcare provider about naloxone and how to get it. Naloxone is an emergency drug used for an opioid overdose. Educate yourself and others around you the symptoms of an overdose, like trouble breathing, unusually tired or sleepy, or not being able to respond or wake up. Make sure caregivers and close contacts know where it is stored and how to use it. After naloxone is administered, you must get emergency help right away.
  • Do not give your Vicodin to someone else. They could die from taking Vicodin.

Storage

  • Vicodin should be kept at room temperature between 68°F to 77°F (20°C to 25°C).
  • Keep this drug away from light.
  • Store your Vicodin securely with the lid on tightly, out of reach from children, and out of sight from potential visitors to the home.
  • Dispose of expired, unwanted or unused Vicodin by flushing down the toilet or via a drug take-back option. Information on disposal can be found at www.fda.gov/drugdisposal.

Alcohol

Avoid alcohol if you are taking Vicodin. Use of products with alcohol while taking Vicodin can increase your risk of overdose and death.

Refills

Vicodin is a Schedule II-controlled substance. Because it is a Schedule II-controlled substance, it cannot be refilled and requires a new prescription each time you fill it from the pharmacy. Talk to your pharmacist if you have questions on filling Vicodin.

Travel

When planning to travel, keep these tips in mind for packing your medication:

  • Bring enough medication for the full number of days of your trip, plus at least two days to be safe.
  • Keep your medication with you, in a purse or a carry-on bag if flying. Do not put it into a checked bag in case you are separated from your luggage.
  • Keep your medications in their original containers, if possible, to reduce delays during airport or security screening. Keep all your medications together to expedite the process.
  • Avoid leaving your medication in a parked car for extended periods to protect it from extreme temperatures (hot or cold).

Availability

Many pharmacies stock this drug. When filling your prescription, be sure to call ahead to make sure your pharmacy carries it and has it in stock.

Prior Authorization

Many insurance companies do not require a prior authorization for Vicodin. If a prior authorization is necessary, your doctor will need to get approval from your insurance company before your insurance company will pay for the prescription.

Medications similar to Vicodin

There are a few medications that work like Vicodin. These include:

  • Lorcet, Norco, Verdrocet, Xodol, Zamicet (hydrocodone/acetaminophen)
  • Endocet, Nalocet, Percocet, Primlev, Prolate (oxycodone/acetaminophen)
  • Tylenol with Codeine #2, Tylenol with Codeine #4 (codeine/acetaminophen)
  • Ultracet (tramadol/acetaminophen)
  • Apadaz (benzhydrocodone/acetaminophen)

Discontinuing use of Vicodin

Do not stop taking this drug unless instructed by your doctor. If you have been taking Vicodin regularly, especially for a long time or at higher doses, your healthcare provider may slowly lower your dose. If you abruptly stop Vicodin after taking it regularly for a prolonged period, you may experience withdrawal symptoms. Talk to your healthcare provider about stopping Vicodin.

Healthgrades Disclaimer

This information is for educational purposes only. It should not be interpreted as medical advice, diagnosis or treatment. Healthgrades takes every effort to ensure this information is accurate and up to date. This content is not intended to cover all possible uses, side effects, warnings, precautions, allergic reactions, or drug interactions. Do not assume that the absence of such information means the medication is safe for your personal use. Always consult your doctor, pharmacist, or healthcare professional before taking or discontinuing any medication.

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Medical Reviewer: University of Illinois Chicago Drug Information Group
Last Review Date: 2021 Jul 14
THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
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