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Doctors' Answers to "Frequently Asked Questions" - Hydrocodone

These comments are made for the purpose of discussion and should NOT be used as recommendations for or against therapies or other treatments. An individual patient is always advised to consult their own physician.

[posted 04/29/2000]
Question: What are the dangers of taking hydrocodone with a heart condition or hypertension? Are there safe levels of hydrocodone that can be taken? What does this drug do to your heart while taking it?

Answer: Not much usually. It can lower your blood pressure by vasodilating your venous system, but usually nothing very marked.

[posted 02/24/2000]
Question: how can i obtain hydrocodone for my constant pain?most doctors won't prescribe it.they give me naproxen or ibuprofen.which does'nt come close to working

Answer: No legal way without a physician.

[posted 12/27/1999]
Question: The specialist treating me for pain prescribed Vicoprophen for pain. It worked well for me but seemed to cause severe edema, have you heard of this side effect before? My family doctor put me on Hydrocodone 7.5/650. What do those numbers mean? The Hydrocodone makes me feel so tired, I asked him to try something else. He prescribed Ultram. What pain medication do you think is best for treating moderate chronic pain and for allowing for the most normal functioning in daily living?

Answer: Any of the narcotics can cause edema, some more than others. As to the hydrocodone, the 7.5 refers to the milligrams of hydrocodone. The 650 the acetaminophen it is combined with. Ultram is a relatively new synthetic drug that is similar to narcotics. As to what is best, I am not convinced that any one is superior to another. They require you to take them and see for yourself. They actually have similar effects and side effects. First criteria is to find one that works-then with the least bothersome side effects for you. This is an individual issue. That is, some are more bothered by mental suppression with the narcotics, others less so.

Hydrocodone interaction with Birth Control [posted 1/12/99]
Question: I have been taking Hydrocodone for 6 months on and off. I am wondering if this interacts with or causes birth control bills not to work? Can you please answer this for me? I would greatly appreciate it.

Answer: Shouldn't be a problem.

Hydrocodone and Pregnancy [posted 1/11/99]
Question: I have just found out that I am 5 weeks pregnant. I take hydrocodone 5/500 for migraines and have taken 2-3 tabs per day on at least 7 occasions in the last 3 weeks, not realizing the increase in headaches may have been related to the pregnancy. Will this have an effect on my fetus, either teratogenic or otherwise? I am terrified and have discontinued the medication. I would appreciate your consideration on my specific situation.

Answer: Should have minimal effects unless taken regularly and close to the end of pregnancy. However, less medications are better than more during pregnancy.

Hydrocodone and Liver damage [posted 1/6/99]
Question: I've heard that use of hydrocodone can damage your liver. Is this true? I've been taking it on and off for about a year for a broken leg and other things. Also, can it have any effect on weight loss or gain?

Answer: Not usually any effect on the liver or weight gain. Does cause constipation and decreased appetite, this could potentially cause weight loss.

Allergic reaction to Hydrocodone   [posted 1/4/99]
Question: I have been taking hydrocodone for 7 months now. I feel that I am very careful and am trying not to become an addict. I have 10/500 mg and I take 2 at bedtime only (I have a 2 year old at home during the day with no help). I can't sleep, my face itches with a blotchy red rash, I am sick to my stomach, and I also get the shakes. If I take more than 2 pills in a 24 hour period it gets much worse . Is this something I should worry about or can I tolerate it until I have back surgery. Can I go into shock from this? Also, is it safe to take Benadryl with this? I am allergic to codeine, darvocet, phenergan, biaxin, and now this. My body tends to be intolerant to anything after a while. I am going to have 3 disks in my back fused in about a month.

Answer: The nausea is an effect of any narcotic. Food prior to taking it can help. The blotching and itching is a histamine response. It wouldn't hurt to take Benadryl, but it may not help. This is not an allergic response per se, but a fairly common response to narcotics.

Hydrocodone Concerns  [posted 12/09/98]
Question: I am currenty taking 10 to 14 hydrocodone tablet (hydrocodone 10mg/Acetemenaphine 500mg) daily. I know the recomended dosage is only 6. Should I be looking for a stronger drug or continue with this dosage? What are the short and long term effects of taking this much medication. (I will be on it the rest of my life)

Answer: Increase the narcotics and hold the acetaminophen at 8 or so.

Hydrocodone Concerns  [posted 12/04/98]
Question: I am currently taking approx 10 hydrocodone  /apap 10/500 for severe chronic pain. According to the info in the bottle the Max should be 6. I am sure the 6 max is just for their protection. Am I really taking to much? If I am still functioning and only taking it at time of pain can I still get addicted? What can I do about the constipation?....What will the long term effects be on this dosage over the the next 10 to 20 years. Are there stronger medications that could be used? Am I really taking to much? A reply would be appreciated very  much. I am very concerned.........

Answer: The limit per day is the acetaminophen part of the drug. This would be 6 in most people ;but, could be stretched to 8 or 10 depending on your weight and liver function. The constipation usually responds to a drug called Senekot-S and/or milk of magnesia. There are many stronger narcotics available, but, you can't take much more acetaminophen. But, there are pure narcotics that you could increase easily. Long term side effects of narcotics are addiction/physical dependence. The acetaminophen if used regularly over a long period will decrease renal and liver function(usually in excess of 8-10 years depending on baseline functional levels).

  Vicoden/Hydrocodone for Pain [posted 12/1/98]
Question: I was diagnosed with a UPJ obstruction which causes severe pain in my kidney. My doctor gave me Vicoden ES for the pain as needed. I usually take 1 pill and within a half hour the pain is gone. About a week ago I was put on prozac for depression which seems to be helping. Yesterday I had a episode of kidney pain and took the Vicoden. After 2 hours and no relief I called my doctor and he said I could take another vicoden. This helped but did not totally get rid of the pain, which really surprised me considering that was a  total of 1500 mg of Vicoden [hydrocodone]. I was wondering if the prozac could have counteracted the vicoden?

Answer: Probably not, just more severe pain, what are they doing to relieve the obstruction?

Hydrocodone with Pancreatitis [posted 11/17/98]
Question: Are there contraindications for hydrocodone or codeine with diagnosed pancreatitis?
Answer: No. Unless caused by gall bladder dysfunction, sometimes these can cause spasm of the bile duct.

Weaning Yourself Off Hydrocodone [posted 10/9/98]
Question: As you can see I have been on Hydocodone for a long time. It does not work as well as it used to, so it was decided to go off the drug. What will longterm use do to me besides being addicted to the drug. Will it hurt me any other way? I am going to try to get off the drug by my self. I read what to do in the questions and answers on Hydrocodone. I was taking about 4-6 a day and after 3 days have cut down to 3 a day. I just started cutting down to 2 a day, It was getting very long for me waiting for the next pill. I have decided to change dosage every three days. Will this be Ok? Is there anything else to use for pain? My injuries stem from a school bus accident(1988), and I've had two herniated disks operations. (1989&1991). I also received a new left knee in 1995. Presently, I am being treated for bilateral sciatica and a bulging dish in L-4. I wish to avoid future operations, but it is getting so bad I can hardly walk anymore.

Answer: You are following an acceptable method of weaning. However, if you do not resolve the cause of the pain, you will need to be on something. Have you seen a pain specialist, injections of steroids in your spine? TENS unit,Etc. The narcotics still work by the way, you are developing tolerance and need to increase the dosage to get pain control. If there is no surgical or injectable way to alleviate the pain, I'd stay with the narcotics.

Hydrocodone [posted 10/1/98]
Question: I have been taking hydrocodone for approx. 7 weeks for pain in my right knee, while undergoing therapy to strengthen the knee. For the past 7 weeks I only take one hydrocodone before bed. In that time, I find that I am constantly tired and have none of my normal ambition. I sleep 9-11 hours per night and still never feel rested. Also the pain is constant now, with no relief in the pain, as I had initially. Is it possible I have built an immunity to this drug? Could the lipitor I take in the morning be reacting with the hydrocodone?

Answer:You won't develop an immunity. If you take it long enough at sufficiently high levels, you will develop some tolerance. However, you have not been taking it long enough for tolerance to develop. You are not taking sufficient narcotics to eliminate the pain. The side effects you are experiencing are probably due to the narcotics-and would increase with higher doses. However, it seems pointless to not take enough of the drug to accomplish its goal.

Hydrocodone and Addiction [posted 8/14/98]
Question: The question that I have is in regards to how a particular controlled substance is assigned to a particular class (schedule). i.e.: Schedule 2, 3, 4, or 5. I realize that controlled substances are assigned to these classes bases on their potential for abuse (how addicting or habit forming a drug may be). However, I would like to give an example of my experience with the drug Hydrocodone (Hycodan, Vicodin) and ask how this drug is assigned as a schedule 3 controlled drug. I was prescribed Hycodan Syrup for a dry, exhausting cough (which was a residue of asthmatic bronchitis). Although it worked extremely well for the cough, it was also much more habit forming than I expected it to be. Most of the time, I took 1 teaspoon. However, if the cough was extremely bad, I would take up to 3 teaspoons (15 mg). At this dose, I would receive extreme euphoria, much more than I've received from any other drug (such as Codeine 30 mg or Valium). Ultimately, I became addicted to the Hydrocodone and I had to be detoxified with Methadone. As an added note, I never tried any illicit drugs and I certainly wasn't looking for "kicks" from using the hydrocodone. It was prescribed for a chronic medical condition. Shouldn't a drug this habit forming really be assigned as a schedule 2 drug which is much more controlled and has higher regulations (I live in NY where all schedule 2 drugs must be on a triplicate prescription form) rather than a schedule 3 drug which has much more relaxed restrictions. I've been prescribed Codeine Phosphate 30 and 60 mg which certainly didn't cause nearly the quality and amount of euphoria that the hydrocodone caused and Codeine is a schedule 3 drug. I've also been prescribed Valium in the past and I didn't feel that there was any "feeling of high" from that drug, yet all benzodiazepines must be put on a triplicate in NY. As my final example, I've taken Percodan (oxycodone) and I certainly feel that the propensity for addiction from the hydrocodone is equivalent to the oxycodone, yet the oxycodone is a schedule 2 drug. The importance of my question and the reason I'm asking how controlled drugs are assigned to different DEA classes is if the hydrocodone were a schedule 2 drug, it would have to be written on a triplicate. Since it isn't, it can be written on a standard script and 5 refills are allowed in a 6 month period. With a triplicate, no refills are allowed and doctors tend to be a little more careful when prescribing triplicate medication since it's registered. Given this background, can you please tell me the guidelines (in more detail, especially regarding the hydrocodone and why it would be a schedule 3 drug given the above information I mentioned) that is used in assigning a particular drug to a DEA class and please use the hydrocodone as an example of why it's a schedule 3 drug.

Answer: These drugs are classed on the potential for abuse as well as for addiction. This does not mean that some individuals do not become addicted. It does mean that smaller percentages of the population will and that fewer individuals are interested in the drug for recreational purposes.

Hydrocodone Cessation [posted 7/17/98]
Question: After taking this medication for a year with back pain what is the best way to stop taking it without withdrawal symptoms?

Answer: It depends on the dosage and the time you have been on the drug. In general, cut the dosage about 20% every week. Once you get to 20% cut 5% a week until it is gone.

Reaction to Hydrocodone
Question: I am currently taking hydrocodone. When I take this drug I get nauseated and have a severe head ache about six hours after I take it. could this be an allergic reaction?

Answer: No, just a usual histamine release phenomenon associated with narcotics in some patients.

Hydrocodone Dependency
Question: I have been on Vicodin ES for five months continuously due to herniated disk at my L2-S1 with a recent surgery in October, 1991. If I don't take the medication, I get severe headaches. When taking the drug I'm easily angered and for the past month I've have had episodes of depression, continual crying, etc. I've tried to stop taking the medication but my body seems to go in shock. Are these side effects and symptoms of hydrocondone dependency?

Answer: With the length of time you have been on vicodine, you should have some dependence.

Question: I have gotten mixed messages about interaction between Hydrocodone and alcohol. From one source I have heard that moderation with alcohol and Hydrocodone is all right. From another source I heard of a patient dying from the combination. This patient’s blood serum showed 10 mg Hydrocodone and BAC equivalent to about 4 drinks. I use Hydrocodone to relieve the pain of a chronic condition I have where the cartilage connecting to my ribcage is calcifying and detaching. Can I have a few beers now and then without the risk of death? What interactions should I be aware of while using this drug? What are the long term effects to my health if I continue to use Hydrocodone for the relief of my pain? This condition is very painful at times and Hydrocodone seems to do the best job of providing pain relief. Naproxen Sodium does very little for me. My daily average daily dosage of Hydrocodone is 15 mg on a bad day 0 mg on a good day. On average I have 2 to 3 days during the week when I require the drug for pain relief. The other days I do not require it.

Answer: Long term use of regular hydrocodone is addicting. This probably means on the order of 6 or more a day. Use of alcohol with narcotics will enhance the mental changes seen with alcohol and reduce ones ability to react appropriately. One to two beers would have the probable effect of 4 to 5. However, long term use of alcohol or narcotics increases the doses necessary to affect mental decisions. Avoid driving or using machinery and you'll probably be all right.

Question: How long does this drug stay in your system?

Answer: It depends on your liver and kidneys since they are the major metabolizers of narcotics. For hydrocodone, it usually takes 4 to 8 hours.

Hydrocodone and Pregnancy  
Question: My wife had knee surgery on January 13th at the Mayo clinic for synovial chondromatosis. As part of her physical therapy she received a prescription for Hydrocodone/APAP 5/500. She is now pregnant. The conception took place on March 12th. Since we were trying to conceive, my wife discontinued the hydrocodone use for the two weeks prior to March 12th. However, she did not think she was pregnant so she started using the pain medicine again. The use occurred over a three day period which was the 27th, 28th, and 29th day of my wife's cycle. The dates were March 24-26. The use was two pills a day for a total of six over the three day period. My wife is very nervous that something terrible has been done to the pregnancy.

Answer: There doesn't seem to be any particular problem with either codeine or acetaminophen ingestion at any stage of pregnancy if the doses are moderate. Parents will always be concerned with any ingestion of "foreign" substances, infections, etc. This risk is almost non-existent.

Question: What is Hydrocodone?

Answer: Hydrocodone is a semi-synthetic narcotic. It is generally used in treating cough, occasionally for minor pain. It has the same addiction profile as any narcotic. Side effects will be nausea, constipation, inability to focus or concentrate.

Question: After an appointment with a doctor I went and got some prescriptions filled. One was for "hydrocodone bitartrate" could you tell me what that is?

Answer: Hydrocodone is included in the class of opioid analgesics. These include morphine and heroin and are narcotics. These are extremely effective for pain control; but, produce all of the side effects of narcotics. These are nausea, constipation and difficulty mentating. Long term use can be addicting. I would get in the habit of inquiring of your physician about a drug prior to leaving his/her office. Remember, they work for you.

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