Hydrocodone chemical structure
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Lortab

Hydrocodone or dihydrocodeinone (marketed as Vicodin, Anexsia, Dicodid, Hycodan, Hycomine, Lorcet, Lortab, Norco, Tussionex, Vicoprofen) is an opioid derived from either of the naturally occurring opiates codeine or thebaine. Hydrocodone is an orally active narcotic analgesic and antitussive. The typical therapeutic dose of 5 to 10 mg is pharmacologically equivalent to 30 to 60 mg of oral codeine. more...

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Sales and production of this drug have increased significantly in recent years, as have diversion and illicit use. Hydrocodone is commonly available in tablet, capsule and syrup form.

As a narcotic, hydrocodone relieves pain by binding to opioid receptors in the brain and spinal cord. It may be taken with or without food, but should never be combined with alcohol. It may interact with monoamine oxidase inhibitors, as well as other drugs that cause drowsiness. It is in FDA pregnancy category C: its effect on an unborn embryo or fetus is not clearly known and pregnant women should consult their physicians before taking it. Common side effects include dizziness, lightheadedness, nausea, drowsiness, euphoria, vomiting, and constipation. Some less common side effects are allergic reaction, blood disorders, changes in mood, mental fogginess, anxiety, lethargy, difficulty urinating, spasm of the ureter, irregular or depressed respiration and rash.

Hydrocodone can be habit-forming, and can lead to physical and psychological addiction. In the U.S., pure hydrocodone and forms containing more than 15 mg per dosage unit are called hydrocodone compounds and are considered Schedule II drugs. Those containing less than 15 mg per dosage unit are Schedule III drugs. Hydrocodone is typically found in combination with other drugs such as paracetamol (acetaminophen), aspirin, ibuprofen and homatropine methylbromide. In the UK it is listed as a Class A drug under the Misuse of Drugs Act 1971.

The presence of acetaminophen in hydrocodone-containing products deters many drug users from taking excessive amounts. However, some users will get around this by extracting a portion of the acetaminophen using hot/cold water, taking advantage of the water-soluble element of the drug. It is not uncommon for addicts to have liver problems from taking excessive amounts of acetaminophen over a long period of time--taking 10–15 grams of acetaminophen in a period of 24 hours typically results in severe hepatotoxicity. It is this factor that leads many addicts to use only single entity opiates such as OxyContin.

Symptoms of hydrocodone overdosage include respiratory depression, extreme somnolence, coma, stupor, cold and/or clammy skin, sometimes bradycardia, and hypotension. A severe overdose may involve circulatory collapse, cardiac arrest and/or death.

How Supplied

Notes

  1. ^  Tarascon Pocket Pharmacopoeia.

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From the pharmacy
From Saturday Evening Post, 9/1/05 by Cory SerVaas

X Glaucoma Alert: Many drugs can worsen-or even triggerglaucoma. Some antidepressants, blood pressure medicines, antihistamines, over-the-counter cold remedies containing pseudaephedrine, and steroids may increase glaucoma risk. Read product information carefully. Regular eye exams are essential if you are over 40, African-American, diabetic, or have a family history of glaucoma.

X BP medicines: Those taking a new drug (or a different dose) to lower blood pressure may experience dizziness. Be cautious--particularly during the first week and when standing up after reclining in a bed, couch, or chair.

X Tetracycline: Common side effects of this antibiotic include increased sensitivity to the sun, abdominal pain, loose stools, nausea, and vomiting. The prescription drug can permanently discolor teeth in children under 8 years old. It is also not recommended for women who are pregnant or breast-feeding. For optimal absorption, avoid taking TUMS, Maalox, Mylanta, or Pepto-Bismol within two hours of this drug.

X Inhalers: Doctors often instruct patients to take two puffs at a time. For the best results, take one puff and then wait one minute before taking the other. This allows the first puff of medicine to begin opening airways, allowing the second puff to travel deeper into the lungs. In some cases, a spacer attachment (commonly used to enhance drug delivery in children) can work wonders in adults.

X Tylenol: To avoid serious side effects, adults should take less than four grams of Tylenol (acetaminophen) per day. Be aware that Tylenol is an ingredient in many prescription pain medicines, including Vicodin, Lortab, Norco, Darvocet, Ultracet, and Fioricet. And those who are also taking over-the-counter preparations such as Tylenol arthritis or cold medications can easily take too much of the drug.

X Flagyl (metronidazole): Drink absolutely no alcohol when taking this antibiotic-consuming even small amounts causes severe facial flushing, nausea and vomiting.

X Warfarin (Coumadin): Be sure to inform all healthcare providers that you are on blood-thinning medicine. Other drugs you are taking may affect the Warfarin dosage you need.

Editor's Note: Pharmacists are equipped to do more than dispense drugs accurately. These well-trained professionals are an integral, and sometimes untapped, part of the healthcare maintenance team.

In this issue, pharmacist Cara Acklin offers tips on taking drugs ranging from painkillers to inhalers. If you have a question about medications, please write to From the Pharmacy, 1100 Waterway Bird, Indianapolis IN 46202.

COPYRIGHT 2005 Saturday Evening Post Society
COPYRIGHT 2005 Gale Group

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