Hydrocodone is in a group of drugs called narcotic pain relievers. It is similar to codeine.

Acetaminophen is a less potent pain reliever that increases the effects of hydrocodone.

The combination of acetaminophen and hydrocodone is used to relieve moderate to severe pain.

Acetaminophen and hydrocodone may also be used for purposes other than those listed in this medication guide.

Use this medication exactly as it was prescribed for you. Do not use the medication in larger amounts, or use it for longer than recommended by your doctor. Follow the directions on your prescription label.

An overdose of acetaminophen can cause serious harm. The maximum amount of acetaminophen for adults is 1 gram (1000 mg) per dose and 4 grams (4000 mg) per day. Taking more acetaminophen could cause damage to your liver. One acetaminophen and hydrocodone tablet may contain up to 750 mg of acetaminophen. Know the amount of acetaminophen in the specific product you are taking.

If your medicine contains 650 mg of acetaminophen or more per tablet, take no more than 5 tablets in 24 hours. If your medicine contains 500 mg or less of acetaminophen, take no more than 8 tablets in 24 hours. Tell your doctor if the medicine seems to stop working as well in relieving your pain.

Take this medicine with a full glass of water.

You may take the medication with food or milk if it causes stomach upset.

Measure the liquid form of this medication with a special dose-measuring spoon or cup, not a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist where you can get one.

Drink 6 to 8 full glasses of water daily to help prevent constipation while you are taking acetaminophen and hydrocodone. Ask your doctor about ways to increase the fiber in your diet. Do not use a stool softener (laxative) without first asking your doctor.

If you need to have any type of surgery, tell the surgeon ahead of time that you are using acetaminophen and hydrocodone. You may need to stop using the medicine for a short time.

You may have withdrawal symptoms when you stop using this medication after using it over a long period of time. Do not stop taking acetaminophen and hydrocodone suddenly without first talking to your doctor. You may need to take less and less before you stop the medication completely.

Store acetaminophen and hydrocodone at room temperature away from moisture and heat.

Before taking this medication, tell your doctor if you are using any of the following drugs:

• an MAO inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate); or

• antidepressants such as amitriptyline (Elavil, Etrafon), amoxapine (Ascendin), clomipramine (Anafranil), desipramine (Norpramin), imipramine (Janimine, Tofranil), nortriptyline (Pamelor), protriptyline (Vivactil), or trimipramine (Surmontil).

If you are using any of these drugs, you may not be able to use acetaminophen and hydrocodone, or you may need dosage adjustments or special tests during treatment.

There may be other drugs not listed that can affect acetaminophen and hydrocodone. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Do not use any other over-the-counter cough, cold, allergy, or pain medication without first asking your doctor or pharmacist. Acetaminophen is contained in many cold and pain medicines available over the counter. If you take certain products together you may accidentally take too much acetaminophen. Read the label of any other medicine you are using to see if it contains acetaminophen.

Do not drink alcohol while you are taking acetaminophen and hydrocodone. Dangerous side effects or death can occur when alcohol is combined with hydrocodone. Check the label of any other medicines you take to be sure they do not contain alcohol.

Avoid using other medicines that make you sleepy (such as cold medicine, pain medication, muscle relaxers, and medicine for seizures, depression or anxiety). They can add to sleepiness caused by hydrocodone, which could result in extreme drowsiness or coma.

Seek emergency medical attention if you think you have used too much of this medicine. An overdose of acetaminophen and hydrocodone can be fatal. Symptoms of an overdose may include extreme drowsiness, muscle weakness, nausea, vomiting, sweating, confusion, cold and clammy skin, shallow breathing, slow heart rate, fainting, or coma.

Since acetaminophen and hydrocodone is sometimes used as needed, you may not be on a dosing schedule. If you are taking the medication regularly, take the missed dose as soon as you remember. If it is almost time for the next dose, skip the missed dose and wait until your next regularly scheduled dose. Do not use extra medicine to make up the missed dose.

Do not take acetaminophen and hydrocodone with alcohol, other narcotic pain medications, sedatives, tranquilizers, muscle relaxers, or other medicines that can make you sleepy or slow your breathing. Dangerous side effects may result.

Do not take this medication without first talking to your doctor if you drink more than three alcoholic beverages per day or if you have had alcoholic liver disease (cirrhosis). You may not be able to take medication that contains acetaminophen.

Hydrocodone may be habit-forming and should be used only by the person it was prescribed for. Acetaminophen and hydrocodone should never be given to another person, especially someone who has a history of drug abuse or addiction. Keep the medication in a secure place where others cannot get to it.

Keep track of how many tablets have been used from each new bottle of this medicine. Hydrocodone is a drug of abuse and you should be aware if any person in the household is using this medicine improperly or without a prescription.

This medication can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.

Never take more acetaminophen and hydrocodone than is prescribed. Tell your doctor if the medicine seems to stop working as well in relieving your pain.

You may have withdrawal symptoms when you stop using this medication after using it over a long period of time. Do not stop using acetaminophen and hydrocodone suddenly without first talking to your doctor. You may need to use less and less before you stop the medication completely.

Do not use this medication if you are allergic to acetaminophen or hydrocodone, or other narcotic pain relievers such as fentanyl (Actiq, Duragesic), hydromorphone (Dilaudid, Palladone), methadone (Methadose, Dolophine), morphine (Kadian, MS Contin, Oramorph, and others), oxycodone (Oxycontin), and oxymorphone (Opana).

Before using acetaminophen and hydrocodone, tell your doctor if you are allergic to any drugs, or if you have:

• asthma, COPD, sleep apnea, or other breathing disorders;

• liver disease;

• kidney disease;

• underactive thyroid;

• a history of head injury or brain tumor;

• epilepsy or other seizure disorder;

• low blood pressure;

• gallbladder disease;

• Addison’s disease or other adrenal gland disorders;

• enlarged prostate, urination problems;

• mental illness; or

• a history of drug or alcohol addiction.

If you have any of these conditions, you may not be able to use acetaminophen and hydrocodone, or you may need a dosage adjustment or special tests during treatment.

Hydrocodone may be habit-forming and should be used only by the person it was prescribed for. Acetaminophen and hydrocodone should never be given to another person, especially someone who has a history of drug abuse or addiction. Keep the medication in a secure place where others cannot get to it.

Keep track of how many tablets have been used from each new bottle of this medicine. Hydrocodone is a drug of abuse and you should be aware if any person in the household is using this medicine improperly or without a prescription.

FDA pregnancy category C. This medication may be harmful to an unborn baby, and could cause addiction or withdrawal symptoms in a newborn. Tell your doctor if you are pregnant or plan to become pregnant during treatment.

Acetaminophen and hydrocodone can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

Do not give this medicine to anyone younger than 18 years old.

Older adults may be more sensitive to the effects of this medicine.

Your pharmacist has information about acetaminophen and hydrocodone written for health professionals that you may read.

Acetaminophen and hydrocodone is available with a prescription under many brand names such as Vicodin, Lortab, Lorcet, Zydone, Hydrocet, and Co-Gesic. Other brand or generic formulations may also be available. Ask your pharmacist any questions you have about this medication, especially if it is new to you.