What Is Hydrocodone/APAP?
Hydrocodone/APAP (hydrocodone and
acetaminophen) is a prescription medication approved to treat moderate to moderately severe pain. It is a narcotic and is classified as a controlled substance, which means that special laws and regulations control its sale and use.
Hydrocodone/APAP Products
Many different hydrocodone/APAP products are available, such as:
Most (but not all) of these products are available in generic form. Both brand-name and generic versions of the drug are made by different manufacturers.
As with any medicine, side effects are possible. However, not everyone who takes the drug will experience side effects. Most people tolerate it quite well. If side effects do occur, in most cases, they are minor and either require no treatment or are easily treated by you or your healthcare provider. Serious side effects are less common.
Common side effects include, but are not limited to:
(Click Hydrocodone/APAP Side Effects to learn more, including potentially serious side effects you should report immediately to your healthcare provider.)
What Should I Tell My Healthcare Provider?
Talk with your healthcare provider prior to taking this medication if you have:
- Liver disease, such as cirrhosis, liver failure, or hepatitis
- Kidney disease, such as kidney failure (renal failure)
- A head injury or high intracranial pressure
- Severe abdominal (stomach) pain
- Hypothyroidism
- Addison's disease
- An enlarged prostate (benign prostatic hyperplasia, or BPH)
- Lung disease of any sort
- A history of drug or alcohol dependence
- Any allergies, including allergies to foods, dyes, or preservatives.
Also, let your healthcare provider know if you are:
Make sure to tell your healthcare provider about any other medications you are taking, including prescription and non-prescription medicines, vitamins, and herbal supplements.
Hydrocodone/APAP contains two different medications:
hydrocodone bitartrate and
acetaminophen. Hydrocodone is a semi-synthetic narcotic, opioid pain reliever. It acts similarly to codeine. Hydrocodone is effective at decreasing pain and relieving coughing, but also causes drowsiness, mood changes, and mental "clouding." In the United States, hydrocodone is only available in combination with other medications; it is not available alone.
Acetaminophen ("APAP") is a pain reliever and fever reducer commonly found in non-prescription medications such as
Tylenol®. APAP is an acronym for one of the chemical names for acetaminophen. Combining hydrocodone with acetaminophen helps improve the medication's effectiveness at relieving pain and may limit the abuse potential of hydrocodone, as the maximum dose of hydrocodone/APAP is usually limited by the acetaminophen content.
What Is the Potential for Abuse?
Hydrocodone/APAP is a commonly abused drug. It is readily available and inexpensive, especially in generic form. It is important to distinguish between actual abuse of the drug and a physical dependence on the drug. Healthcare providers can have difficulty distinguishing behaviors associated with inadequate pain control from drug-seeking behaviors associated with abuse. Because it is a highly desired drug of abuse, people often obtain it through illegal means, such as from foreign countries or online sources that do not require a prescription. People who abuse it and suddenly stop using it are likely to experience withdrawal symptoms.
For more information, visit the following eMedTV articles:
When and How to Take Hydrocodone/APAP
General considerations for when and how to take the medication include the following:
- The medication comes in tablet, capsule, or syrup form. It is taken by mouth, usually every four to six hours as needed for pain.
- It is either taken "as needed" or on a scheduled basis. "As needed" means you will only take a dose if you are experiencing pain (if you are not in pain, you will skip the dose), while "scheduled use" means you should take it on schedule, even if you are not in pain. Most healthcare providers prescribe it on an "as needed" basis, rather than a scheduled basis.
- It is best to take it with food, as this may help reduce stomach upset.
- Be careful not to exceed the maximum recommended daily dose, as this could lead to overdose symptoms or to poisoning from the acetaminophen component, which can cause liver failure.
- For the medication to work properly, it must be taken as prescribed. Do not increase your dose without your healthcare provider's approval. Do not suddenly stop taking it, especially if you have taken it regularly for more than several weeks (see Hydrocodone/APAP Withdrawal).
The dosage your healthcare provider recommends will vary, depending on a number of factors, including:
- The strength of your particular hydrocodone/APAP product
- How you respond to hydrocodone/APAP
- Other medications you are taking
- Other medical conditions you may have.
As is always the case with any medication, do not adjust your dose unless your healthcare provider specifically instructs you to do so.
What If I Take an Overdose of Hydrocodone/APAP?
People who take too much of this medication may have overdose symptoms that could include:
- Difficulty breathing
- Extreme drowsiness, leading to coma
- Cold, clammy skin
- A slow heart rate (bradycardia)
- Low blood pressure (hypotension)
- Cardiac arrest
- Nausea and vomiting
- Sweating
- Liver failure
- Death.
If you happen to overdose, seek immediate medical attention.
It should be stored at room temperature, away from moisture and heat. Keep hydrocodone/APAP and all other medications out of the reach of children. Because it is a highly desired drug of abuse, make sure to keep it in a safe place.
What Should I Do If I Miss a Dose?
Hydrocodone/APAP is often prescribed "as needed," which means you do not need to take a dose if you do not feel pain. If you forget to take a dose and notice significant pain, take your missed dose right away. However, make sure to wait the recommended time before the next dose.
Strengths of Hydrocodone/APAP
The medication is available in the following strengths and forms:
- Tablets:
- Hydrocodone/APAP 2.5/500 mg
- Hydrocodone/APAP 5/300 mg
- Hydrocodone/APAP 5/325 mg
- Hydrocodone/APAP 5/400 mg
- Hydrocodone/APAP 5/500 mg
- Hydrocodone/APAP 7.5/300 mg
- Hydrocodone/APAP 7.5/325 mg
- Hydrocodone/APAP 7.5/400 mg
- Hydrocodone/APAP 7.5/500 mg
- Hydrocodone/APAP 7.5/650 mg
- Hydrocodone/APAP 7.5/750 mg
- Hydrocodone/APAP 10/300 mg
- Hydrocodone/APAP 10/325 mg
- Hydrocodone/APAP 10/400 mg
- Hydrocodone/APAP 10/500 mg
- Hydrocodone/APAP 10/650 mg
- Hydrocodone/APAP 10/660 mg
- Hydrocodone/APAP 10/750 mg
- Capsules: hydrocodone/APAP 5/500
- Syrup (elixir):
- Hydrocodone/APAP 7.5/325 mg per 15 mL (per tablespoonful)
- Hydrocodone/APAP 7.5/500 mg per 15 mL (per tablespoonful)
- Hydrocodone/APAP 10/500 mg per 15 mL (per tablespoonful).
For the various strengths of this drug, the smaller number refers to the content of
hydrocodone bitartrate, and the larger number refers to the content of
acetaminophen. For instance, hydrocodone/APAP 5/500 mg contains 5 mg of hydrocodone bitartrate and 500 mg of acetaminophen.
