Lortab (Acetaminophen/Hydrocodone)

 
4.6 (4)
  (for Lortab)
Lortab is one brand name of the medicine also known by its generic name Acetaminophen/Hydrocodone. This page displays only reviews left by users of Lortab. Click here to see all reviews left for all forms of Acetaminophen/Hydrocodone. You can also choose other review combinations.

More about Acetaminophen/Hydrocodone

What is/are Hydrocodone?

Hydrocodone is a semi-synthetic opioid derived from codeine. Hydrocodone is used orally as narcotic analgesic and antitussive, often in combination with paracetamol (acetaminophen) or ibuprofen.[1] Hydrocodone is prescribed predominantly in the United States. International Narcotics Control Board reports that 99% of worldwide supply in 2007 was consumed in the United States.

Medical uses

Hydrocodone is used to treat moderate to severe pain and as an antitussive to treat cough.[1] It is approximately 1.5 times less potent opioid than oxycodone. Analgesic action of hydrocodone begins 20–30 minutes after taking it and lasts 4–8 hours.

Adverse effects

Common side effects of hydrocodone are nausea, vomiting, constipation, drowsiness, dizziness, lightheadedness, fuzzy thinking, anxiety, abnormally happy or sad mood, dry throat, difficulty urinating, rash, itching, and narrowing of the pupils. Serious side effects include slowed or irregular breathing and chest tightness.

Several cases of progressive bilateral hearing loss unresponsive to steroid therapy have been described as an infrequent adverse reaction to hydrocodone/acetaminophene combination. This adverse effect has been considered due to the ototoxicity of hydrocodone. Recently, researchers suggested that acetaminophen is the primary agent responsible for the ototoxicity.

It is in FDA pregnancy category C. No adequate and well-controlled studies in humans have been conducted. A newborn of a mother taking opioid medications regularly prior to the birth will be physically dependent. The baby may also exhibit respiratory depression if the opioid dose was high. An epidemiological study indicated that opioid treatment during early pregnancy results in increased risk of various birth defects.

Symptoms of hydrocodone overdose include narrowed or widened pupils; slow, shallow, or stopped breathing; slowed or stopped heartbeat; cold, clammy, or blue skin; excessive sleepiness; loss of consciousness; seizures; and death.

Hydrocodone can be habit-forming, causing physical and psychological dependence. Its abuse liability is similar to morphine and less than oxycodone.

Contraindications and interactions

Patients consuming alcohol, other opioids, antihistamines, antipsychotics, antianxiety agents, or other central nervous system (CNS) depressants together with hydrocodone may exhibit an additive CNS depression. Hydrocodone may interact with serotonergic medications.

Pharmacology

As a narcotic, hydrocodone relieves pain by binding to opioid receptors in the CNS. It acts primarily on μ-opioid receptors, with about six times lesser affinity to δ-opioid receptors. In blood, 20-50% of hydrocodone is bound to protein.

Studies have shown hydrocodone is stronger than codeine but only one-tenth as potent as morphine at binding to receptors and reported to be only 59% as potent as morphine in analgesic properties. However, in tests conducted on rhesus monkeys, the analgesic potency of hydrocodone was actually higher than morphine. Per os hydrocodone has a MEDD factor of .4, meaning that 1 mg of hydrocodone is equivalent to .4 mg of intravenous morphine. However, because of morphine's low oral bioavailability, there is a 1:1 correspondence between orally administered morphine and orally administered hydrocodone

Pharmacokinetics

Hydrocodone is biotransformed by the liver into several metabolites, and has a serum half-life that averages 3.8 hours.The hepatic cytochrome P450 enzyme CYP2D6 converts it into hydromorphone, a more potent opioid. However, extensive and poor cytochrome 450 CYP2D6 metabolizers had similar physiological and subjective responses to hydrocodone, and CYP2D6 inhibitor quinidine did not change the responses of extensive metabolizers, suggesting that inhibition of CYP2D6 metabolism of hydrocodone has no practical importance. Ultrarapid CYP2D6 metabolizers (1-2% of the population) may have an increased response to hydrocodone; however, hydrocodone metabolism in this population has not been studied.

A major metabolite, norhydrocodone, is predominantly formed by CYP3A4-catalyzed oxidation. Inhibition of CYP3A4 in a child who was, in addition, a poor CYP2D6 metabolizer, resulted in a fatal overdose of hydrocodone. Approximately 40% of hydrocodone metabolism is attributed to non-cytochrome catalyzed reactions.

Recreational use

Many users of hydrocodone report a sense of satisfaction, especially at higher doses. A number of users also report a warm or pleasant numbing sensation throughout the body, one of the most well known effects of narcotics. Withdrawal symptoms may include, but are not limited to; severe pain, pins and needles sensation throughout body, sweating, extreme anxiety and restlessness, sneezing, watery eyes, fever, depression, stomach cramps, diarrhea, and extreme drug cravings, among others. Taking over 4,000 milligrams (4 grams) of paracetamol in a period of 24 hours can result in paracetamol overdose and severe hepatotoxicity; doses in the range of 15,000–20,000 milligrams a day have been reported as fatal.

Taking hydrocodone with grapefruit juice is one of the measures to enhance its narcotic effect. It is believed that CYP3A4 inhibitors in grapefruit juice may decrease metabolism of hydrocodone, although there has been no research into this issue.

Detection in body fluids

Hydrocodone may be quantitated in blood, plasma or urine to monitor for misuse, confirm a diagnosis of poisoning or assist in a medicolegal death investigation. Many commercial opiate screening tests cross-react appreciably with hydrocodone and its metabolites, but chromatographic techniques can easily distinguish hydrocodone from other opiates. Blood or plasma hydrocodone concentrations are typically in the 5-30 µg/L range in persons taking the drug therapeutically, 100-200 µg/L in abusers and 0.1-1.6 mg/L in cases of acute fatal overdosage.

History

Hydrocodone was first synthesized in Germany in 1920 by Carl Mannich and Helene Löwenheim. It was approved by the Food and Drug Administration on 23 March 1943 for sale in the United States and approved by Health Canada for sale in Canada under the brand name Hycodan.

This article uses material from the Wikipedia article Hydrocodone , which is released under the Creative Commons Attribution-Share-Alike License 3.0.

Reviews for Lortab (Acetaminophen/Hydrocodone)

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4 reviews

Overall rating 
 
4.6
Overall satisfaction 
 
4.6  (4)
Efficacy  
 
4.5  (4)
Lack of side effects 
 
4.6  (4)
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No complaints

I have been taking this off and on for almost 5 years now. At only 17, I have had several dental problems since my permanent teeth have came. I have had my adult teeth for about 5 years now. I do take good care of my teeth and I brush very thoroughly, so I know that isn't my problem. I have had toothache after toothache, root canal after root canal, abscess after abscess, and even 2 extractions, 1 of which was a surgical extraction. The medication helps with the pain better than anything else for pain. I don't take it every day so I won't get addicted. Usually 5mg doesn't do much for me, but the 7.5mg dosage is perfect for me. It doesn't take away the pain completely, but it makes it where I can tolerate it. To take it away completely, I take the medicine with Bayer Advanced Aspirin. The only problem I have with hydrocodone is that it makes me itch, otherwise no complaints.

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Brand Name
Lortab
Medical Condition
Pain

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How long have you taken this medicine for?
More than 2 years
Reviewed anonymously by a forum member
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Causes major constipation

I have taken Lortab 10/325 for two years off an on for lower back pain, and herniated disk in my neck. Taken every 4 hours works best for me, doctor wants me to take every 6 hours, some days I need it every 4hs. Causes major constipation.

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Brand Name
Lortab
Medical Condition
Pain

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How long have you taken this medicine for?
More than 2 years
Reviewed anonymously by a forum member
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Great pain reliever

Great pain reliever if you need it.

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Brand Name
Lortab
Medical Condition
Pain

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How long have you taken this medicine for?
1 month - 6 months
Reviewed anonymously by a forum member
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Lortab and Migraines

This is my experience with Lortab. Hope it helps.

I have had debilitating migraine headaches for many years. Unfortunately I'm one of the few who are allergic to Imitrex and similar meds - I had a severe reaction to it. My doctor has prescribed Lortab 7.5mg with 325mg of acetaminophen for pain. Flashing lights and vision changes are my first clue a migraine is coming. If I take one Lortab as soon as this starts, I can rest in a quiet dark place for 30-60 minutes and usually fight the migraine off. If I don't take this med quickly at the first sign, it develops into a major problem and takes more medicine to work. I've had migraines last for 4 days without any relief until I had to go to ER and get a shot of strong narcotic to relieve my agony.
For me, having my doctor prescribe Lortab saves me many days of misery. I'm glad to have a doctor who understands my problems and trusts me enough to prescribe it for me.

Side effects I noticed: Dry mouth, sometimes nausea (but migraines also cause nausea, so hard to judge how much is the medicine and how much the headache?). Sometimes due to stress, weather, or ? I may have several days in a row where I have to take the med to fight off migraines - when this happens the Lortab causes constipation. Those are the only side effects I've noticed and they are nothing compared to the agony of a full-blown migraine that won't go away for days.

I watch amount of acetaminophen I'm taking when I must take this med for pain, like all other products with acetaminophen in them, after reading a lot of bad stuff about too much acetaminophen damaging the liver.

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Brand Name
Lortab
Medical Condition
Pain

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How long have you taken this medicine for?
More than 2 years
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