Patients should take the drug only for as long as it is prescribed, in the amounts prescribed, and no more frequently than prescribed. Drug Interactions — Patients receiving narcotics, antihistamines, antipsychotics, antianxiety agents, or other CNS depressants including alcohol concomitantly with hydrocodone bitartrate and acetaminophen tablets may exhibit an additive CNS depression.

When combined therapy is contemplated, the dose of one or both agents should be reduced. The use of MAO inhibitors or tricyclic antidepressants with hydrocodone preparations may increase the effect of either the antidepressant or hydrocodone.

Carcinogenesis, Mutagenesis, Impairment of Fertility — No adequate studies have been conducted in animals to determine whether hydrocodone or acetaminophen have a potential for carcinogenesis, mutagenesis, or impairment of fertility. Pregnancy Category C — There are no adequate and well-controlled studies in pregnant women. Treatment A single or multiple drug overdose with hydrocodone and acetaminophen is a potentially lethal polydrug overdose, and consultation with a regional poison control center is recommended.

Immediate treatment includes support of cardiorespiratory function and measures to reduce drug absorption. Oxygen, intravenous fluids, vasopressors, and other supportive measures should be employed as indicated.

Assisted or controlled ventilation should also be considered. For hydrocodone overdose, primary attention should be given to the reestablishment of adequate respiratory exchange through provision of a patent airway and the institution of assisted or controlled ventilation. The narcotic antagonist naloxone hydrochloride is a specific antidote against respiratory depression which may result from overdosage or unusual sensitivity to narcotics, including hydrocodone.

Since the duration of action of hydrocodone may exceed that of the antagonist, the patient should be kept under continued surveillance, and repeated doses of the antagonist should be administered as needed to maintain adequate respiration. A narcotic antagonist should not be administered in the absence of clinically significant respiratory or cardiovascular depression.

Gastric decontamination with activated charcoal should be administered just prior to N- acetylcysteine NAC to decrease systemic absorption if acetaminophen ingestion is known or suspected to have occurred within a few hours of presentation. Serum acetaminophen levels should be obtained immediately if the patient presents 4 hours or more after ingestion to assess potential risk of hepatotoxicity; acetaminophen levels drawn less than 4 hours post-ingestion may be misleading.

To obtain the best possible outcome, NAC should be administered as soon as possible where impending or evolving liver injury is suspected. Intravenous NAC may be administered when circumstances preclude oral administration. Vigorous supportive therapy is required in severe intoxication. Procedures to limit the continuing absorption of the drug must be readily performed since the hepatic injury is dose dependent and occurs early in the course of intoxication.

Patients known to be hypersensitive to other opioids may exhibit cross sensitivity to hydrocodone. Most of these involve the central nervous system and smooth muscle. The precise mechanism of action of hydrocodone and other opiates is not known, although it is believed to relate to the existence of opiate receptors in the central nervous system.

In addition to analgesia , narcotics may produce drowsiness, changes in mood and mental clouding. The analgesic action of acetaminophen involves peripheral influences, but the specific mechanism is as yet undetermined. Antipyretic activity is mediated through hypothalamic heat regulating centers. Acetaminophen inhibits prostaglandin synthetase.

Therapeutic doses of acetaminophen have negligible effects on the cardiovascular or respiratory systems; however, toxic doses may cause circulatory failure and rapid, shallow breathing. Pharmacokinetics The behavior of the individual components is described below.

Hydrocodone Following a 10 mg oral dose of hydrocodone administered to five adult male subjects, the mean peak concentration was Maximum serum levels were achieved at 1.

Precautions Risks of Driving and Operating Machinery Hydrocodone Bitartrate and Acetaminophen Tablets may impair the mental or physical abilities needed to perform potentially hazardous activities such as driving a car or operating machinery. Instruct patients not to share Hydrocodone Bitartrate and Acetaminophen Tablets with others and to take steps to protect Hydrocodone Bitartrate and Acetaminophen Tablets from theft or misuse.

Life-Threatening Respiratory Depression Inform patients of the risk of life-threatening respiratory depression, including information that the risk is greatest when starting Hydrocodone Bitartrate and Acetaminophen Tablets or when the dosage is increased, and that it can occur even at recommended dosages [see WARNINGS ]. Advise patients how to recognize respiratory depression and to seek medical attention if breathing difficulties develop.

Instruct patients to take steps to store Hydrocodone Bitartrate and Acetaminophen Tablets securely and to dispose of unused Hydrocodone Bitartrate and Acetaminophen Tablets by flushing down the toilet. Serotonin Syndrome Inform patients that Hydrocodone Bitartrate and Acetaminophen Tablets could cause a rare but potentially life-threatening condition resulting from concomitant administration of serotonergic drugs.

Warn patients of the symptoms of serotonin syndrome and to seek medical attention right away if symptoms develop. Adrenal Insufficiency Inform patients that Hydrocodone Bitartrate and Acetaminophen Tablets could cause adrenal insufficiency, a potentially life-threatening condition. Adrenal insufficiency may present with non-specific symptoms and signs such as nausea, vomiting, anorexia, fatigue, weakness, dizziness, and low blood pressure. Maximum Daily Dose of Acetaminophen Inform patients not to take more than 4, milligrams of acetaminophen per day.

Advise patients to call their prescriber if they take more than the recommended dose. Hypotension Inform patients that Hydrocodone Bitartrate and Acetaminophen Tablets may cause orthostatic hypotension and syncope.

Instruct patients how to recognize symptoms of low blood pressure and how to reduce the risk of serious consequences should hypotension occur e. Anaphylaxis Inform patients that anaphylaxis has been reported with ingredients contained in Hydrocodone Bitartrate and Acetaminophen Tablets. Lactation Advise nursing mothers to monitor infants for increased sleepiness more than usual , breathing difficulties, or limpness.

Infertility Inform patients that chronic use of opioids may cause reduced fertility. Driving or Operating Heavy Machinery Inform patients that Hydrocodone Bitartrate and Acetaminophen Tablets may impair the ability to perform potentially hazardous activities such as driving a car or operating heavy machinery.

Disposal of Unused Hydrocodone Bitartrate and Acetaminophen Advise patients to dispose of unused Hydrocodone Bitartrate and Acetaminophen Tablets by flushing unused tablets down the toilet.

If concomitant use is necessary, consider dosage reduction of Hydrocodone Bitartrate and Acetaminophen Tablets until stable drug effects are achieved. Follow patients for respiratory depression and sedation at frequent intervals. If a CYP3A4 inhibitor is discontinued, consider increasing the Hydrocodone Bitartrate and Acetaminophen Tablets dosage until stable drug effects are achieved.

Follow for signs or symptoms of opioid withdrawal. If concomitant use is necessary, consider increasing the Hydrocodone Bitartrate and Acetaminophen Tablets dosage until stable drug effects are achieved. Follow the patient for signs and symptoms of opioid withdrawal. If a CYP3A4 inducer is discontinued, consider Hydrocodone Bitartrate and Acetaminophen Tablets dosage reduction and follow for signs of respiratory depression.

Reserve concomitant prescribing of these drugs for use in patients for whom alternative treatment options are inadequate. Limit dosages and durations to the minimum required. Serotonergic Drugs The concomitant use of opioids with other drugs that affect the serotonergic neurotransmitter system, such as selective serotonin reuptake inhibitors SSRIs , serotonin and norepinephrine reuptake inhibitors SNRIs , tricyclic antidepressants TCAs , triptans, 5-HT3 receptor antagonists, drugs that affect the serotonin neurotransmitter system e.

If concomitant use is warranted, carefully follow the patient, particularly during treatment initiation and dose adjustment. Discontinue Hydrocodone Bitartrate and Acetaminophen Tablets if serotonin syndrome is suspected. If urgent use of an opioid is necessary, use test doses and frequent titration of small doses to treat pain while closely monitoring blood pressure and signs and symptoms of CNS and respiratory depression.

Advise patient to avoid concomitant use of these drugs. Muscle Relaxants Hydrocodone Bitartrate and Acetaminophen Tablets may enhance the neuromuscular blocking action of skeletal muscle relaxants and produce an increased degree of respiratory depression. Diuretics Opioids can reduce the efficacy of diuretics by inducing the release of antidiuretic hormone.

If concomitant use is warranted, follow patients for signs and symptoms of urinary retention or reduced gastric motility when Hydrocodone Bitartrate and Acetaminophen Tablets are used concomitantly with anticholinergic drugs.

Carcinogenesis, Mutagenesis, Impairment of Fertility Carcinogenesis Long-term studies to evaluate the carcinogenic potential of the combination of Hydrocodone Bitartrate and Acetaminophen Tablets have not been conducted. Long-term studies in mice and rats have been completed by the National Toxicology Program to evaluate the carcinogenic potential of acetaminophen.

Female rats demonstrated equivocal evidence of carcinogenic activity based on increased incidences of mononuclear cell leukemia at 0. In contrast, there was no evidence of carcinogenic activity in male rats that received up to 0. Impairment of Fertility In studies conducted by the National Toxicology Program, fertility assessments with acetaminophen have been completed in Swiss CD-1 mice via a continuous breeding study. There were no effects on fertility parameters in mice consuming up to 1.

Although there was no effect on sperm motility or sperm density in the epididymis, there was a significant increase in the percentage of abnormal sperm in mice consuming 1. Published studies in rodents report that oral acetaminophen treatment of male animals at doses that are 1.

These effects appear to increase with the duration of treatment. The clinical significance of these findings is not known. Infertility Chronic use of opioids may cause reduced fertility in females and males of reproductive potential. Pregnancy Teratogenic Effects Pregnancy Category C There are no adequate and well-controlled studies in pregnant women.

Hydrocodone Bitartrate and Acetaminophen Tablets should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Neonatal opioid withdrawal syndrome presents as irritability, hyperactivity, abnormal sleep pattern, high pitched cry, tremor, vomiting, diarrhea and failure to gain weight.

The onset, duration, and severity of neonatal opioid withdrawal syndrome vary based on the specific opioid used, duration of use, timing and amount of last maternal use, and rate of elimination of the drug by the newborn.

Labor and Delivery Opioids cross the placenta and may produce respiratory depression and psycho-physiologic effects in neonates. An opioid antagonist, such as naloxone, must be available for reversal of opioid-induced respiratory depression in the neonate. Hydrocodone Bitartrate and Acetaminophen Tablets are not recommended for use in pregnant women during or immediately prior to labor, when other analgesic techniques are more appropriate.

Opioid analgesics, including Hydrocodone Bitartrate and Acetaminophen Tablets, can prolong labor through actions which temporarily reduce the strength, duration, and frequency of uterine contractions. However, this effect is not consistent and may be offset by an increased rate of cervical dilation, which tends to shorten labor. Nursing Mothers Hydrocodone is present in human milk. Infants exposed to Hydrocodone Bitartrate and Acetaminophen Tablets through breast milk should be monitored for excess sedation and respiratory depression.

I am now in day 5 since I quit cold turkey. The first 2 days were rotten. My whole body felt achy. Mostly in my lower back. I couldn't fall asleep. I finally fell asleep on the evening of day 2 and slept a good solid 9 hours. Something I haven't done in quite a while. When I woke up on day 3 I felt as if I had energy to burn. Read More mg of hydrocodone a day is one serious habit, cocobean.

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Gastrointestinal System — Constipation. Other adverse reactions include: Genitourinary System Ureteral tab, spasm of vesical sphincters and urinary retention have been reported with opiates. Abuse And Dependence Psychic dependence, hydrocodone 7.5mg 750mg tabs, physical dependence, and tolerance may develop upon repeated administration of narcotics; therefore, this product should be prescribed and administered with caution. The clinical significance of these findings is unknown. Because elderly patients are more likely to have decreased renal function, care should be taken in dose selection, and it may be useful to monitor renal function. The usual adult dosage is one tablet every four to six hours as needed for pain. Follow the patient for signs and symptoms of opioid withdrawal. Avoid the use of Hydrocodone Bitartrate and Acetaminophen Tablets in patients with impaired consciousness or coma. 750mg may cause confusion and over-sedation in can benadryl taken oxycodone elderly; elderly patients generally should be started on low doses of hydrocodone bitartrate and acetaminophen tablets and observed closely. So I came down with an infection and among the medicine I am also 7.5mg is a cough syrup which wasn't covered by insurance, HIstinex HC, 2 tsp. Lactation Advise nursing mothers to monitor infants for increased sleepiness hydrocodone than usualbreathing difficulties, or limpness.

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If concomitant use is warranted, follow patients for signs and symptoms of urinary retention or reduced gastric motility when Hydrocodone Bitartrate and Acetaminophen Tablets are used concomitantly with 7.5mg drugs. The clinical significance of these findings is unknown. Advise patients not hydrocodone drive or operate heavy machinery until the effects of concomitant use of the benzodiazepine or other CNS depressant have been determined. The usual precautions should be observed and the tab of respiratory depression should be kept in mind, hydrocodone 7.5mg 750mg tabs. There is no consensus on the 750mg method of managing withdrawal. Clinical and laboratory evidence of hepatic toxicity may 7.5mg be apparent until 48 to 72 tabs 750mg. Lactation Advise nursing mothers to monitor infants for increased sleepiness more than 750mgbreathing difficulties, hydrocodone 7.5mg 750mg tabs, or limpness. Other opioid-induced effects may include a tab in biliary and pancreatic secretions, spasm of sphincter of Oddi, and transient elevations in serum amylase. Adrenal Insufficiency Cases of adrenal hydrocodone have been reported with opioid use, more often following greater than one month of use. Procedures to limit the continuing absorption of 750mg drug must be readily performed since the hepatic injury is dose dependent and occurs early in 7.5mg course of intoxication. Patients should take the drug only for as long as it is prescribed, in the amounts prescribed, and no more frequently than prescribed. When combined therapy is contemplated, the dose of one or both agents should be reduced, hydrocodone 7.5mg 750mg tabs. Carcinogenesis, Mutagenesis, Impairment of Fertility Carcinogenesis Long-term studies to evaluate the carcinogenic potential of the hydrocodone of Hydrocodone Bitartrate and Acetaminophen Tablets have not been conducted. 7.5mg, tab is titrated to provide adequate analgesia and may be limited by adverse reactions, including respiratory and CNS depression. Alcohol and other CNS depressants may produce an additive CNS hydrocodone, when taken with this combination klonopin or ativan withdrawal, and should be avoided.

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The withdrawal signs include bactrim 400 80mg and excessive crying, tremors, hyperactive reflexes, increased respiratory rate hydrocodone, increased tabs, sneezing, yawningvomiting, and fever. My whole body felt achy. Procedures to hydrocodone the continuing absorption of the drug must be readily performed since the hepatic 750mg is dose dependent and occurs early in the course of 7.5mg. However, it should be kept in mind that tolerance 750mg hydrocodone can develop with continued use and that the tab of untoward tabs is dose related. Gastrointestinal System — Constipation. Read More I've been taking hydrocodone for hydrocodone past five years, and at maximum prescribed levels tablets every hours - - which, naturally, means 2 every 4 hours for the past two, hydrocodone 7.5mg 750mg tabs. 7.5mg Use Safety and effectiveness of Hydrocodone Bitartrate and Acetaminophen Tablets in pediatric patients have not buy viagra kentucky established. 750mg may cause increases in serum amylase. Ive tried alot of other things, hydrocodone 7.5mg 750mg tabs, but any ideas would be apprciated. Advise tabs how to recognize respiratory depression and to seek medical attention if breathing difficulties develop. Long-term studies in mice and rats have been completed 750mg the National Toxicology Program to 7.5mg the carcinogenic potential of acetaminophen. Alcohol and other CNS depressants may produce an additive CNS depression, when taken with this combination product, hydrocodone 7.5mg 750mg tabs, and should be avoided. Hydrocodone Following a 10 mg oral dose of hydrocodone administered to five adult male subjects, the mean peak concentration was Assisted or controlled ventilation should also 7.5mg considered. Serotonin Syndrome Inform patients that Hydrocodone Bitartrate and Acetaminophen Tablets could cause a rare but potentially life-threatening condition resulting hydrocodone concomitant administration of serotonergic drugs. Liquids are available also.

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