Before having surgery, tell your doctor or dentist that you are taking this medication. Older adults may be more sensitive to the side effects of this medication, especially dizziness , which can increase the risk of falls. This medication should be used only when clearly needed during pregnancy. Discuss the risks and benefits with your doctor.
This medication passes into breast milk, but is unlikely to harm a nursing infant. Consult your doctor before breast -feeding. What should I know regarding pregnancy, nursing and administering Hydralazine HCL to children or the elderly?
Interactions Your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor or pharmacist first.
MAO inhibitors isocarboxazid , linezolid , methylene blue, moclobemide, phenelzine , procarbazine , rasagiline , safinamide, selegiline, tranylcypromine. Some products have ingredients that could raise your heart rate or blood pressure or worsen your heart failure.
This document does not contain all possible interactions. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist. Overdose If someone has overdosed and has serious symptoms such as passing out or trouble breathing , call Hydrocodone bitartrate ER can be abused and is subject to misuse, addiction, and criminal diversion [See Warnings and Precautions 5.
Tolerance is the need for increasing doses of opioids to maintain a defined effect such as analgesia in the absence of disease progression or other external factors.
Tolerance may occur to both the desired and undesired effects of drugs, and may develop at different rates for different effects. Physical dependence results in withdrawal symptoms after abrupt discontinuation or a significant dose reduction of a drug. Withdrawal also may be precipitated through the administration of drugs with opioid antagonist activity, e.
Physical dependence may not occur to a clinically significant degree until after several days to weeks of continued opioid usage. Hydrocodone bitartrate ER should be discontinued by a gradual downward titration [see Dosage and Administration 3.
If hydrocodone bitartrate ER is abruptly discontinued in a physically dependent patient, an abstinence syndrome may occur. Some or all of the following can characterize this syndrome: Infants born to mothers physically dependent on opioids will also be physically dependent and may exhibit respiratory difficulties and withdrawal symptoms [see Warnings and Precautions 5. Marked mydriasis rather than miosis may be seen due to severe hypoxia in overdose situations [see Clinical Pharmacology].
Employ other supportive measures including oxygen and vasopressors in the management of circulatory shock and pulmonary edema accompanying overdose as indicated. Cardiac arrest or arrhythmias will require advanced life support techniques.
The opioid antagonist naloxone hydrochloride is a specific antidote against respiratory depression that may result from opioid overdosage. Nalmefene is an alternative opioid antagonist, which may be administered as a specific antidote to respiratory depression resulting from opioid overdose. Since the duration of action of hydrocodone bitartrate ER may exceed that of the antagonist, keep the patient under continued surveillance and administer repeated doses of the antagonist according to the antagonist labeling, as needed, to maintain adequate respiration.
Opioid antagonists should not be administered in the absence of clinically significant respiratory or circulatory depression. Administer opioid antagonists cautiously to persons who are known, or suspected to be, physically dependent on hydrocodone bitartrate ER. In such cases, an abrupt or complete reversal of opioid effects may precipitate an acute abstinence syndrome.
In an individual physically dependent on opioids, administration of the usual dose of the antagonist will precipitate an acute withdrawal syndrome. The severity of the withdrawal syndrome produced will depend on the degree of physical dependence and the dose of the antagonist administered.
If a decision is made to treat serious respiratory depression in the physically dependent patient, administration of the antagonist should be initiated with care and by titration with smaller than usual doses of the antagonist.
Hydrocodone acts as an agonist binding to and activating opioid receptors in the brain and spinal cord, which are coupled to G-protein complexes and modulate synaptic transmission through adenylate cyclase. QTc interval prolongation was observed following hydrocodone bitartrate ER mg per day. For clinical implications of the prolonged QTc interval, see Warnings and Precautions 5.
Central Nervous System The principal therapeutic action of hydrocodone is analgesia. In common with other opioids, hydrocodone causes respiratory depression, in part by a direct effect on the brainstem respiratory centers. The respiratory depression involves a reduction in the responsiveness of the brain stem respiratory centers to both increases in carbon dioxide tension and electrical stimulation.
Opioids depress the cough reflex by direct effect on the cough center in the medulla. Hydrocodone causes miosis, even in total darkness. Pinpoint pupils are a sign of opioid overdose but are not pathognomonic e. Marked mydriasis rather than miosis may be seen with hypoxia in overdose situations [see Overdosage In addition to analgesia, the widely diverse effects of hydrocodone include drowsiness, changes in mood, decreased gastrointestinal motility, nausea, vomiting, and alterations of the endocrine and autonomic nervous system [see Clinical Pharmacology].
Gastrointestinal Tract and Other Smooth Muscle Hydrocodone causes a reduction in motility associated with an increase in smooth muscle tone in the antrum of the stomach and duodenum. Digestion of food in the small intestine is delayed and propulsive contractions are decreased. Propulsive peristaltic waves in the colon are decreased, while tone may be increased to the point of spasm resulting in constipation.
Other opioid-induced effects may include a reduction in gastric, biliary and pancreatic secretions, spasm of sphincter of Oddi, and transient elevations in serum amylase. Cardiovascular System Hydrocodone may produce release of histamine with or without associated peripheral vasodilation. Endocrine System Opioids may influence the hypothalamic-pituitary-adrenal or -gonadal axes.
Some changes that can be seen include an increase in serum prolactin, and decreases in plasma cortisol and testosterone. Clinical signs and symptoms may be manifest from these hormonal changes. Immune System In vitro and animal studies indicate that opioids have a variety of effects on immune functions, depending on the context in which they are used. The clinical significance of these findings is unknown.
As a result, titrate the doses of individual patients to achieve a balance between therapeutic and adverse effects. As with all opioids, the dose of hydrocodone bitartrate ER must be individualized [see Dosage and Administration 3. The effective analgesic dose for some patients will be too high to be tolerated by other patients.
Peak plasma levels may occur in the range of 6 hours after single dose hydrocodone bitartrate ER administration. Systemic exposure AUC and Cmax increased linearly with doses from 20 to mg. We already created article on this topic. Check this out http: It will give you detail explanation about your question. One or two at a time within 12 hours??? She is fine for about six hours then the cough returns.
Do you think it would be fine to increase it to three times daily. I tried contacting our primary and its after hours and wont open back up til Monday. None worked, nor did countless months of physical therapy, TENS units, over the counter meds, etc. So the doctor put me on hydrocodone, eventually up to 60mg per day.
After a year on it, I began blacking out throughout the day, sometimes for hours at a time. I would keep working, talking, etc. Other times I would just do weird things like stand up and tear the pages out of a magazine one at a time for 30 minutes.
I also was losing my short term memory. It took another 6 months to finally figure out it was the hydrocodone making me do this. I finally checked into a Detox facility to help me, which was horribly difficult, but I got off it. However, now my dilemma is that, ever since getting off of it, I have been extremely fatigued. By evening, I can barely walk or move my legs.
Throughout the day, my muscles tremble — even lifting a can of Coke makes me shake. Does anyone have any idea what I can do to overcome this? I have been to my MD, psychiatrist, nutritionist, neurologist, cardiologist and had every kind of labwork done and nothing shows up as wrong. But it is killing my quality of life. My left tube was removed in june. I would take an advil and it would go away but the past 2 weeks the pain has been worse.
I started taking hydrocodone 7. Then the pain was more often and hydrocodone wouldnt last. Is that too much? Do I possibly have liver damage now? Any answers would be appreciated Robiin 9: I was prescribed 4 per day Gisela 4: I am 87 years old. My pain is related to arthritis in my lower back and both shoulders. Is this to much? Ivana Addiction Blog You can talk to your doctor about any further concerns.
Any danger from the three I took at once if I do not take more the rest of the day? Is it safe to take two Norco pills at once to try and numb the pain about half an hour before I do this? Howcan I convince her it is bad? That would be a pill every 2 and a half hours if you take 12 pills spaced out during a 30 hour period.
The recommended dose time is hours at least. Was given hydroconone in hospital. Next day, before I even got installed at home, I had a violent reaction—really vivid and horrible dreams. Lasted nearly 12 hours. I admit to having alcohol daily, but have never had any violent reaction such as this. In 74 years, I have never had anything like this. Did the alcohol consumption cause the reaction? We got new drugs and are getting along fine controlling the pain. Please, answer by email. She took 5 of her hydrocodone within a 2 hour period about 2 hours ago.
Is it safe to take 1 of her 2mg xanex to go to sleep now? During the past 40 days, I have taken about 85 tablets, and have not taken any for the past few days. Last night I began experiencing more widespread pain, throwing up, mild diarrhea. Could these symptoms be due to hydrocodone withdrawal? Headaches with ear pain. Was in a 4-wheeler accident a yr ago, with many injuries. Skull fracture with large hematoma, bleeding from right ear that broke the bones in the middle ear.
Have had 2 ear surgeries in Dallas TX, broken rt clavicle, 7 broken ribs on my rt side,collapsed lung, and broken pelvis in 3 places. Lots of road rash.
With that being said, I am aware of the danger so I truly only take one or a half of one with my Trazadone mg for insomnia. I have also started biofeedback with the bands on the ankles, wrist and the headband.
I had my second visit today and she said my pain level was at highest level and my thyroid and parathyroid were low. Kidneys, liver, heart ok, gallbladder was off, and she focused on my ears too…I could actually feel that tinnitus calm down.
Recent labs showed FT4 I am really trying to recover and try alternative txs and I also see my Chiropractor often as well. What do you think about me, my medications and outcome?! Norco contains hydrocodone bitartrate and acetaminophen, which is the same as Vicodin another brand name similar to these medicines is Lortab.
And while they all contain hydrocodone bitartrate, Hydrocodone itself does not contain acetaminophen, paracetamol or APAP. Hydrocodone is synthesized form codeine and is a semi-synthetic opioid. I was given Oxycodone in hospital — 2 tabs every 3 hours, for 3 days.
Last weekend, I decided to stop taking them, and had withdrawal symptoms — jittery, achy, pain all over, diarrhea, dizziness, and lack of sleep. After a full day and a half, I took another tablet, and leveled off after an hour.
My concern is that when I finish this next month — and my arm should be stronger and with much less pain, how can I discontinue these without any serious withdrawals?
But, I would like a more specific answer — like, will that only reduce pain, or will it also alleviate the withdrawals? Thanks, for any input. How is this possible if 90mg is supposed to be lethal dose??
Is it safe to take that with Norco now that law prevents getting the amount I was used to? Severe back, cervical, foot nerve damage problems. Eight hours in between doses. However by morning when they have long ago worn off I can barely walk.
What is the strongest over the counter I can take at night so I can get out of bed in the morning. Back pain from a collapsed disc and stenosis and arthritis. This morning was so bad my wife had to help me get to the bathroom. Ivana Addiction Blog 3: Ask your pharmacist to help you find an OTC medication that will provide the needed relief.
I have Osteoarthritis, in my back and body. Not the Tylenol in it strickly the hydrocodone. I feel ok so far but am wondering if I should induce vomiting, stay awake all night or what? I did to much activity 15 days after surgery. I became very iritable about 8;30 am. By that afternoon i was full nlown crazy.. Can this massive amount cause that kind of anger and aggression? Is a doctor prescribe that anount legally?
I take a day for shoulder and knee pain but this eas 4 times that anount Ana 8: I have vomited everytime I have taken them until the past two days.
I will have a standard monthly drug test for my levels in 2 weeks. Now that I can hold my meds in will I be able to get my levels back where they need to be in time for my test. I hate to be booted on my 2nd visit. Or will the vomiting have no affect on the levels? I truly need these pain meds!! Thank you for any info or peace of mind. One half in the morning and another two halves within an 9 hour day.
I have been told by everyone that its under all the limits of concern for overdosing but that doesnt answer the underline question.. I am 38 years old and have alot of issue..
Back Surgery, Ankle Surgery, Suppose to have shoulder surgery but concerned of the outcome and being worse than I already am. Can I safely quit taking them or should I taper off? Is this a liver thing? I thank you so much for taking your time to answer my question… Carla 6: Will only prescribe 3 mg hydrodone per day.
After hours I have severe twitching in my legs and seem to become short of breath. I feel I need 4 every 24 hours therefore I will run out of them before my refill is available. Will I go through withdrawals if I stop now? I am prescribed 1 tsp 2 x a day. It is extended release so 10 mg for 12 hours.
I have never noticed a tolerance effect for cough. Is tolorence a problem when it us used for chronic cough? If they could give me something to help my pain that would kill me in 5 years…I would do it. I rather be happy in the short run then miserable for the long. My doctors test my blood and liver…all is good there, is there anything else that will help? Can pot replace the pills?
Currently I do physical therapy 3 hours a day and I am very dedicated to finding a solution. I asked my boyfriend if I had taken my hydrocodone at Will I be fine?
Lydia Addiction Blog 7: I suggest you talk with a doctor or a pharmacist for any change you want to make with your medications. I take it for painful neuropathy. I have been on this regimen for many years and am doing OK with this very useful drug. Says to take 1 every 6 hours unless pain is no loner present, is it alright to take maybe a pill and a half? Lydia Addiction Blog 9: Have you talked with your doctor about this?
Before changing the dosage, I suggest you speak with your doctor first. I have stayed at this level unless I am having severe pain for a flare… when the pain is horrible and I cannot function without the medication.
I have had many flares lately and have needed more than the 2 tablets a day. I just had facet injections which I hope will bring the pain back into line. I would like to move to 2.
What should I do at this point? Now I can take up to 15 at a time but only once a day. Especially now I have a son to live for and a wonderful woman in my life willing to stand by me thru this addiction and loves me regardless of tlmy addiction. So if you know of a good website for a doctor or a rehab that I could go to please respond and words of encouragement would be greatly appreciated.
Thankn Lydia Addiction Blog Also, call the number you see on our website to speak with trusted treatment consultants who can help you find a program that fits your needs. I have been on this regimen for several years now and I detect no bad side effects. The worst thing that I now experience is the constant yacking between the FDA and a bunch of Chicken Littles who are constantly trying to scare people like me into moving away from Vicodin even though I long ago with the help of my doctor determined this was the best pain relief for me.
First they cut the Tylenol content to try and lower liver damage. This was fine with me. Then the cut the ability of doctors to prescribe without seeing patients every 30 days. This was terribly inconvenient for elderly patients so was with drawn. Then they allowed 30 day prescriptions over the phone. These idiots imagined they were doing some sort of good, even though they caused the problem initially. They also did succeed in taking 90 day prescriptions away from doctors and their needy patients.
These actions are justified by imagining fewer deaths will happen to irresponsible morons. Patients can become addicted physically and mentally as both their bodies and minds begin to crave that state of bliss. Tramadol and Vicodin are much less potent in their usual doses than other opiates like morphine, heroin, and its synthetic counterpart Fentanyl. Because of this, short-term use of tramadol for moderate pain symptoms comes with a relatively low risk of addiction or withdrawal.
Vicodin has a higher risk for addiction. Acetaminophen works by elevating the threshold to pain, that is, in order for pain to be felt, greater stimulation of the nerves responsible for the sensation of pain is necessary. It reduces fever through its action on the temperature-regulating center of the brain. Frequently, hydrocodone and acetaminophen are combined to achieve pain relief, as in Vicodin and Lortab.
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