Doctors' Answers to "Frequently Asked Questions" - Vicodin

These comments are made for the purpose of discussion and should NOT be used as recommendations for or against therapies or other treatments. An individual patient is always advised to consult their own physician.

Vicodin and Percodan alternatives [posted 1/13/99]
Question: I am currently in the U.K. and I have severe pain. I have had knee problems since I was a child and have now had a stress fracture on my foot. I cannot find a similar pain reliever as they do not prescribe percodan or vicodin here. Perhaps there is another name for the drug. I was given Votoral, which made me very sleepy and did not relieve the pain.

Answer: Generic of Vicodin is hydrocodone bitartrate plus acetaminophen. Try asking for the generic equivalent.

Vicodin Side Effect [posted 1/13/99]
Question: I was given vicodin at the hospital when I was accidentally burned in the eye with a cigarette. I didn't use all of the tablets, but saved some. Last night I burnt my fingertips and palm on the stove. The pain was quite severe, I held ice in my hand for about 5 hours until I was ready to go to bed. I also drank 3 beers over a period of 3 hours. (I took one vicodin for the purpose of a sleep aid once, and it had no effect.) I have trouble sleeping anyway, so I took two vicodin. I became very drowsy and eventually dosed off into a light sleep. I woke up at one point to get up for a glass of water. I barely made it to the kitchen when I started to faint, every time I tried to stand up I would start to black out. I crawled to the bathroom because I felt nauseated, but could not vomit. Finally I crawled back to bed thinking that I would wake up with some sort of brain damage, but this morning I felt fine. I was wondering if you think a dosage of two tablets of vicodin simultaneously could cause liver or kidney damage? Are fainting spells or loss of consciousness a common side effect of vicodin?

Answer: Probably wouldn't cause liver or renal problems, but clearly are the nausea and the mental difficulties.

Vicodin [posted 1/11/99]
Question: If Vicodin has no effect on my pain what so ever, what pain medication would? Why would it not work? This was prescribed following spinal fusion surgery of the L5-S1 vertebrae using B.A.K. implants.

Answer: You will need higher doses of morphine or equivalent. It will work in sufficient dosing.

Vicoprofen [posted 1/8/99]
Question: I am a 25 year old male, and have been taking 4 tabs of vicoprofen a day for about 2 months, however, I was on vicodin for about 7 months prior. I am concerned about the hydrocodone in these two drugs. Will I be able to control the addictive side effects of the drug after (if ever), I have to stop taking it? I went 24 hours once to see how addicted I was, and I spent the night sweating and shaking. It wore off the next day, but I had to resume my medication for the chronic back pain in which I suffer. Is there a better substitute? Should I take my concerns to my O.P.?

Answer: You have an addiction now. Discuss options with your doctor. There may be no option other than the medications.

Vicodin replacement [posted 1/6/99]
Question: I was recently in an auto accident. My Doctor gave me lortab. When I gave it to the pharmacy, they replaced it with Vicodin. What is The difference between the two drugs. And should I take it because I'm allergic to codeine?

Answer: Both contain hydrocodone and acetaminophen, so substitution is ok. Hydrocodone is similar to codeine, but technically different. I wouldn't expect your reaction to be much different, but judge by effects.

Norco, Vicodin  and Insomnia [posted 12/08/98]
Question: I love this site and just found it! Why does Norco keep me awake at night but Vicodin does not? My physician was surprised when I told her Norco keeps me awake all night. I also take  Baclofen and Nuerontin for muscle spasm and nerve pain, thanks.

Answer: Most patients experience somnulence on barbiturates;but, some do get a paradoxical response, sounds like this could be you.

Vicodin & Difficulty Breathing   [posted 12/04/98]
Question: My 60 yr old mother (weighs 95 lbs/smoker), June broke her wrist last June and had surgery. She was prescribed Vicodin(5-500mg tabs)2 pills every 4 hrs as needed for pain. 10 days into the recovery she experienced lightheadedness and respiratory distress that ended her up in the hospital for 4 days. In the emergency room, she told the DR's that she felt she was having a reaction to the Vicodin she had been taking, because she had just taken 2 pills 20-30 min before. They assumed she had asthma and gave her Albuterol and 5hrs later sent her home with Albuterol. During the next 6hrs she had 3 additional attacks and returned to hospital and was admitted. They continued the Vicodin and Albuterol for 4 days until discharge, where my mother refused the Vicodin for fear of another respiratory attack. Since she discontinued the use of Vicodin she has not had another attack.  My questions are: 1)Can the respiratory distress be caused by the amount of Vicodin prescribed? 2)Does her weight matter? 3)Is it possible a build up of Vicodin in her system caused the respiratory distress? 4)Can a reaction happen after 10 days of use? 5)Could the Albuterol intensify the reaction to Vicodin?

Answer: Wouldn't be a usual reaction to narcotics. Respiratory reaction to narcotics is usually decreased breathing and somnulence. But, if she gets a reaction every time she takes it, I would be suspicious of some reaction-possibly to the dye or binders in the pill.

  Vicodin & Addiction  [posted 12/04/98]
Question: I have been taking Vicodin for migraines off and on for 4 years. They tend to make my headaches worse but I have become "addicted" to it. I have noticed my increase usage and have just decided to stop completely. What withdrawal symptoms should I expect to have?

Answer: Nausea, vomiting, chills, goosebumps, headaches. Try clonidine to help block some of these.

Vicodin Liver Concerns  [posted 12/04/98]
Question:  Isn't vicodin an opiate? I recently vacationed with a friend who has been talking vicodin for several years, plus now she is on a sleeping medication (name unknown) and she takes prozac and advil. I am very concerned about her..what is the interaction of these drugs and....won't they  damage the liver? She denies being addicted to any of the above!

Answer: Yes it is an opiate. Long term use in high doses could damage her liver, addiction would be a more common problem.

How Much is a Vicodin Overdose [posted 11/17/98]
Question: I have a prescription for Vicodin. The bottle says take 1 to 2 for severe pain. Two seems a lot at one time for a narcotic. What exactly would constitute a limit for overdose?

Answer: Depends on your weight, age and other concurrent medications;but, would usually for a 150 # person take at least 8 before one would see major problems in respiration.

Vicodin [posted 11/10/98]
Question: I have been taking Vicodin for a few months following a foot surgery. I got to the point where I was only taking a pill before bed. I stopped taking Vicodin 2 nights ago and now I am having a terrible time sleeping. I doze off but then wake up with a jerky motion. Is there some help without more drugs? Or do I have to wait until this stuff is out of my system?

Answer: Try an antihistamine at bedtime. They produce somnulence and are an adjunct to any analgesic. Tylenol PM for example would combine acetaminophen with an antihistamine.

If I Have an Ulcer, Will 2 -3 Vicodin Caplets a Week Have Adverse Effects [posted 10/30/98]
Question: I've been in several major car accidents and have undergone therapy for chronic neck pain.The therapy was helpful to some degree, but I still experience flare-ups that cause severe headaches. The only over the counter drugs that help are of the anti-inflammatory variety. Unfortunately, I've been diagnosed w/ an ulcer and it was recommended that I don't use these. The only thing that is successful in treating the pain has been vicodin. I'm very health conscious and don't want to do anything detrimental to my health, but when I get these neck induced headaches, vicodin provides relief. On average, I take 2-3 caplets a week. Is this a problem?

Answer:Probably not at this dosage. Have you seen a chiropracter?

Vicodin Effects on Sex Drive [posted 10/28/98]
Question: A friend called me this am and asked if I could find some info on the net about Vicodin. She wanted to know if it has any affects on your sexual drive. I told her that almost all if not all pain medicine has an affect on your sexual drive. Any ideas?

Answer: All the narcotics usually decrease sexual drive.

Vicodin for High Blood Pressure [posted 10/28/98]
Question: My sister has been having a problem with high blood pressure and her doctor recently prescribed a prescription for Vicodin. Knowing that Vicodin is a painkiller, I would like to know what value it has in treating hypertension. The doctor also told her it was alright to dring alcohol while taking Vicodin, and I know that is not correct. Any comments?

Answer: There is no effect of vicodin on hypertension unless the chronic pain was elevating the blood pressure, a possible effect of pain. Do not mix alcohol with narcotics that is the way to the morgue.

Vicodin, Kidney Stones & Preganancy [posted 10/6/98]
Question:At 24 weeks of pregnancy I was admitted to the hospital for a kidney stone and severe blockage and pain. Not wanting to do Xrays the urologist gave me surgically inserted a stent to keep my kidney from being blocked, but was unable to remove the stone. Since then almost a month has passed and I have passed one stone. Until an Xray is done I still have the stent in place and this causes me a great deal of pain. My urologist and obstetrician have given me Vicodin to take. They assure me it is safe for the baby but I have read about addiction problems and put off taking it when I can. I usually take about 3 per day and try to sleep to avoid taking another pill. I may need to use it for another month or two until the baby is born or the stent is removed. I am very worried about the effects on my baby but my physicians have a "don't worry about it" attitude and conclude it is worse for the baby if I am constantly in pain. I am also not sure if the drug is causing deppression or if I am just upset over this whole thing and extra emotional because of the pregnancy. Thank you for your time.

Answer: Vicodin is potentially addictive when taken for a sufficient time. However, I would take the medications and fight that later. The real question is the potential effects on your baby. Unfortunately, the baby will probably have a mild addiction. If the pediatricians know this, they can treat the baby with no major problems. This is the direction I would go, having also suffered from stones personally.

Vicodin [posted 8/11/98]
Question: Is it okay to take Vicodin for pain while taking SMZ-TMP? What types of problems may occur if these two drugs are taken together?

Answer: No obvious problem.

Vicodin and Addiction [posted 8/11/98]
Question: I take 4 vicodin a day for severe osteoporosis and arthritis. I sometimes take as many as six a day when the pain is real bad. I am afraid of addiction so I worry every time I take a pill. Could you give me your views on this?

Answer: Taking this dosage for long periods will certainly result in addiction. This is pretty severe pain for osteoarthritis. I'd ensure that you don't have metabolic bone disease, hyperparathyroidism, etc. Have you had a bone density? Sometimes, treatment with Fosamax or Miacalcin will help the pain - this is for osteoporosis not arthritis.

Vicodin - Severe Side Effects [posted 8/5/98]
Question: I was given a prescription for Vicodin ES for tooth pain. I took a total of two caplets five hours apart. The first dose helped my toothache immensely. I took a second dose of one caplet and four hours later developed nausea/vomiting, dizziness, and an excruciating headache. I do not remember ever having had a worse headache. I do not plan to take this medication again, but I am wondering if this was an allergic reaction, or just an adverse reaction. What do you think?

Answer: The nausea, etc., would be common side effects to any narcotic - especially if taken on an empty stomach. The headache would be much less common, and I'm not sure what caused this problem.

Vicodin [posted 8/4/98]
Question: I have recently been taking vicodin and am presently in the process of acquiring employment. They will do a drug screen. What could I do in this situation? Can I wait for a certain period of time for it to clear out my system? I really want this position, and I am not abusing the medication, nor do I need it every day. I only take one or two a night at night when I go to bed in order to sleep. I have been extremely careful because I do realize that vicodin can become addictive. During the day I take 3 motrin 600 mg to help the pain and that is working for me.

Answer: It will show in your urine for a fairly long period. You'll need to find another method of sleep. Try a drug like Elavil 25 or 50 mg.

Vicodin [posted 7/17/98]
Question: My father has been diagnosed with cancer. The areas affected are the liver, upper left lung, left shoulder joint. The doctor has prescribed him some vicodin. Could you help me out with sending me information on vicodin.

Answer: Vicodin is a combination of hydrocodone(a semisynthetic narcotic) and acetaminophen (tylenol). Very effective pain reliever, but is limited by the amount of acetaminophen one can take per day-usually 12 at max. Codeine or hydrocodone by itself gives better control without the limits of acetaminophen, but combination with the acetaminophen increases the effect of both. Side effects of narcotics are nausea, constipation, mental status changes.

Vicodin and Liver [posted 7/17/98]
Question: I need to know specifically how vicodin can damage the liver/heart and in what time frame. I’ve been using it for chronic pain in my knee and shoulder (have had 4 knee surgeries and 2 shoulder).

Answer: Vicodin is a combination of hydrocodone and acetaminophen. The acetaminophen can affect ones liver if taken in large doses acutely and possibly over the long haul chronically (less data here). The hydrocodone (narcotic part) would have minimal effect on the liver or heart long term. Hence, the only long term risk is to the liver.

Vicodin and Percocet
Question: Can you tell me the difference between Vicodin and Percocet? Are they of the same family with Percocet being more powerful? For arthritis pain, how serious is the risk of addiction with a dose of 1 or 1/2 Vicodin per day?

Answer: Vicodin is a class 3 narcotic, with hydrocodone. Percocet is a class 2 narcotic with oxycodone, which is a much stronger narcotic derivative. The risk of addiction varies with the dosage (small), with the length of time the drug is used and the personality of the patient.

Question: I have been taking Vicodin for my own pleasure. I had it at first because of pain, but after two days the pain went away. Since then I have taken 30 (500 mg) pills of Vicodin over two months. I am wondering your professional opinion on this.

Answer: This addiction, like most, tends to grow and possess your whole life. Some patients can dabble occasionally, but most tend to become more and more focused on the drug and less and less on their own life needs. You are flirting with a potentially destructive mode of behavior.

Question: How long does this drug stay in your system, i.e. for drug testing for employment purposes?

Answer: This depends on the type of drug screen used and if it measures metabolites up to several days. Usually 24-36 hours. I'd recommend in excess of 5 days to be completely sure. This also depends on the amount you are taking.

Vicodin vs. Ultram for Osteo-Arthritis Pain
Question: I am currently taking 3 Vicodin (5 mg in 500 mg tylenol) per day to control my arthritis pain. I have tried Ultram (50 mg), 2 tablets 2 to 3 times per day. In my experience the Ultram seems far less effective in pain reduction. I realize Vicodin may be habit forming, whereas ultram is less so. How many Vicodin tablets per day can I take for the ten years? How many Ultram tablets per day can I take for the next ten years. I'm 74 years old. Can I mix Vicodin and Ultram? If so, how? Is there a better pain reliever that you would recommend? I am also taking 20 mg of Feldene per day.

Answer: Vicodin is the brand name for a combination of hydrocodone and acetaminophen. Of these, hydrocodone is potentially addicting and acetaminophen is potentially toxic to ones liver (in high enough doses). Over time acetaminophen can damage ones kidney-slowly reducing the ability to function. This is by regular use over many years. The effect can be seen if carefully studied after 2-3 years of regular use. This is also true for Feldene (piroxicam) and the combination is probably slightly more toxic than either individually. This renal problem is called Analgesic Kidney and other names to reflect the kidney damage caused by common analgesics. Ultram(tramadol hydrochloride) is a relatively new analgesic. It is synthetic and its mode of action is not completely understood. Long term studies of Ultram renal toxicity have not been performed. Its dose should be decreased in renal insufficiency.

Question: What effects will long term use of Vicodin will have on the body systems. For example, the liver. Also, does the antidepressant effect of hydrocodone have any use in a pain management case.

Answer: Vicodin and other narcotics are depressants - not antidepressants. There may be an anti-depressant effect if pain is prevented since pain does cause depression. Generally, there are few long term side effects other than addiction.

Question: I have been taking vicodin up to 6 times per day for the past 2 1/2 years for chronic sciatic nerve pain. Surgery has helped lessen the pain, but it has not eradicated it. I am concerned that I may be addicted to the vicodin, and I want to know how to wean my body from this drug.

Answer: At this point you probably do have some physical addiction to the drug. There are several ways to "wean" yourself, but they all will depend on you being in control of the pain which started the use of the drug. If you still need the drug (or equivalent) to control the pain, I doubt that you will be able to stop. Tapering the drug is helpful. Also, use of the drug clonidine (usually used for blood pressure) will help the withdrawal symptoms.

Question: I’m taking Vicodin e.s. for pain and also soma compound and sinequan. Will these drugs be effective if taken together?

Answer: Will they work? - yes. Will they have additive toxicities? - yes. Sinequan with narcotics can produce profound sedation and should be used with extreme caution. Soma is probably no major risk.

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Last modified January 13, 1999