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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.

[posted 08/4/2000]
Question: After a medical procedure to correct uncomfortable episiotomy stitches, the doctor gave me Vicodin (5 mg hydrocodone, 500 mg acetaminophen) for pain. As a breastfeeding mom (discussed with my doctor), I took the minimum dose of 2 tablets, 6 hours apart. I discontinued use immediately when I noticed impact to my baby. Have I potentially harmed my baby? I'm very worried...

Answer: No, there will be sedation from the narcotic passed in your milk. But, once your child has about 6 hours, it should wear off without sequelae.

[posted 06/10/2000]
Question: My question has to with the difference between Loratab and Vicoden. I currently take Loratab for my Endometriosis...A friend of mine offered me a Vicoden when I was running low. Since I work at a place that does random drug screens I was wondering would it show up as something other than Loratab? It's ok if I take Loratab,since I have a prescription for that. But if I take Vicoden...would my employer know the difference? Or would it just show up as Hydrocodone? Any information you could give me would be greatly appreciated. Thank you for your time.
Sincerely,
Theresa Owens

Answer: It will show up as a narcotic, both will. Some tests are sensitive to the different types of narcotics, most are not and are merely looking for the presence/absence of the drug. The active narcotic in both is hydrocodone so there will be no difference in the drug testing.

[posted 05/20/2000]
Question: I have been taking Vicodin for a number of years, two tablets a day for neropathy pain. I would take it for awhile, stop, and then a couple months later go back on it. I don't think at that point that I was 'addicted". I had surgery to remove anal displasia in October of 99. I have had 2 more sugeries since then. As you know these are very painful operations, the second surgery took 7 weeks to heal. This when I started using Vicodin pretty heavily. Somedays 6 tablets a day. I stopped taking my AID's medications for personal reasons in January. Mainly because I was going through so much pain from the surgery and the AID's medications also made me sick. So after I started to heal from the third surgery I decided to try and get off the Vicodin. I became very sick, with high fevers, cold sweats, anxiety attacks and severe fatigue. I got scared thinking I had an AID's related sickness, so I started back on my medications and at the same time am down to two Vicodins a day. I tried for two weeks to completly get off Vicodin. Are these symptoms of drug withdrawl or could it be AID's related?. I didn't tell my doctor about stopping the Vicodin, but I did have drug cultures to see if anything was going on. I know I am addicted, is going cold turkey the best way or just to go off it slowly?

Answer: Certainly could be withdrawal, also if they abated with the narcotic probably was. As to stopping, this is an individual decision, but usually easier to just stop cold. However, there are patients who are successful with tapering. In your heart you will know which way will be successful for you.

[posted 05/12/2000]
Question: I have been taking Vicodin for pain after surgery for four days. 2 every 4 hours and have been cutting it back slowly during the last few days to 1 every 9 hours. Last night I took one at 10pm and at 1:45 I woke up with a strong aching pain across my back and in my left chest area, my heart was racing, I broke out in a sweat,felt nauseated and began to shake so hard my teeth chattered. It subsided and repeated three times, each time less violent, but I went to the ER because I thought I was having a heart attack. They monitored me for 2 hours, did chest xray, blood work and EKG. All checked out normal and symptoms went away. Do you think this could have been a reaction to the Vicodin? I am afraid to take any more, but the ER people didn't think it was related. I feel I can get along with just Tylenol now anyway, but wonder whether I should take Vicodin ever again in the future if prescribed.

Answer: Possibly, hard to know. If it is the Vicodin, it probably is esophageal spasm etc. as the cause.

[posted 04/11/2000]
Question: I've been taking Vicodin for over 4 years, 1 of those years was switched to Vicoprofen and then later returned to Vicodin. I'm taking them due to a severe lower lumbar back injury and have been told I will be on pain killers long term. My concern is in the last two years I've started developing heart PVC's, they came out of nowhere. I'm currently only taking Vicodin and Prilosec, have a no caffine diet. Unfortunately I can't exercise much with my injury. Will the long term use of vicodin cause PVC's or PAB's? Last year we thought it was caffine, dropped that, then stress, tried Paxil, didn't work? Ran a treadmill and an EKG, no problems found. The PVC's are so prominent, its almost worth dealing with the back pain if the vicodin is the cause. Any thoughts?

Answer: Wouldn't think that the drug is the cause, since if so, you would have had them from starting the drug.

[posted 04/8/2000]
Question: Hi,
I began taking vicodin after my breast augmentation in March '98. Since then, I have found access to taking them on a daily basis. The longest I have been off of them, was for 2 wks.. 'recent' .. I began taking them again yesterday.
I have never 'really' abused the drug, in the sense that I've always followed the dosage recommendations.

My question is not, 'am I addicted' ..because I know that I am. My question is, 'what health effects should I be concerned with?'

I realize that acetaminophen can cause liver/kidney damage, so is there any preventative measures that can be taken to avoid this.. w/o discontinuing the use of the vicodin? Will exercise, drinking fluids, ect.. help? Or could it possibly be too late? ...could my liver/kidneys already show signs of damage?

For the most part... over the past 2yrs., I've taken 6 to 8 of the vicodin 7.5 daily (1 every two hours-when I didn't lose count).
And for the past 3mo. or so, I've been taking vicodin ES.. 4 at the most a day, only because that's the dosage.

Is vicodin ES less of a risk vs. vicodin 7.5?? Would you happen to know the 'real' difference between the two?

Thanks for your time,
Tracy

Answer: Vicodin ES is 7.5 hydrocodone and 750 mg acetaminophen, Vicodin 7.5 is 7.5 hydrocodone and 500 mg acetaminophen. The toxis dosage per day of acetaminophen is 10 gm but, most would not recommend taking more than 4-5 gms a day. This is a long term risk of renal insufficiency and will take 10 years or so, depending on your kidneys initially. There don't seem to be anything that prevents this problem and some patients experience it more than others so there are clearly genetic and predisposing factors.

[posted 03/8/2000]
Question: My husband is 35 and was diagnosed with osteporosis and fibro-myalgia four years ago. He currently takes fosamax, flexiril, and vicodin or darvocet daily. I know that vicodin and darvocet will cause a decreased sex drive, but would any of these drugs cause decreased sperm count or sperm motility problems?

Answer: Not to my knowledge. But, what is the cause of the osteoporosis? This would be very peculiar at his age in the absence of steroids. One cause is testerone deficiencystinch also effects sex drive etc.

[posted 01/24/2000]
Question: I have been taking Vicodin for about 2 years now for migrain headaches.
I have tried about every other form of medication but nothing works as w
well as the vicodin. Now my doctor will not prescribe this to me anymore
because he thinks i will become addicted. I can go days, even weeks
between migrains without taking the vicodin. How can i explain this to him
because the headaches are to much to bear without the vicodin. Thank you

Answer: Probably can't. Except inquire how one becomes addicted with -only rare narcotic usage. If that doesn't get anywhere-you'll need a different md.

[posted 01/29/2000]
Question: I HAVE SEVERE OSTEO ARTHRITIS AND HAVE TROUBLE CONTROLLING THE DEBILITAING PAIN THAT COMES WITH IT. I HAVE AN UPPER TIBIAL OSTEOTEMY ON MY LEFT LEG, A TOTAL HIP REPLACEMENT ON MY RIGHT, I NEED A TOTAL KNEE REPLACEMENT ON MY RIGHT BUT M Y ORTHO DOCTOR DOESN'T FEEL I WOULD BE A GOOD CANDIDATE BECAUSE I RIPPED THE ANTERIOR CRUCIATE LIGAMENT 25 YEARS AGO BEFORE CORRECTIVE SURGERY WAS AVAILABLE FOR THAT INJURY AND A NEW KNEE MAY NOT BE SUCCESFUL? I HAVE ALSO LOST 6 INCHES IN HEIGHT DUE TO COMPRESSED DISCS. I ALSO HAVE INPAIRED NERVE DAMAGE DUE TO ARTHRITIS ENCROACHMENT IN THE SHOULDER. WITH ALL THESE VARIOUS PROBLEMS YOU MIGHT IMAGINE THE DEPTH OF PAIN I PUT UP WITH. MY QUESTION IS CAN I INCREASE MY VICODIN FROM 1 EVERY 6 HRS.? I CERTAINLY FEEL LIKE I SHOULD. OVER THE YEARS I HAVE TAKEN EVERY NSAID AND BETA BLOCKER ON THE MARKET, IT DIDN'T HELP WITH PAIN REDUCTION BUT IT VERY DEFINETLY WORKED A NUMBER ON MY GASTRIC SYSTEM. I NEED SOME ADVICE ON WHAT TO DO NEXT, MY DAILY ACTIVITY IS DOWN TO A GET-BY LEVEL. THANKS FOR ANY SUGGESTIONS YOU MAY HAVE.

Answer: Vicodin is limited by the acetaminophen aspect of the drug. Too much a day has liver toxicity. However, every 4 hours is probably ok. But, you might raise some of the long acting narcotics(MS Contin, Oxy Contin) etc. or the narcotic patches(fentanyl) as a base for the pain and taking Vicodin for breakthrough. This would eliminate the need for limitations of the acetaminophen. Constipation and nausea would be the risk of increasing the narcotics. You will become addicted, but you probably already are and you'll need the narcotics to function. It's not that anyone can decrease the pain. Another option to consider is miacalcin, I assume you have had bone densities, but it sounds like you also have osteoporosis. Miacalcin is a treatment for osteoporosis and sometimes helps pain(fosamax is another alternative-but may have more gi toxicity).

[posted 01/24/2000]
Question: Two months ago I had a an extensive knee surgery called a high
tibial osteotomy. My surgeon prescribed vicodin for the post-
op pain and I took it up until about five days ago.
9 days ago I began to have mild nausea that seemed to occur
about 1/2 hour after eating. It would last a few hours and return
after my next meal. Then five days ago I began to have the
nausea around the clock. I also noticed that my stools were some
times black but not every time and sometimes they were watery.
Yesterday I felt dizzy, like the room was almost spinning and
that I might fall. I also had a severe headache. My husband
insisted on taking me to my doctor. The doctor did a rectal exam
and said there was blood in my stool. He ran a CBC and
it was normal. He then gave me cautionary instructions in
case I noticed any more blood and sent me home with a
prescription for antivert and a referral to a gastroenterologist.
The antivert has helped the dizziness but not the nausea and
I still have a slight headache. I also have had severe stomach
cramps today. Today my stool was not black, but yellowish.
My doctor mentioned that I might have an ulcer
or a half dozen other things. I asked if the vicodin could
cause an ulcer and he said yes.
My questions are: 1) Is it possible for vicodin to cause a
bleeding ulcer in such a short amount of time? 2) Why would
my stools have blood sometimes and not others? 3) My doctor
seemed to think I had an inner ear problem and the bleeding
is a separate issue. Could the other symptoms I mentioned
also be related to an ulcer?

Answer: Vicodin is a combination of acetaminophen(tylenol) and a narcotic. One would not expect this to cause an ulcer(unless it had aspiring which it doesn't). But, you clearly have a gi bleed. You need to be on something to decrease the acid in your stomach until you see the gi specialist(zantac, tagamet available otc or prevacid/prilosec available by Rx). The vertigo would only be expected from a gi bleed(like an ulcer) if your blood pressure was low or you were anemic(which you are not). Don't know your bp, but worth checking. Avoid any aspirin, motrin or other nsaids.

[posted 01/17/2000]
Question: I have been taking Vicodin for several years off and on for fun
and for a car accident and now consistantly for Kidney stones
I am 33 years old and I think about Vicodin all the time, I definitely
have an addiction problem. My doctor is trying to cut me off
but I will say my kidney still hurts so I can get the pills,
then I will feel the pain for real, is this part of addiction?
On one hand I am afraid of being cut off then on the other hand
I know it is best for me. Is their anything my doctor can do to
help the craving for Vicodin? She knows I am an addict but neither
one of us talk about it. I am afraid if I tell her she will totally
cut me off completely.

Answer: I would get a urologist to eliminate the stone. Hopefully, by ultrasonic pulsation, so that you will not have a direct reason to need narcotics. After that, I would get into an addiction program. You'll be hard pressed to do this alone.

[posted 11/23/1999]
Question: I am allergic to Vicodin, but was recently prescribed Robitussin with Codeine for a cough, the provider was aware of my allergy but not concerned. Doesn't Vicodin have Codeine? Why would it be OK to prescribe Robitussin AC? A clarification would put my mind at ease.

Answer: Vicodin is hydrocodone and acetaminophen. Both codeine and hydrocodone are narcotics but structurally different. This would depend a lot on what your allergy manifests as-what happens when you take codeine?

[posted 10/13/1999]
Question: Hello:

I have been taking 3 vicoden hp tablets for awhile now. My doctor is very reluctant to prescribe these narcotics. (something about fda regulations). However, I now am walking on my 3rd disk herniation, several bulging disks, and pinched nerves. I cannot function without the pain meds. I will be going for more testing (MRI's) in another week for my middle back and neck area. Sometimes the pain is so bad, it wakes me up in the middle of the night. I try to tell him that 3 tablets are not enough. I live in constant pain. I went to my nureosurgion and he said that I had so many problems with my back, that surgery would not take me out of pain.
I have had back surgery for disk herniation that radiated
down to my right leg. My concern is that my doctor is more concerned with me becomming addicted than anything else. I have had surgery, MRI's, and several tests to back up these problems. What do you suggest I do?

Thank you.

Answer: See a pain specialist, injections may be of some help. Also, find a doctor who is more concerned about relief of your pain than the fda. No one loses their license for seeing and treating patients apporpriately.

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 helpfuchec 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.

Vicodin
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.

Vicodin
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.

Vicodin
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.

Vicodin
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.

Vicodin
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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