One of the most commonly prescribed and effective narcotic painkillers, hydrocodone (brand name Vicodin) carries many side effects. Most often, these effects may be managed with an over-the-counter symptom reliever. Pay close attention, however, to the potentially toxic side effects and drug dependence risks that may manifest as a result of using this combination (hydrocodone bitartrate and acetaminophen) pain reliever.
Liver Toxicity
Due to the high concentration of acetaminophen (500mg) in the most prescribed dosage of hydrocodone (5/500), liver toxicity is possible. According to the PDR Nurse's Drug Handbook 2010, the recommended dose should not exceed one to two tablets every four to six hours, with no more than eight tablets taken in a 24-hour period. Because acetaminophen is metabolized slowly by the liver, toxic levels may quickly be reached--resulting in irreversible liver damage and even death.
Respiratory Depression
People with compromised respiratory systems should be cautioned that hydrocodone may cause respiratory depression through its direct action on the brain stem. Any person who experiences difficulty in breathing or notices her breath is more labored and feels she's unable to get enough oxygen into the lungs is experiencing respiratory depression. Seek immediate medical attention in this case.
Stomach Upset
One of the most common side effects reported by patients taking hydrocodone is stomach upset, characterized most often by nausea. Vomiting is rare. Your physician may prescribe an antacid, or these symptoms may be managed by an over-the-counter remedy. Check with your doctor for possible drug interactions with other medications you're taking.
Central Nervous System Side Effects
Mental and physical performance may be compromised with any narcotic pain reliever such as hydrocodone. Drowsiness is possible; take care while performing tasks that require attention to safety detail. Operating heavy machinery and driving may be risky if a person isn't accustomed to taking hydrocodone on a regular basis.
Dependency Risks
As with any opioid, side effects of physical and psychological dependence are possible. Generally, a dependence on hydrocodone develops after a long period in which the body develops a tolerance for the recommended dosage and the patient begins doubling the dosage without consulting his doctor. If a patient no longer experiences pain relief with the prescribed dosage, he should not increase the amount of tablets taken nor shorten the time between doses. Discuss any changes in pain relief with a doctor.
References
- "PDR Nurse's Drug Handbook 2010"; Thomson Reuters and Alexander Ivy; 2009
- "Mosby's 2010 Nursing Drug Reference"; Linda Skidmore-Roth, 2009
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