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Vicodin (Hydrocodone with Acetaminophen) and Hydrocodone

CAUTION: Vicodin can cause drowsiness. Be careful if you must be alert. The codeine derivative in Vicodin may upset the stomach, so you may want to take it with food or milk. Vicodin contains acetaminophen (Tylenol), and you should limit your daily intake of acetaminophen to 3000mg to avoid liver problems. Make sure all your health care providers have a complete list of your medications, including over-the-counter medications, herbals and vitamins.

In the United States, hydrocodone is only available with the addition of acetaminophen (Tylenol). Brand names include Vicodin, Norco and Lortab.

General Vicodin questions follow this chart.

Can I take Vicodin (Norco, Lortab) with:
Aleve Sinus? Yes. The two pain relievers can have an additive effect to reduce pain. Avoid pseudoephedrine if you have high blood pressure or heart problems.
Allergy Medicine? Yes. Both can cause drowsiness. This can be additive. Take both as needed.
Ambien? Yes. They may be taken together. Ambien should only be taken at bedtime, if you can devote eight hours for sleep. Take only as needed.
Amoxicillin? Yes. Finish the amoxicillin antibiotic.
Adipex (Phentermine)? Yes. Take the pain reliever only as needed.
Aspirin? Yes. The main problem may be stomach irritation.
Atenolol (Tenormin) Yes.
Azithromycin (Zithromax)? Yes. Take azithromycin until finished and the Vicodin as needed.
Benadryl (Diphenhydramine)? Yes. Both can cause drowsiness, and the added drowsiness of taking both can be a problem.
Celebrex? Yes. Both may upset your stomach.
Chlorpheniramine Maleate? Yes. Both can cause drowsiness, and the added drowsiness of taking both can be a problem.
Citalopram (Celexa) and Alprazolam (Xanax)? The hydrocodone in Vicodin interacts with both. You may feel drowsy or more tired when taking these drugs together. This effect may last for a few days after you stop taking these drugs. Do not drive or operate machinery until you know how these drugs affect you. If you notice slurred speech, confusion, severe weakness or difficulty breathing, contact your doctor immediately. Citalopram can reduce the effectiveness of hydrocodone. Most pain relievers, especially the narcotic types, have this issue for those who take antidepressants and anti-anxiety medications.
Clarithromycin Antibiotic (Biaxin), Methylprednisolone (Medrol) and C-Phen DM Syrup? There is an interaction with clarithromycin and the steroid methylprednisolone. The longer you take these two together, the greater the chance and frequency of side effects of the steroid. Take both with food. Vicodin and the cough syrup can cause drowsiness, which can be additive when taking both. Take only as needed.
Colace (Docusate), Nexium, Miralax, Maalox and Tums? Yes. Vicodin can cause drowsiness. Limit daily acetaminophen intake to no more than 3000mg. Drink plenty of water with Colace. Narcotic pain relievers can cause constipation, thus Colace, Maalox and Miralax. Drink plenty of water, and eat foods with fiber and much fruit.
Diclofenac Sodium? Yes. Take with food to avoid stomach upset.
Flexeril (Cyclobenzaprine)? Yes. These two types of drugs are commonly given together -- Flexeril as the muscle relaxant and Vicodin as the pain reliever. Both can cause drowsiness and dizziness. Take only as long as prescribed.
Flexeril (Cyclobenzaprine) and Indocin (Indomethacin)? Yes. Take Indocin with food or milk to prevent stomach upset. Both Flexeril and Vicodin can cause drowsiness. Take only as needed.
Flexeril (Cyclobenzaprine) and Naprosyn (Naproxen)? Yes. They are prescribed for slightly different reasons. Naprosyn is an anti-inflammatory to reduce pain and fever. Vicodin is a pain reliever. Flexeril is a muscle relaxant. Take Naprosyn with food or milk to avoid stomach upset. Vicodin and Flexeril cause drowsiness.
Hydrochlorothiazide (HCTZ)? Opiate narcotics like hydrocodone can increase the effects of (HCTZ) hydrochlorothiazide on your blood pressure. If the blood pressure drops too low while taking these medications, you may get dizzy or feel faint. To limit this, do not stand or sit up too quickly. Contact your doctor if you have dizziness that does not go away. Limit Tylenol to 3000mg per day.
Ibuprofen (Motrin)? No. They both can cause stomach distress and should be taken with food or milk. You could alternate the doses of each every 4-6 hours, but do not exceed half the daily dose of either medication. Talk to your doctor before mixing the two.
Ketoprofen? Yes. Take ketoprofen with food or milk. Take only as needed.
Lisinopril? Yes. Take Lisinopril in the morning.
Lithium? Yes. Do not take lithium if pregnant or breastfeeding.
Lovenox? Yes. It may upset your stomach and cause drowsiness. Follow instructions with Lovenox. Report bruising or bleeding symptoms to your doctor. Clean injection site well before each injection.
Metformin (Glucophage)? Yes. Metformin should be taken regularly at the same time each day.
Metformin (Glucophage)and Spironolactone (Aldactone)? There can be an interaction between Vicodin and spironolactone. Opiate agonists (like hydrocodone) may increase the effects of spironolactone on blood pressure. If your blood pressure drops too low, you may get dizzy or feel faint. Do not stand or sit up too quickly. Call your doctor if you have dizziness that does not go away. Metformin does not interact with either of the other two. Take Vicodin only as needed, and be careful if you must be alert.
Methylprednisolone (Medrol)? Yes. Take Medrol early in the day with food, unless otherwise prescribed by your physician.
Midol (Acetaminophen with Pyrilamine)? Yes. Take no more acetaminophen than 3000mg in 24 hours. Hydrocodone can cause drowsiness.
Naproxen? Yes. Take both with food or milk to avoid stomach upset. Take both as needed.
Neurontin (Gabapentin)and Keflex (Cephalexin)? Yes. They may be taken together. Take Keflex until the prescription is finished. Take Vicodin as needed. Watch for drowsiness.
Norvasc (Amlodipine) ?  Yes.
NyQuil (Acetaminophen, Dextromethorphan, Doxylamine and Pseudoephedrine) and 2 Tylenol? No. I don't know what you're treating. Drowsiness is a big side effect with NyQuil and the narcotic hydrocodone. Then there is the amount of Tylenol (acetaminophen) with all these. The daily limit of Tylenol is 3000mg, so depending on what strength and how many doses taken today, you may have already exceeded the limit.
Phenobarbital? No. There could be a major drug interaction with phenobarbital (PB) and the hydrocodone narcotic in Vicodin. Concurrent use of opioid analgesics and barbiturates (PB) can result in additive respiratory depression. This can be a big problem, particularly if you have breathing problems. If you are prescribed these drugs, the physician should be monitoring you closely. If these are prescribed by different doctors, let them know what you are taking before starting this combination.
Prednisone? Yes. If you take prednisone once daily, take it in the morning with breakfast. Follow your doctor's directions. Take Vicodin as needed.
Pristiq (Desvenlafaxine)? Yes. Take Pristiq as prescribed and hydrocodone as needed. Both can cause drowsiness. Avoid alcohol.
Prozac (Fluoxetine)? Yes. You may notice more drowsiness. Take Prozac at the same time daily and the pain reliever as needed.
Robitussin Cough & Expectorant? Yes. Vicodin can make you sleepy and upset your stomach. Drink plenty of water with the Robitussin.
Seroquel? Yes. Each can cause drowsiness, so watch for decreased alertness. Take both with food or milk to avoid stomach upset.
Singular (Montelukast)? Yes. Take hydrocodone as needed for pain. Take Singular regularly to prevent asthma. Normally it is taken in the evening. If you are treating asthma, talk to your doctor about the pain reliever. Codeine-related drugs can affect breathing and make asthma worse.
Sleeping Pill (or Melatonin)? Yes. Melatonin is taken at the time of sleep if you can devote eight hours for sleep.
Sudafed PE? Yes.
Xanax (Alprazolam)? Yes, if you do not need to be alert or operate machinery. Be careful, and take these only as long as needed.
Zyrtec D? Yes. Do not take Zyrtec D without consulting with your physician if you have high blood pressure or heart problems. Take only as needed, and be careful if you must be alert.

Can I take promethazine-codeine cough syrup, vicodin for pain and amoxicillin together?
The amoxicillin (Amoxil) may be taken with either the Vicodin (hydrocodone and acetaminophen) or promethazine w/codeine (Phenergan w/Codeine).

Does Vicodin have steroids in it?

Is it OK to take Flexeril, Neurontin and Vicodin?
The Neurontin (gabapentin) does not interact with either the Flexeril (cyclobenzaprine) and Vicodin (hydrocodone with acetaminophen). But with these other two, an interaction is possible. None the less, these drugs are sometimes used together. You may feel drowsy or more tired when taking these drugs together. If you notice slurred speech, confusion, severe weakness, or difficulty breathing, contact your health care provider immediately. The Neurontin may be taken with either of the others.

Can I take Vicodin for back pain with prescribed promethazine DM syrup for my cough? I am also taking the Z-Pak.
First, there are no drug interactions between the Z-Pak (azithromycin) and either of the other two medication. Take this until it is finished. There is a possible drug interaction between Vicodin (hydrocodone with acetaminophen) and promethazine DM (Phenergan with dextromethorphan). You may feel drowsy or more tired. Discuss any new or worsening side effects, such as confusion, constipation, dizziness, difficulty with urination, dry mouth and eyes, changes in vision, or fast heartbeat with your health care provider. Take either one of these only as needed.

My Vicodin prescription says to take 1 tablet twice a day with a maximum dose of 5 tablets daily. How long should 60 last?
Vicodin (acetaminophen with hydrocodone) should be take only as needed. Your doctor wants you to take two to five tablets daily if needed. You have 60 tablets. You may take up to 5 tablets per day. So, 60 tablets should last a minimum of 12 days.

Will hydrocodone cause a drop in blood sugar?
There are no contraindications or precautions with diabetes and hydrocodone products. Short-term, limited use of hydrocodone would not be a problem for diabetics. Long-term use may cause kidney damage and urinary retention. This product, in the long run, could affect blood sugars.

Can I take lisinopril (Prinivil), atenolol, Prilosec and Vicodin 5/500?
Yes. Vicodin can cause drowsiness and stomach upset. Limit the number per day to 6 or less -- fewer if you take plain Tylenol in the same day. Take atenolol (Tenormin) and lisinopril at the same time each day.

Can I take hydrocodone ibuprofen (Vicoprofen) with Flexeril (cyclobenzaprine), Lithium, Lamictal (lamotrigine) and Xanax (alprazolam)?
Hydrocodone ibuprofen taken with Xanax can result in additive drowsiness and respiratory depression. This can occur with any combination of opioid analgesics and benzodiazepine drugs. Flexeril and Lamictal can cause drowsiness. The ibuprofen part of hydrocodone/ibuprofen, added to lithium, can increase the risk of lithium toxicity causing weakness, tremor, thirst and confusion.

Can I take a hydrocodone-APAP 5-325 tablet if I am taking ciprofloxacin 500mg tablet?
Yes. There are no direct drug interactions between hydrocodone-APAP (Norco, Vicodin, Lorcet, Lortab) and ciprofloxacin (Cipro). Take the ciprofloxacin before meals twice daily until finished. Take the pain medication only as needed. This can make you drowsy.

Does Vicodin increase blood sugar levels?
I cannot find any definitive studies showing connection between blood sugar and Vicodin. Blood sugars can increase when you have injury so if pain is caused by an injury or infection, this could be the cause of elevation in blood sugar. If this continues, contact your doctor.

If my Vicodin says take 1 every 6 hours how long should 30 last? Do I take them at night when I wake up in pain?

This is a question you should always ask your doctor when you receive a new prescription. For how long and when should I take this medication. Generally speaking, if you may take one tablet up to every six hours, this would be a maximum of 4 tablets per day. So at the very least, this should last a week or so. If it has been at least 6 hours, it should be OK to take another dose even in the middle of the night.

Does Vicodin contain aspirin?
There is no aspirin in Vicodin -- only hydrocodone and acetaminophen. 

I took Excedrin for a headache six hours ago. Can I take a Vicodin

Yes. You could take these every four hours apart if needed. If you have ulcers, bleeding or GI issues, avoid Excedrin.

How can taking a Vicodin cause a panic attack? 
Vicodin is an opioid analgesic that is thought to work by attaching to receptors in the central nervous system. There are many documented side effects of this drug, but none that I can find related to panic attacks.

When does Vicodin expire? 
If the drug is stored properly, away from extreme temperatures and high humidity, the manufacturer has data proving the drug is safe and effective and still has the approved amount of active ingredient until the date on your bottle. Your prescription bottle should have an expiration date on the label. This is an arbitrary date set by state law or board of pharmacy requirements. The pharmacy where you had your prescription filled should have records of the stock bottle with lot number and expiration date. Please contact your pharmacy. As a general rule of thumb, any medication over one year old should be properly discarded. The short answer to your question is the date on the label.

I took Zoloft (50mg), Vicodin and Zyrtec D all at once at night? Was this a bad decision? 
No. There are no direct drug interactions between Zoloft (sertraline), Zyrtec D (cetirizine with pseudoephedrine) and Vicodin. They may be taken at the same time if needed. Side effects include drowsiness and dry mouth. Avoid alcohol. Drink plenty of water. Take Zoloft every day and the others only as needed.

How long can a doctor prescribe Vicodin? While taking Vicodin, Crestor and high blood pressure medicines, how often should I have blood tests?
A licensed physician with a current DEA certificate may prescribe Vicodin indefinitely. There are no direct drug interactions between Vicodin or Crestor (rosuvastatin) and the most common blood pressure drugs. As far as blood tests, if you have to take Vicodin for a long period of time, the FDA recommends:

  • Renal function tests in patients with pre-existing renal disease
  • Liver function tests in patients with pre-existing hepatic disease

If you have to take large amounts of Vicodin (8 or more daily), you should also have liver function tests due to the acetaminophen (Tylenol) part of the Vicodin. This drug can be liver toxic in high doses or over time.

Can I take tramadol (Ultram) and Vicodin at the same time? I was told that I could alternate but I'm not quite sure what that means.
Yes. Both can cause drowsiness, which could be heightened when taking the two together. Both of these pain medications are dosed every 4-6 hours as needed. Normally the way to alternate doses is to take one and then 4-6 hours later, take the other. Be careful if you must be alert. Always make sure that you understand the instructions before you leave the doctor or pharmacy. Never make assumptions with your health or medications.

For gout, can you take Valium for inflammation and Vicodin for pain?
Valium (diazepam) is not an anti-inflammatory drug, so it would be inappropriate for gout. Vicodin is a good pain reliever, so if your physician prescribed this for your gout pain, it would be OK to take as needed. These drugs both cause drowsiness. Avoid alcohol.

How long should I wait to drink alcohol if I am taking Vicodin?
At least one day after finishing the Vicodin.

I take Valium 5mg prn for anxiety, Vicodin 5/500 prn for neck issues and Albuterol prn for induced asthma. Now I am sick and was given Z-pak and Ceron DM. In addition to being sick, the Ceron is not really helping my cough and I need to get some sleep. What do you advise? Today I have taken the Ceron DM and Z-pak with minimal relief. Is it safe to take Valium with this? Can I mix the Vicodin in my cough syrup?
The only real drug interaction is between the two drugs you regularly take. Valium (diazepam) and Vicodin taken together may result in respiratory depression. If you have asthma, this is not a good condition. The cough syrup, Valium and Vicodin can make you drowsy, so if you take them together be careful if you must be alert. Take the Z-pak until complete, and drink plenty of fluids throughout the day. If you finish the Z-pak and do not feel better, contact your physician.

I work with infants. Can I take Xanax and Vicodin together while at work?
Because both medications can cause drowsiness and a reduction of alertness, possibly slowing reaction times, I would not suggest taking these two medications while working. I would speak to your occupational health department or your supervisor, as well as your physician before taking these and working.

Can Vicodin cause chest pain?
Unless you have some unusual side effect or allergy, Vicodin should not cause pain. It is designed to alleviate pain.

Can I take Vicodin and colchicine at the same time to relieve the pain caused by gout?
Yes. Vicodin can cause drowsiness and sometimes cause GI problems. The colchicine can cause diarrhea. Take these only as needed, and talk to your physician about ways to reduce gout outbreaks.

Can you take Lithium, Lexapro, Allegra D and Vicodin (as needed for pain) at the same time? My boyfriend has panic/anxiety attacks every 2-3 days. He recently had surgery and was prescribed Vicodin for pain. He barely takes it, but not long after he does, has a panic attack. Could the anxiety attacks be a reaction to Vicodin?
Are these medications prescribed by the same doctor? Does he get them from the same pharmacy? He should talk to the prescriber of the Lexapro (escitalopram). Lexapro may interact with both the lithium and the hydrocodone in the Vicodin. The concurrent use of SSRIs (Lexapro) may increase the risk of SSRI related serotonin syndrome which can cause hypertension, tachycardia and mental status changes. Have him talk to his doctor.

What is the strength of Vicodin 7.5/750?
Vicodin 7.5/750 contains 7.5mg of hydrocodone and 750mg of acetaminophen per tablet.

Can prolonged Vicodin use -- one per day -- cause hives?
Contact your physician. Did this reaction begin when you started taking the drug? First-time exposure may only produce a mild reaction, however, repeated exposures may lead to more serious reactions. Once a person is sensitized (has had a previous sensitivity reaction), even a very limited exposure to a minute amount of allergen can trigger a severe reaction. If the hives did not occur after the second or third time you took Vicodin, I would suggest something else is causing this reaction.

Does Vicodin reduce hunger?
No. It can cause stomach upset and drowsiness, which can reduce the desire to eat.

Can Vicodin cause side effects like anxiety?
Vicodin is a pain reliever. This drug combination would not cause anxiety on its own. If anything, it would cause drowsiness. Talk to your doctor.

Is there any other medicine I could take instead of Vicodin?
If you want a strong pain reliever that does not have a codeine type product in it, use Ultram (tramadol). It does not cause drowsiness, have the addictive properties or chance of stomach upset that most other pain relievers have. Other choices are NSAIDs: ibuprofen (Motrin), naproxen (Aleve) and others. These don't cause drowsiness, but can upset the stomach. Talk with your doctor about Vicodin.

Does Vicodin cause ulcers?
Vicodin does not on its own cause ulcers. It can cause nausea and vomiting, and can irritate an already ulcerated area.

Does Vicodin cause abdominal or chest pains?
Vicodin can be irritating to the stomach lining, so you could have stomach pain. It's best to take these types of drugs with food or milk to coat the stomach. People who are sensitive to codeine products are more likely to have this problem.

What is the strength of the Vicodin 3598?
Vicodin does not have any number markings, but there are many manufacturers of generic Vicodin. One of those uses V3598 to identify its 10mg tablets. This formulation has 660mg of acetaminophen per tablet.

What is the difference between Vicodin es 7.5/650mg and Vicodin es 7.5/750mg?
The only difference in the two is the amount of acetaminophen (100mg more in the 7.5/750mg pill). This may not seem like a big difference, but it can be if you take a lot. The rule of thumb is no more than 3 gm (3000mg) of acetaminophen per day. Remember, also to check the acetaminophen in cold relievers. Many of these products contain acetaminophen.

I got a prescription for 30 Vicodin 7.5mg, with directions to take one every 4-6 hours. Is a full week long enough before I can get my prescription refilled?
Depending on how the physician wrote the prescription, a week could be long enough.

I have been taking Vicodin 5/500, one tablet a day, 2-3 times per week. Usually break in half and if needed, take the other half. It causes terrible constipation. I have been taking Citrucel and one stool softener at night, plus an increase in fiber (as well as eight 8-oz. glasses of water). I don't feel much better. The only thing that really works is prune juice. Is this safe? Also, can I take something else to regulate this (like Senokot S) while taking the stool softener?
Vicodin is an opiate. This drug class is very constipating. It sounds like you are doing all the right things to correct the side effect. Prune juice is an effective laxative for some people. It is not a drug, and I have never come across anyone who admitted to being addicted to prunes. If the prune juice works, continue to take it. Citrucel and Senokot are fiber-type laxatives. Senokot S adds a stool softener to the fiber. Talk to your physician about the problem.

Can Vicodin cause schizophrenia?

Can I take Vicodin at the same time as Advil or Aleve?
Yes. Take these products with food. There is a prescription product available with both hydrocodone and ibuprofen together. Talk to your physician if the combination helps you.

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