Below are answers to some frequently asked questions about Vicodin and acetaminophen
AbbVie's Vicodin, which contains 5 mg/300 mg, 7.5 mg/300 mg, or 10 mg/300 mg, is a generic product. This means patients will pay a generic co-pay at the pharmacy.
When you receive a prescription that says “Vicodin,” “Vicodin ES,” or “Vicodin HP,” on it and the product strength is not included, remember that this product is only available with 300 mg acetaminophen.
This means that a product with 300 mg of acetaminophen, together with the appropriate hydrocodone strength, should be dispensed.
The formulations of AbbVie's Vicodin look like this1:
You can assist us with monitoring the safety of Vicodin by reporting negative side effects to AbbVie at 1-800-633-9110.
You are encouraged to report negative side effects of prescription drugs to the FDA.
Visit www.fda.gov/medwatch or call 1-800-FDA-1088.
Information about the risk of liver toxicity and overdose associated with acetaminophen can be found on the FDA website at http://www.fda.gov/Drugs/DrugSafety/ucm239821.htm and by clicking on the link “Additional Information for Healthcare Professionals.”2 Additional information can be found in the Vicodin Prescribing Information.
You can find information to help counsel patients about liver toxicity and overdose associated with acetaminophen on the FDA website at http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm168830.htm.3
Patients should not exceed the maximum dose of 4000 mg (4 g) of acetaminophen within a 24-hour period.1,4
You should tell your patients that versions of AbbVie's Vicodin have a lower acetaminophen content in accordance with the U.S. Food and Drug Administration's (FDA) request to drug companies to limit the amount of acetaminophen in prescription medications.2 You should also tell your patients that they should not exceed the maximum dose of 4000 mg (4 g) of acetaminophen within a 24-hour period. You can direct patients to the FDA website at http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm239871.htm for more information.4
AbbVie does not offer co-pay assistance for patients taking Vicodin. Vicodin is a generic product. This means patients will pay a generic co-pay at the pharmacy.
You may advise patients of the following steps to properly dispose of their medications5:
For more information, please visit http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm101653.htm.
VICODIN® 5 mg/300 mg, VICODIN ES® 7.5 mg/300 mg, and VICODIN HP® 10 mg/300 mg (hydrocodone bitartrate and acetaminophen) tablets, USP are indicated for the relief of moderate to moderately severe pain.
HEPATOTOXICITY: ACETAMINOPHEN HAS BEEN ASSOCIATED WITH CASES OF ACUTE LIVER FAILURE, AT TIMES RESULTING IN LIVER TRANSPLANT AND DEATH. MOST OF THE CASES OF LIVER INJURY ARE ASSOCIATED WITH THE USE OF ACETAMINOPHEN AT DOSES THAT EXCEED 4000 MILLIGRAMS PER DAY, AND OFTEN INVOLVE MORE THAN ONE ACETAMINOPHEN-CONTAINING PRODUCT.
VICODIN, VICODIN ES, and VICODIN HP tablets are contraindicated in patients previously exhibiting hypersensitivity to hydrocodone or acetaminophen, and also in patients known to be hypersensitive to other opioids, as they may exhibit cross-sensitivity to hydrocodone.
Controlled Substance: VICODIN, VICODIN ES, and VICODIN HP contain hydrocodone, which is an opioid agonist and a Schedule II controlled substance with an abuse liability.
Abuse and Dependence: VICODIN, VICODIN ES, and VICODIN HP can be abused in a manner similar to other opioid agonists, legal or illicit. Psychological dependence, physical dependence, and tolerance may develop upon repeated administration of narcotics; therefore, these products should be prescribed and administered with caution.
Serious Skin Reactions: Rarely, acetaminophen may cause serious skin reactions, such as acute generalized exanthematous pustulosis (AGEP), Stevens-Johnson syndrome (SJS), and toxic epidermal necrolysis (TEN), which can be fatal. Patients should be informed about the signs of serious skin reactions, and use of the drug should be discontinued at the first appearance of skin rash or any other sign of hypersensitivity.
Hypersensitivity/Anaphylaxis: There have been post-marketing reports of hypersensitivity and anaphylaxis associated with use of acetaminophen.
Respiratory Depression: At high doses or in sensitive patients, hydrocodone may produce dose-related respiratory depression.
Head Injury and Increased Intracranial Pressure: The respiratory depressant effects of narcotics and their capacity to elevate cerebrospinal fluid pressure may be markedly exaggerated in the presence of head injury or other intracranial pressure.
Acute Abdominal Conditions: The administration of narcotics may obscure the diagnosis or clinical course of patients with acute abdominal conditions.
As with any narcotic, special caution should be used when prescribing hydrocodone to elderly or debilitated patients and those with severe impairment of hepatic or renal function, hypothyroidism, Addison's disease, prostatic hypertrophy, or urethral stricture. Caution should also be exercised with patients who are likely to take other acetaminophen-containing medications, antihistamines, antipsychotics, antianxiety agents, other narcotic analgesics, or other central nervous system (CNS) depressants (including alcohol) concomitantly. When combined therapy is contemplated, the dose of one or both agents should be reduced. Hydrocodone, like all narcotics, may impair mental and/or physical abilities required for the performance of potentially hazardous tasks, such as driving a car or operating machinery.
The use of monoamine oxidase (MAO) inhibitors or tricyclic antidepressants with hydrocodone preparations may increase the effect of either the antidepressant or hydrocodone.
VICODIN, VICODIN ES, and VICODIN HP tablets should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Babies born to mothers who have been taking opioids regularly prior to delivery will be physically dependent. Administration to the mother during labor or shortly before delivery may result in some degree of respiratory depression in the newborn.
The most frequently reported adverse reactions include lightheadedness, dizziness, sedation, nausea, and vomiting. Prolonged administration may produce constipation.
VICODIN 5 mg/300 mg: The usual adult dosage is one or two tablets every four to six hours as needed for pain. The total daily dosage should not exceed 8 tablets.
VICODIN ES 7.5 mg/300 mg: The usual adult dosage is one tablet every four to six hours as needed for pain. The total daily dosage should not exceed 6 tablets.
VICODIN HP 10 mg/300 mg: The usual adult dosage is one tablet every four to six hours as needed for pain. The total daily dosage should not exceed 6 tablets.
Please see Full Prescribing Information, including Boxed WARNING, for Vicodin formulations.
References: 1. VICODIN, VICODIN ES, VICODIN HP 5, 7.5, 10 mg (hydrocodone)/300 mg (acetaminophen) [package insert]. 2. US Department of Health and Human Services. FDA drug safety communication. US Food and Drug Administration website. http://www.fda.gov/Drugs/DrugSafety/
ucm239821.htm. Accessed January 21, 2016. 3. US Department of Health and Human Services. Acetaminophen and liver injury: Q & A for consumers. US Food and Drug Administration website. http://www.fda.gov/ForConsumers/
ConsumerUpdates/ucm168830.htm. Accessed January 21, 2016. 4. US Department of Health and Human Services. Questions and answers about oral prescription acetaminophen products to be limited to 325 mg per dosage unit. US Food and Drug Administration website. http://www.fda.gov/ForConsumers/
ConsumerUpdates/ucm239871.htm. Accessed January 21, 2016. 5. US Department of Health and Human Services. How to dispose of unused medicines. US Food and Drug Administration website. http://www.fda.gov/ForConsumers/
ConsumerUpdates/ucm101653.htm. Accessed January 21, 2016.