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What Is the Interaction between Acetaminophen and Hydrocodone?

By Lee Prangnell
Updated May 17, 2024
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From a pharmacological perspective, acetaminophen and hydrocodone have different modes of action and, as such, there exists no negative or dangerous chemical interaction between the two drugs. The combination of acetaminophen and hydrocodone provides positive therapeutic utility for a number of pain-related conditions, primarily because this combination brings about an enhanced level of analgesia, or pain relief. An individual suffering from severe back pain along with a fever, for example, would gain relief from the hydrocodone for the back pain and from the acetaminophen for the fever. Acetaminophen and hydrocodone is the drug combination in a prescription product called Vicodin®.

Clinical trials of acetaminophen and hydrocodone have demonstrated that no significant chemical interactions exist between the drugs, which means that an individual can use these drugs concurrently without suffering from negative side effects. Acetaminophen is an analgesic and an antipyretic — a type of drug that treats fever. Acetaminophen is a useful treatment for complaints such as toothache, headache and common cold. Hydrocodone is a powerful narcotic opioid analgesic and an antitussive medication — an antitussive is a type of drug that acts as a cough suppressant — and it can be used to treat severe pain. It is also used to treat chest infections, of which a cough is a primary symptom.

The combination of acetaminophen and hydrocodone is generally considered safe and highly effective for a number of pain-related conditions. The potential hepatoxicity, also known as liver toxicity, associated with acetaminophen is one of the reasons drugs containing adetaminophen are generally considered best on a short-term basis only. The recommended single dosage for acetaminophen is one gram (1,000 mg), with a maximum daily dosage recommendation of four grams (4,000 mg). Exceeding the daily dosage of four grams could potentially cause serious damage to the liver, in which case the administration of an antidote medication might be required. Caution is always advised when using acetaminophen for sustained periods of time.

Hydrocodone is an opiate drug, in the same class as heroin, and it has a high potential for abuse. Ingesting hydrocodone in excessive amounts can produce an intense feeling of euphoria, which is similar in nature to the euphoria produced by other opiate drugs. If products containing acetaminophen and hydrocodone are ingested on a long-term basis, addiction to hydrocodone is quite likely, which is another reason prescription drugs like Vicodin® are typically prescribed on a short-term basis only.

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