Hydrocodone/acetaminophen solution, most commonly known by the brand name Hycet, is a combination medication that contains an opioid and an analgesic. It's used to manage pain for people who've tried non-opioid medications but haven't gotten enough pain relief from them. This medication is taken by mouth. It can cause side effects like constipation, nausea, and sleepiness. This medication is a controlled substance because of its risk for misuse and dependency.
Please note: Although all brand names of the oral solution are discontinued, it's now only available as a generic.
Pain that isn't relieved by non-opioid pain medications alone
Hydrocodone/acetaminophen solution is a combination of two medications that work together to treat pain.
Hydrocodone is an opioid. It attaches to certain mu-opioid receptors in your brain to lower how much pain you feel.
Acetaminophen is an analgesic. It blocks the production of certain chemicals in your brain that play a role in pain. As a result, acetaminophen helps relieve pain.
Hydrocodone/acetaminophen solution can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Risk factors: Personal or family history of alcohol or substance use disorder | Personal or family history of mental health conditions
Hydrocodone/acetaminophen solution is a controlled substance because it has a risk for misuse and addiction. Take the medication exactly as prescribed. Don't change the dose or how often you take it without talking to your prescriber first.
Misusing hydrocodone/acetaminophen solution might cause the medication to work less well. It can also raise the risk for serious and possibly life-threatening side effects, such as dangerously slow breathing, not able to stay awake, addiction, and opioid overdose. You'll be prescribed the lowest amount of hydrocodone/acetaminophen solution that's necessary to manage your pain for the shortest period of time possible.
Because of the risk for misuse, addiction, and overdose, hydrocodone/acetaminophen solution is only available through a Risk Evaluation and Mitigation Strategy (REMS) program called the Opioid Analgesic REMS program. Your prescriber and pharmacy must register with the program, receive training on proper medication use, and discuss with you about how to use hydrocodone/acetaminophen solution safely.
Risk factors: Taking medications that can cause slow breathing | Drinking alcohol | Older age | Being frail | Medical conditions that cause breathing problems (e.g., COPD, asthma, head injury) | Taking too much hydrocodone/acetaminophen solution
Hydrocodone/acetaminophen solution can cause dangerously slow breathing, which can be life-threatening. This can happen to anyone and at recommended doses. But the risk is greatest when you first start treatment or when your dose goes up.
Don't drink alcohol while you're taking hydrocodone/acetaminophen solution. And don't take the opioid medication with other medications that slow your body down (e.g., benzodiazepines, other opioids, muscle relaxants). Doing so raises your risk of extremely slowed breathing.
Your prescriber might write a prescription for naloxone (Narcan), a medication that can reverse slowed breathing from opioids. Your prescriber will instruct you to carry it with you at all times. Use naloxone, call 911, and get medical help right away if you or your loved one notices that you have trouble breathing or have bluish-colored lips, fingers, or toes.
Risk factors: History of opioid use disorder | Previous opioid overdose | Taking high doses of hydrocodone/acetaminophen solution | Taking more opioids than prescribed | Alcohol use
Take hydrocodone/acetaminophen solution exactly as prescribed. Taking too much medication or taking it more often than prescribed can lead to an overdose. It can be very dangerous if someone accidentally swallows the medication. Be sure to keep the opioid medication out of reach from children, pets, or visitors to prevent accidental exposure or overdose.
Symptoms of an opioid overdose include not responding to sound or touch, extremely slowed breathing, extreme sleepiness, slow heartbeat, and cold or clammy skin. Be sure you and your loved ones know how to recognize an overdose. Your prescriber will probably write a prescription for naloxone (Narcan), a medication that can treat an opioid overdose. Carry naloxone with you at all times; use it and call 911 right away if an overdose happens.
Risk factors: Taking high doses of hydrocodone/acetaminophen solution | Age 65 years or older | Drinking alcohol | Taking other medications that can cause sleepiness
Hydrocodone/acetaminophen solution can cause extreme sleepiness and lower your ability to think, react, and focus. Don't drink alcohol or take other medications that can cause sleepiness or "brain fog" (e.g., benzodiazepines, muscle relaxants, sleep medications) with hydrocodone/acetaminophen solution. Doing so can worsen these side effects.
Make sure you know how hydrocodone/acetaminophen solution affects you before driving a car or doing activities that require your concentration. Talk to a healthcare professional (HCP) if you feel too sleepy from the medication.
Risk factors: Drinking alcohol | Taking other medications containing acetaminophen | Taking too much hydrocodone/acetaminophen solution | History of liver problems
This opioid medication contains acetaminophen. Taking too much acetaminophen can cause liver damage that can be life-threatening. The risk for liver damage is higher if you're taking more than one medication that contains acetaminophen, if you already have liver problems, or if you regularly drink alcohol.
Let your prescriber know about your medical history, especially if you have liver problems, before you take hydrocodone/acetaminophen solution. Also avoid drinking alcohol while you're taking this medication. Your prescriber can discuss how much acetaminophen you can take per day depending on your age and your risk for liver damage.
Call an HCP right away if you notice any symptoms of liver damage. These symptoms can include tiredness, dark urine, upset stomach, stomach pain, or yellowing of the skin or whites of the eyes.
Hydrocodone/acetaminophen solution interacts with a lot of common medications. So it's important to tell your prescriber and pharmacist about the medications you're taking and planning to take with this opioid medication. Your care team can check that your medications are safe to take together. Also talk to your care team first before making any changes to your medications because sudden dose adjustments can also lead to harm.
Some interactions can raise the level of hydrocodone/acetaminophen solution in your body. This can raise your risk for serious side effects, including potentially life-threatening slowed breathing. Examples of medications that can lead to this type of interaction with hydrocodone/acetaminophen solution include erythromycin, ketoconazole, and ritonavir (Norvir).
Other drug interactions can lower the levels of hydrocodone/acetaminophen solution in your body. This can cause the opioid medication to work less well for pain and possibly lead to withdrawal symptoms. These interactions include taking hydrocodone/acetaminophen solution with rifampin (Rifadin) or carbamazepine (Tegretol).
Long-term use of hydrocodone/acetaminophen solution during pregnancy can cause your unborn baby to become dependent on the medication. This is because the opioid in the medication (hydrocodone) can pass through the placenta to your unborn baby.
Once your baby is born, they can experience withdrawal symptoms, such as high-pitched crying, poor feeding behavior, trembling, abnormal sleep patterns, and seizures. This condition is called neonatal opioid withdrawal syndrome and can be life-threatening if not recognized and treated in time. Let your HCP know if you've used hydrocodone/acetaminophen solution during pregnancy or if you notice these symptoms in your baby.
Risk factors: Allergy to other opioids
Severe allergic reactions to hydrocodone/acetaminophen solution are possible, including life-threatening reactions like facial swelling, shock, and anaphylaxis (e.g., closing of the throat). Additionally, acetaminophen can rarely cause serious skin reactions, such as rash, blisters, skin reddening, or skin peeling. Get medical attention right away if you notice these types of changes in your skin, swelling of the lips or tongue, or difficulty breathing after you take this medication.
Risk factors: Long-term use of hydrocodone/acetaminophen solution
Hydrocodone/acetaminophen solution can cause physical dependence when it's taken for a long period of time. This means that your body starts to rely on the medication to function. You might experience withdrawal if you suddenly stop taking the medication or lower your dose too fast. Withdrawal symptoms can be bothersome and include anxiety, restlessness, irritability, runny nose, sweating, and chills.
Don't lower your dose or stop taking the medication suddenly without talking to your prescriber first. Your prescriber will slowly lower your dose to prevent withdrawal symptoms. Talk to your prescriber about alternative pain medications if you have concerns about the risk for dependence and withdrawal with hydrocodone/acetaminophen solution.
Hydrocodone/acetaminophen solution can cause extremely low blood pressure. Your blood pressure might drop when you stand from a sitting or lying down position. This can lead to dizziness and fainting. To avoid falling, get up slowly if you've been sitting or lying down. Talk to your HCP if any dizziness or lightheadedness doesn't go away.
Risk factors: Taking hydrocodone/acetaminophen solution for longer than 1 month
Some people taking opioid medications like hydrocodone/acetaminophen solution have had low adrenal hormone levels. This might be more likely to happen after taking opioids for longer than 1 month. Symptoms include tiredness, dizziness, weakness, not feeling hungry, nausea, and vomiting. Tell your HCP if you have these symptoms. If your adrenal hormone levels are too low, you might need to stop hydrocodone/acetaminophen solution and be treated with corticosteroids.
Risk factors: History of seizure conditions
Opioids such as hydrocodone can raise the risk of having seizures more often in people who've had one before. Hydrocodone/acetaminophen solution can also raise your risk of seizures in certain situations. Get medical help right away if you have a seizure while you're taking this medication.
Source: DailyMed
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
More common
Dizziness
lightheadedness
Incidence not known
Back, leg, or stomach pains
black, tarry stools
bleeding gums
blood in the urine or stools
blood in vomit
bluish lips or skin
chills
choking
dark urine
decrease in the frequency of urination
decrease in urine volume
difficult or trouble breathing
difficulty in passing urine (dribbling)
difficulty with swallowing
fast heartbeat
fever with or without chills
general body swelling
general feeling of tiredness or weakness
headache
hoarseness
irregular, fast or slow, or shallow breathing
light-colored stools
loss of appetite
lower back or side pain
nosebleeds
not breathing
painful or difficult urination
pale or blue lips, fingernails, or skin
pinpoint red spots on the skin
puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
severe or continuing stomach pain
sore tongue
sores, ulcers, or white spots on the lips or in the mouth
tightness in the chest
unable to speak
unusual bleeding or bruising
unusual tiredness or weakness
upper right abdominal or stomach pain
vomiting
yellow eyes and skin
Get emergency help immediately if any of the following symptoms of overdose occur:
Symptoms of overdose
Bloody or cloudy urine
change in consciousness
chest pain or discomfort
cold and clammy skin
decreased awareness or responsiveness
extreme drowsiness
general feeling of discomfort or illness
increased sweating
irregular heartbeat
lightheadedness, dizziness, or fainting
loss of consciousness
no blood pressure or pulse
no muscle tone or movement
not breathing
severe sleepiness
slow or irregular heartbeat
stopping of heart
sudden decrease in the amount of urine
unpleasant breath odor
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common
Drowsiness
relaxed and calm feeling
sleepiness
Incidence not known
Belching
changes in mood
difficulty having a bowel movement
fear or nervousness
feeling of indigestion
hearing loss
impaired hearing
pain in the chest below the breastbone
unusual drowsiness, dullness, tiredness, weakness, or feeling of sluggishness
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Can start to relieve pain within 30 minutes
A good option for people who struggle with swallow pills
Comes fruit-flavored for better taste
Available as a lower-cost, generic medication
Has a risk for misuse and dependence
Not recommended to take with other products containing acetaminophen since it can raise the risk for liver damage
Has special requirements to get a prescription filled because it's a controlled medication
Hydrocodone/acetaminophen solution comes in a few different strengths that have different amounts of hydrocodone and acetaminophen. Make sure you know which strength you have and your prescribed dose to avoid accidentally taking the wrong amount per dose. Ask your prescriber or pharmacist if you're not sure about the strength and dose that you've been prescribed to take.
Only use a medication dose cup or oral syringe from the pharmacy to measure out your dose of hydrocodone/acetaminophen solution. Don't use household spoons because they aren't accurate and using them might cause you to take the wrong dose.
Constipation is a common side effect of hydrocodone/acetaminophen solution. Drink plenty of water every day and add more fiber to your diet. Speak with your care team if these suggestions aren't enough to help with constipation. They can recommend certain medications or a change in your pain treatment.
Avoid alcohol while you're taking hydrocodone/acetaminophen solution. Alcohol can worsen opioid side effects like sleepiness and dizziness. It can also lower how clearly you can think or how fast you can react, as well as damage your liver.
Take hydrocodone/acetaminophen solution exactly as your prescriber instructed you to. Don't change your dose or stop taking it without talking to your prescriber first. Your prescriber might lower your dose slowly over a span of time before you can completely stop the medication. This helps lower your risk for bothersome withdrawal symptoms like muscle aches and chills.
Always have naloxone (Narcan) with you if it's been prescribed for you. Naloxone is a medication that can help reverse the effects of hydrocodone/acetaminophen solution in situations like an accidental overdose. Discuss with your loved ones about how to give naloxone to you if you can't do it yourself. Be sure to call 911 if you need to use naloxone because you'll need more medical attention.
Store hydrocodone/acetaminophen solution at room temperature and keep it in the original container from the pharmacy.
Keep hydrocodone/acetaminophen solution away from children, pets, or visitors. Ask your pharmacist about drug take-back options to get rid of the medication if you don't need to take it anymore safely. This lessens the risk for accidental overdose and medication misuse.
Hydrocodone/acetaminophen solution is taken by mouth, typically every 4 to 6 hours as needed for pain.
Your prescriber will work with you to find the right dose of hydrocodone/acetaminophen solution for your individual needs. It's recommended to use the lowest dose possible for the shortest period of time to manage your pain. The dose might be based on weight for some people.
Keep in mind that the oral liquid is available in different strengths and can contain different amounts of hydrocodone and acetaminophen. Make sure you know which strength you're using and how to take it properly. Ask your prescriber or pharmacist if you have any questions about your dose.
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
Severely slowed breathing (respiratory depression)
Severe asthma
Medical conditions that cause blockage of the stomach passageway
Allergy to hydrocodone or acetaminophen
Pain that isn't relieved by non-opioid pain medications alone
Toothache
Backache
Muscle aches
Minor arthritis pain
Ankylosing spondylitis (AS) (arthritis of the spine)
Polyarticular juvenile idiopathic arthritis (arthritis in children)
Tendonitis and bursitis
Pain
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