Hydrocodone/ibuprofen is a combination opioid medication that's used to treat pain when non-opioid medications don't provide enough relief. Your provider will discuss with you about your specific needs for pain relief to determine your dosage. Hydrocodone/ibuprofen can commonly cause side effects like headache, sleepiness, and constipation. This medication also has many serious warnings, such as slowed breathing, risk of misuse and dependency, and stomach bleeding. Although the brand name (Vicoprofen) is no longer available, the generic form is still on the market.
Pain that isn't relieved with non-opioid pain medications - used as short-term treatment (for less than 10 days)
Hydrocodone/ibuprofen is a combination of two medications.
Hydrocodone is an opioid medication that attaches to proteins in your brain called mu-opioid receptors to change how you react to pain. This helps lower how much pain you feel.
Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID). It blocks certain proteins that are involved in the inflammation process in your body. This helps relieves pain and swelling.
Hydrocodone/ibuprofen 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 substance or alcohol abuse | History of mental health conditions (like depression)
Hydrocodone/ibuprofen has a risk for addiction and misuse because it contains hydrocodone (an opioid). Addiction can develop even at recommended doses as prescribed or when hydrocodone/ibuprofen is used for reasons other than prescribed (misuse). Sometimes, addiction and misuse can lead to life-threatening overdose. To lower the risk for addiction and misuse, your provider will prescribe the lowest amount of hydrocodone/ibuprofen that's necessary for you for the shortest period of time possible.
Because of the risk for addiction and misuse, the FDA requires a Risk Evaluation and Mitigation Strategy (REMS) program for hydrocodone/ibuprofen. Under the Opioid Analgesic REMS program, your provider will talk to you about how to take hydrocodone/ibuprofen safely, what its risks are, and proper storage and disposal. These steps help keep you and your loved ones safe. Talk to your provider about other treatment options for pain if you have concerns about taking hydrocodone/ibuprofen.
Risk factors: Age 65 years or older | Severe breathing problems like chronic obstructive pulmonary disease (COPD) | Sleep-related breathing problems (e.g., apnea) | Head injury | Severe weakness or muscle loss | Drinking alcohol | Taking medications that slow your body down | Taking high doses of hydrocodone/ibuprofen
Opioids like hydrocodone can cause extremely slowed breathing that can be deadly. This can happen at any time, even when the medication is used as recommended by your provider. But the risk is generally highest when you first start the medication or after your dose is raised. Don't take hydrocodone/ibuprofen with alcohol or other medications that can slow your body down (e.g., benzodiazepines, muscle relaxants). Doing so can slow down your breathing even more. Get medical help or call 911 right away if you or a loved one notices that you have trouble breathing; slow and shallow breathing; or bluish-colored lips, fingers, or toes.
Risk factors: History of opioid use disorder | Previous opioid overdose | Taking medications that can slow the body down | Alcohol use | Taking high opioid doses | Taking more opioids than prescribed | Age 65 years or older | Age 18 years or younger
It's possible to accidentally take too much hydrocodone/ibuprofen, even at recommended doses of the medication. Overdoses can also happen if it's accidentally taken by a child or a loved one. Overdoses can be life-threatening if it's not recognized or treated in time. Your provider might recommend that you carry naloxone (Narcan) with you at all times to quickly, but temporarily reverse the effects of the medication if an accidental overdose happens. It's important for you and your caregiver to know how to use naloxone (Narcan) in case this happens. Opioid overdose symptoms include extremely slowed breathing, slow heartbeat, extreme sleepiness, cold or clammy skin, and not responding to sound or touch. Call 911 right away if you think an overdose has happened.
Risk factors: History of heart problems | Recent heart attack | Heart bypass surgery in the last two weeks | Planned heart bypass surgery | Taking hydrocodone/ibuprofen for a long time
Hydrocodone/ibuprofen can raise your risk of having blood clots, heart attack, and stroke. Talk to your provider before starting this medication if you have heart problems, especially if you've recently had a heart attack or heart bypass surgery. To lower your risk, take hydrocodone/ibuprofen at the lowest dose and for the shortest amount of time possible. Don't take hydrocodone/ibuprofen if you've recently had or will be having heart surgery. Call 911 if you experience chest pain, trouble breathing, weakness on one side of your body, or trouble speaking or walking.
Risk factors: Older adults | History of stomach bleeding or ulcers | Bleeding problems | Liver problems | Taking other medications that raise your risk for bleeds | Drinking alcohol | Smoking | Having poor health | Taking hydrocodone/ibuprofen for a long time
NSAIDs like ibuprofen can raise your risk for serious bleeding,ulcers, and tears in the stomach, gut, or esophagus (tube that leads from your mouth to your stomach). In some cases, this can be life-threatening. Serious stomach or gut problems can happen without warning while you're taking hydrocodone/ibuprofen. Your risk for stomach bleeds might be higher if you're also taking other medications that can cause bleeding, such as oral corticosteroids, blood thinners (anticoagulants), and other NSAIDS like aspirin.
Make sure your provider is aware of all of your medical conditions and medications before starting hydrocodone/ibuprofen so they can discuss with you about your risk for stomach or gut bleeds. Get medical help right away if you have severe stomach pain, black and tarry stools, or blood in your vomit or urine while using hydrocodone/ibuprofen.
Certain medications can interfere with how well your body gets rid of hydrocodone/ibuprofen. This can affect the amount of hydrocodone/ibuprofen in your body, how well it works, and the risk of side effects.
Some medications, like erythromycin (Ery-Tab) and ritonavir (Norvir), can raise the levels of hydrocodone/ibuprofen in your body. Higher levels can lead to potentially deadly slowed breathing. Other medications, such as rifampin (Rifadin) and carbamazepine (Tegretol), can lower the levels of hydrocodone/ibuprofen in your body. This can cause the pain medication to not work as well and lead to withdrawal.
If you're already taking stable doses of hydrocodone/ibuprofen with one of these other medications, don't stop taking them suddenly. Doing so can lead to unsafe hydrocodone/ibuprofen levels. Let your provider or pharmacist know what other medications you’re taking before starting hydrocodone/ibuprofen to make sure your medications are safe for you.
Risk factors: Long-term use during pregnancy | Currently in second or third trimester of pregnancy
If you take opioids (like hydrocodone in hydrocodone/ibuprofen) for a long period of time during pregnancy, there's a risk that your unborn baby can become dependent on the medication. Once born, your baby can develop a condition called neonatal opioid withdrawal syndrome (NOWS) and experience withdrawal symptoms. Withdrawal symptoms in your newborn can include high-pitched crying, poor feeding and sucking behavior, trembling, irritability, and sometimes seizures. This condition can be life-threatening if not recognized and treated in time.
In addition, this medication can can cause harm to your unborn baby if it's taken after 20 weeks of pregnancy. NSAIDs (like ibuprofen in hydrocodone/ibuprofen) can cause serious complications, such as heart or kidney problems in your unborn baby, if they're taken during the second half of pregnancy.
Speak to your provider about the risks and benefits of taking hydrocodone/ibuprofen if you're pregnant. Let your provider know if you've used this medication during pregnancy or if you notice withdrawal symptoms in your baby. Ask whether there are safer alternatives.
Risk factors: Age 65 years or older | Taking other medications that lower blood pressure or slow your body down| Dehydration or loss of body fluid through severe vomiting, bleeding, or diarrhea
Hydrocodone/ibuprofen can cause extremely low blood pressure, including a sudden drop in blood pressure when you stand from a sitting or lying down position. As a result, you might feel dizzy or even faint. To avoid falling, get up slowly if you've been sitting or lying down. If dizziness or lightheadedness doesn't go away, talk to your provider.
NSAIDs (like ibuprofen in hydrocodone/ibuprofen) can raise your blood pressure or cause swelling in the arms or legs. It can also put you at risk for heart failure or hospitalization from heart failure complications. This is because NSAIDs can cause your body to hold onto extra fluid. Some blood pressure or heart failure medications might not work as well when taken with hydrocodone/ibuprofen. Let your provider know if you have any heart problems (especially heart failure) or if you're taking medications for these conditions so they can make sure hydrocodone/ibuprofen is safe for you.
Check your blood pressure regularly while you're taking hydrocodone/ibuprofen, and let your provider know if you notice any changes. Also contact your provider if you experience trouble breathing, tiredness, swelling in your body, or sudden weight gain as these can be symptoms of heart failure.
Risk factors: Older adults | Kidney or liver problems | Heart failure | Taking certain blood pressure medications (e.g., water pills, ACE inhibitors, ARBs) | Loss of body fluid through severe vomiting, bleeding, or diarrhea | Using hydrocodone/ibuprofen for a long time
Taking hydrocodone/ibuprofen for a long time can damage your kidneys by lowering blood flow to the kidneys. The risk of kidney damage is higher if you're taking certain blood pressure medications (like ACE inhibitors, ARBs, or water pills). Your risk might also be higher if you have certain medical conditions, such as kidney problems, liver problems, and heart failure. Kidney damage is usually reversible once you stop taking hydrocodone/ibuprofen. Tell your provider if you notice a change in how often you urinate after starting this medication since this can be a sign of kidney damage.
In addition, kidney damage from NSAIDs like ibuprofen can lead to high potassium levels. Sometimes, NSAIDs can cause high potassium levels even in people with healthy kidneys. Call your provider right away if you experience symptoms of high potassium levels, such as nausea, vomiting, muscle weakness, or tingling in your limbs because it can lead to dangerous health problems.
Some people have had liver damage while taking NSAIDs like the ibuprofen in hydrocodone/ibuprofen. Although rare, this liver damage can be life-threatening. Stop taking this medication and contact your provider right away if you experience signs and symptoms of liver problems, such as nausea, fatigue, itchiness, yellowing of your skin of whites of your eyes, pain on the upper right side of your stomach, or flu-like symptoms.
Some people taking opioid medications like hydrocodone/ibuprofen experienced a drop in their hormone levels. This is more likely to happen if you take the medication for more than a month. Symptoms of low hormone levels include nausea, loss of appetite, tiredness, weakness, and dizziness. Let your provider know if you have these symptoms.
Risk factors: History of seizures
Opioids, such as hydrocodone in hydrocodone/ibuprofen, can more frequent seizures to happen in people who've had seizures in the past. The medication might also raise the risk of seizure in other situations where seizures can occur. Let your healthcare provider know if you have seizures more often while you're taking hydrocodone/ibuprofen.
Risk factors: Long-term use of hydrocodone/ibuprofen
If you take hydrocodone/ibuprofen regularly for a long time, you can become physically dependent on the medication. This means your body starts to rely on the medication to function. And you might experience withdrawal if you suddenly lower your dose or stop taking the medication. Withdrawal symptoms can include restlessness, muscle pain, runny nose, yawning, sweating, chills, anxiety, and uncontrolled pain. Don't lower your dose or stop taking the medication suddenly without talking to your provider. To prevent withdrawal symptoms from happening, follow your provider's instructions carefully to slowly lower your dose. Talk to your provider about alternative pain medications if you have concerns about this risk.
Hydrocodone/ibuprofen can cause serious allergic reactions and skin reactions that can sometimes be life-threatening. Stop taking this medication and get medical help right away if you develop any type of rash, skin peeling, painful blisters, fever, swollen lymph nodes, facial swelling, trouble breathing, or anaphylaxis.
Risk factors: Asthma | Stuffy nose with or without nasal polyps | History of allergic reaction to aspirin or other NSAIDs
Be careful using hydrocodone/ibuprofen if you have asthma. You might have worsening asthma symptoms while you're taking hydrocodone/ibuprofen if you have asthma or if you've had asthma attacks after taking aspirin or another NSAID. Get medical help right away if your throat tightens and you can't breathe.
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:
Rare
Bloody stools
burning feeling in the chest or stomach
changes in facial skin color
difficulty with swallowing
fast or irregular breathing
frequent urge to urinate
irregular heartbeat
lightheadedness or dizziness
loss of bladder control
puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
ringing or buzzing in the ears
tightness in the chest
trouble breathing
stomach pain
tenderness in the stomach
visual disturbances
yellow eyes or skin
Incidence not known
Agitation
confusion
darkening of the skin
difficulty swallowing
dizziness
fainting
loss of appetite
mental depression
overactive reflexes
poor coordination
puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
restlessness
shivering
talking or acting with excitement you cannot control
trembling or shaking
twitching
unusual tiredness or weakness
vomiting
Get emergency help immediately if any of the following symptoms of overdose occur:
Symptoms of overdose
Blurred vision
cold or clammy skin
confusion
difficulty hearing or ringing or buzzing in the ears
dizziness
general feeling of illness
headache
mood or mental changes
severe drowsiness
severe stomach pain
skin rash
slow heartbeat
stiff neck or back
swelling of the face, fingers, feet, or lower legs
vomiting
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
increased sweating
nervousness
pounding heartbeat
sleepiness
trouble in sleeping
Rare
Decreased appetite
decrease in sexual ability
headache
increased thirst
irritability
mood or mental changes
mouth ulcers
pain or burning in the throat
sensation of burning, warmth, heat, numbness, tightness, or tingling
slurred speech
stomach upset
thinking abnormalities
unexplained weight loss
unusual feeling of well-being
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.
Helps relieve pain that isn't well-controlled with non-opioid pain medications alone
Combines two different medications to ease pain in different ways
Might start to notice pain relief in 30 minutes
Available in a lower-cost, generic form
Can cause serious slow breathing and stomach and heart problems
Shouldn't use with other NSAID medications
Is a controlled substance because of the risk of misuse and dependency so there are special requirements to getting a prescription filled
Take hydrocodone/ibuprofen exactly as prescribed by your provider. Taking the medication any differently than it's prescribed can cause side effects or an accidental overdose.
Hydrocodone/ibuprofen can cause sleepiness, dizziness, or lightheadedness, which can affect your ability to focus and think. Avoid driving or doing anything that requires your full attention until you know how hydrocodone/ibuprofen affects you to prevent accidentally hurting yourself or others.
Don't mix hydrocodone/ibuprofen with alcohol, with any medication that contain alcohol, or with other medications that make you sleepy or react slower. Doing so can affect your ability to think clearly and lead to accidental injuries. It could even lead to a deadly overdose.
Drink plenty of water and eat fiber-rich foods to help with constipation from hydrocodone/ibuprofen. If your constipation doesn't get better or if it worsens, talk to your provider about other ways to manage this side effect.
Let your provider and pharmacist know about all the other medications you take or plan to take with hydrocodone/ibuprofen. They can check for potentially dangerous drug interactions and make sure your medications are safe for you to take. For example, taking hydrocodone/ibuprofen with certain antidepressants can put you at risk for serious side effects like serotonin syndrome.
If you've taken hydrocodone/ibuprofen for a long period of time, don't suddenly lower your dose or stop taking the medication without talking to your provider first. Doing so can lead to withdrawal symptoms, like restlessness, body aches, trouble sleeping, and anxiety. Follow your provider's instructions to slowly cut back on your dose over a few weeks to prevent withdrawal.
Ask your provider or pharmacist about naloxone (Narcan), a medication that can help reverse the effects of accidentally taking too much hydrocodone/ibuprofen. It's important that you and your loved ones know when and how to use naloxone in case an accidental overdose happens. Still call for emergency medical help if you need to use naloxone because its effects can go away.
Keep hydrocodone/ibuprofen out of reach of children and in a location that can't be easily accessed by visitors to your home. If you no longer need the medication or if it's expired, throw the medication away through a take-back program or by flushing it down the toilet. This helps keep your loved ones safe from accidental overdose and prevent medication misuse.
Your provider will work with you to find the right dose and treatment regimen for your individual needs. In general, it's recommended to use the lowest dose possible for the shortest duration of time to manage your pain.
Each tablet contains 200 mg of ibuprofen and either 2.5 mg, 5 mg, 7.5 mg, or 10 mg of hydrocodone. The typical starting dose is 1 tablet by mouth every 4 to 6 hours on an as-needed basis for pain.
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.
Severe asthma, trouble breathing, severely slowed breathing, or lung problems
Blockage or narrowing in your stomach or intestines
Right before or after heart bypass surgery
Asthma attack, hives, or other allergic reactions to aspirin or other NSAIDs
Allergy to other opioid medications
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