Expected Side Effects & Vicodin

The Vicodin as a drug has a number of side effects and adverse effects. Patients have been reported to have a sense of lightheadedness, nausea, sedation, psychic dependence, vomiting, dizziness and mood changes. These form the primary side effects of the Vicodin drug. Vicodin can also cause interruption in the central nervous system (CNS) which leads to mental clouding, drowsiness, lethargy, physical and mental performance impairment, fear, anxiety, dysphoria, confusion, and changes in the moods.

Neurological disorders may result following overdose of Vicodin which ends up damaging some tissues in the brain. The general behavior of a person, and the way of thinking is also affected (Khashab, Tector & Kwo, 2007). Patients can present problems with the liver following a prolonged use of Vicodin. The liver plays a critical role of detoxification of the body and if this role is compromised by Vicodin, patients will end up suffering more deleterious effects such as immunosuppression brought about by an increase toxic load.

Prolonged use of Vicodin damages the genitourinary and gastrointestinal systems of a patient. The effects to genitourinary system include vesical sphincters and ureteral spasms as well as the problem of urine retention that has been reported in some patients. Vicodin affects the gastrointestinal system by producing constipation. However, constipation results following a prolonged administration of Vicodin (Khashab, Tector & Kwo, 2007). Dose-related depression of the respiratory system is not unusual and patients may expect this to happen following Vicodin overdose.

The drug causes respiratory depression by directly acting on the brain stem respiratory controls. Other effects of Vicodin include dermatological effects which include pruritus and skin rashes (Smith, 2009). Allergic reactions, thrombocytopenia, rashes and agranulocytes are adverse effects related to acetaminophen administration. These side effects are considered as the effects of Vicodin since it contains the secondary analgesic acetaminophen. Concurrent medications, age and/or co-morbidity limitations

Hydrocodone should never be administered with cocaine, alcohol, methyphenidate, amphetamine, barbiturates, benzodiazipines and other medications which may result to severe adverse interactions causing respiratory distress, heart attack, heart failure, pulmonary failure, amnesia, blackout, coma, jaundice, seizures and kidney or liver failures (Smith, 2009). Vicodin should be used with care in debilitated or elderly patients as well as those with serious renal and hepatic functions.

Care should be taken when administering Vicodin in patients with hypothyroidism, urethra stricture or prostatic hypertrophy and Addison’s disease. Commercial hydrocodone is associated with serious health risks when concomitantly administered with alcohol since the drug contains a secondary analgesic, acetaminophen. Acetaminophen is also known as para-acetylaminophenol and para-acetylaminophenol, abbreviated APAP. Acetaminophen is solely metabolized in the liver and if the drug is mixed with alcohol, there is an increased risk of hepatotoxicity due to overdose.

It has been shown that significantly lower levels of acetaminophen can lead to overdose leading to hepatotoxicity when concomitantly taken with alcohol (Smith, 2009). Patients should therefore be warned on this specific drug interaction that may lead to serious negative effects to the stomach wall and kidneys apart from the liver. There are high risks of developing coma, having CNS damage and other respiratory problems when acetaminophen is taken with alcohol.

Depression of the CNS is not unusual with concomitant administration of Vicodin and other narcotic analgesics, other CNS depressants, antipsychotics, antihistamines and antianxiety agents. At the same time, the activity of hydrocodone and antidepressants may be potentiated with concomitant use of tricyclic antidepressants and monoamine oxidase inhibitors. Vicodin effectiveness and safety among pediatric and geriatric populations has not been fully established although care has to be taken when administering Vicodin to young and very old patients.

Administration of Vicodin among elderly patients should begin at the low end dosing range. This should reflect the high frequency of impaired renal, cardiac and hepatic functions as well as the concomitant drug therapy or disease (Smith, 2009). The drug should not be given to patients who have a previous history of hypersensitivity to either acetaminophen or hydrocodone. In addition, it is not recommended to administer Vicodin to patients with increased hypersensitivities to other compound in the opioid family since they may exhibit similar cross-sensitivity to the opioid hydrocodone.

Required Monitoring To prevent serious side effects, both the patients using Vicodin and the doctors prescribing the drug should practice extra care. Physicians should closely monitor patients to ensure that the side effects are contained and managed in a timely manner. The patients should always follow doctors’ prescriptions. Vicodin should be prescribed when necessary and only when other analgesics have failed to give positive results. It is also advisable for doctors to have close monitoring to establish the kind of drugs the patient is using at the time of Vicodin administration.

This will ensure that there are no contraindications or any adverse drug interactions when Vicodin is administered (Smith, 2009). Monitoring is also required for the doctor to establish other conditions or rather other ailments that the patient is suffering from. Vicodin use may not be appropriate with patients who have the history of liver diseases. Hydrocodone as well as the main acetaminophen metabolites are known to be excreted by kidneys. Therefore, patients with compromised renal function may have increased risks of Vicodin intoxication due to plasma accumulation of the metabolites or parent compounds.

Close monitoring will ensure that the doctor understands the patients’ medical history and thus avoid serious effects following Vicodin administration. The patients should be educated of the side effects associated with the use of Vicodin, so that at the first symptom they can report to the doctors so that they can prevent further harm of the side effects. Dosages by age group and condition The dosage depends on pain severity as well as how the patient is responding to medication. More severe symptoms may therefore require higher dosages and the dosage may be reduced or withdrawn after the patient shows some adverse side effects.

It is important to check on the dosage because overuse of Vicodin for a long time may cause tolerance to hydrocodone. At the same time, untoward effects may develop if the drug is administered for a long time or if the dosage used does not tally the recommended one as per the physician’s prescription. The normal adult dosage ranges from one tablet to two tablets taken after every four to six hours. However, the total daily dosage is not supposed to exceed eight tablets with tablets containing 500mg acetaminophen and 5mg hydrocodone.

Patients with no history of liver problems are allowed a maximum of 4 grams or 4000 milligrams every day and any excess may lead to serious liver complications and patients may present symptoms of liver damage such as extreme fatigue, stomach pain and yellowing of the skin and eyes. Patients who are not tolerant to opiates should not exceed dosages of over 40 milligrams (Ho & Burton, 2007). Conclusion Vicodin has become an important drug that is widely prescribed among patients of diverse populations.

A detailed understanding of pharmacological properties of Vicodin is essential in the effective management of pain, cough and fever. The most important research should be directed towards understanding major inhibitors of cyclooxygenase which can block the synthesis of prostaglandins without causing many side effects. Perhaps current research in pharmacogenomics may help decipher some of the hidden secrets in pain research.


Chandrasekharan, B. V, et al. (2002). COX-3, a cyclooxygenase-1 variant inhibited by acetaminophen and other analgesic/antipyretic drugs: Cloning, structure, and expression.Proc National Academy of Sciences. 99 (21): 13926-13931. Draganov, P, et al. (2000). Alcohol-acetaminophen syndrome: even moderate social drinkers are at risk. Postgraduate Medicine. 107 (1): 189-95 Ho, T, Vrabec, J. T & Burton, A. W. (2007). Hydrocodone use and sensorineural hearing loss. Pain Physician. 10 (3): 467-472. Khashab, M. , Tector, A. J. , & Kwo, P. Y. (2007). Epidemiology of acute liver failure. Current Gastroenterology Reports. 9(1): 66-73. Smith, H. S. (2009). Potential Analgesic mechanisms of acetaminophen. Pain Physician. 12 (1): 269-280

Vicodin (hydrocodone and acetaminophen combination) is one of the most prescribed pain medicines. The special combination of acetaminophen and hydrocodone makes Vicodin to be a powerful antipyretic, analgesic and antitussive medicine. The two compounds act in synergy in the management …

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