HYDROCODONE-ACETAMINOPHEN (Generic for NORCO)

Hydrocodone Bitartrate 5mg, Acetaminophen 325mg, Oral tablet

Alcohol

· Severity: Major

· Notes for Consumers: Do not drink alcohol while taking this medication. Drinking alcohol while taking this medication increases the risk of liver injury. Contact your care team right away if you experience right upper belly pain, loss of appetite, nausea, light-colored stool, dark yellow or brown urine, yellowing skin or eyes, or unusual weakness or fatigue.

· Notes for Professionals: The risk of developing hepatotoxicity from acetaminophen appears to be increased in patients who regularly consume alcohol. Patients who drink more than 3 alcohol-containing drinks a day and take acetaminophen are at increased risk of developing hepatotoxicity. Acute or chronic alcohol use increases acetaminophen-induced hepatotoxicity by inducing CYP2E1 leading to increased formation of the hepatotoxic metabolite of acetaminophen. Also, chronic alcohol use can deplete liver glutathione stores. Administration of acetaminophen should be limited or avoided altogether in patients with alcoholism or patients who consume alcohol regularly.

Hydrocodone Bitartrate 5mg, Acetaminophen 325mg, Oral tablet

Cannabis

· Severity: Major

· Notes for Consumers: Discuss cannabis use with your care team. The effects of your medication may be altered if used with cannabis. Call emergency services right away if you experience slow or shallow breathing, shortness of breath, feeling faint, dizziness, confusion, or trouble staying awake.

· Notes for Professionals: Advise patients to avoid cannabis use while taking CNS depressants due to the risk for additive CNS depression and potential for other cognitive adverse reactions.

Hydrocodone Bitartrate 5mg, Acetaminophen 325mg, Oral tablet

Grapefruit juice

· Severity: Moderate

· Notes for Consumers: It is recommended that you limit and do not significantly alter your intake of grapefruit or grapefruit juice while taking hydrocodone. Side effects from hydrocodone may get worse if you increase your intake of grapefruit juice. Talk to your doctor first. Contact your doctor right away if you have symptoms of hydrocodone side effects such as slurred speech, confusion, weakness, or trouble breathing. Do not drive or operate machinery until you know how hydrocodone affects you.

· Notes for Professionals: Patients should not significantly alter their intake of grapefruit or grapefruit juice during therapy with hydrocodone. Grapefruit juice, a CYP3A4 inhibitor, may increase plasma concentrations of hydrocodone, a CYP3A4 substrate. This may increase or prolong hydrocodone-related toxicities including respiratory depression. Advise patients accordingly; patient monitoring and dosage adjustments may be necessary if grapefruit is consumed regularly.

<b>DISCLAIMER:</b><em> This drug information content is provided for informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Patients should always consult their physician with any questions regarding a medical condition and to obtain medical advice and treatment. Drug information is sourced from GSDD (Gold Standard Drug Database ) provided by Elsevier.</em>