How to Use Vicodin Safely for Pain Relief

Addiction and Liver Toxicity Associated With Misuse

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Sharyn Morrow

Vicodin is a combination of two pain relievers; acetaminophen (commonly known by the trade name Tylenol) and hydrocodone (a synthetic codeine). Vicodin is one of the most widely prescribed pain relievers in the U.S. and one of the most frequently abused.

The drug is marketed under a number of brand names including:

  • Vicodin
  • Vicodin HP (300 mg acetaminophen/5 mg hydrocodone)
  • Vicodin ES (750 mg acetaminophen/7.5 mg hydrocodone)
  • Lortab
  • Anexsia
  • Zydone
  • Lorcet
  • Norco

Vicodin is considered an effective pain reliever when used as prescribed over the short term. Careless, inappropriate, or deliberate misuse of Vicodin can have serious consequences, including drug dependence and liver damage.

Drug Dosing

Vicodin is taken orally in a tablet form and contains 300 mg of acetaminophen and 5 mg of hydrocodone. The standard adult dose is one or two tablets every four to six hours as needed. The total daily dose should not exceed eight tablets.

Vicodin HP and Vicodin EP (see above) contain larger doses of the active drugs. Follow the recommending dosing schedule on the patient information insert, and speak with your doctor of pharmacist if you have any questions.

Addiction Warning

Because Vicodin has a high degree of physical and emotional dependence, largely a result of the hydrocodone component, anyone taking the drug should be aware of the warning signs of addiction.

They include::

  • Feeling physically ill when you run out of Vicodin or stop taking Vicodin? These include muscle and joint pain, night sweats, anxiety, "jitters," and insomnia.
  • Taking more pills than before (or recommended) to get the same effect.
  • Being overly cautious or aware of when the drug's effects are waning.
  • Juggling doctors to get prescriptions.
  • Having been advised by family or friends that you are taking too much or using too often.
  • Keeping Vicodin use secret or feeling guilty or ashamed.
  • Hiding Vicodin or keeping a supply in your office, car, bedroom, kitchen and bathroom so they're always nearby.

If you answered "yes" to any of these questions, your Vicodin use may have reached excessive, addictive levels. If so, talk to your doctor or a counselor about getting help. The longer you wait, the more difficult it can be to kick the habit.

Withdrawal symptoms, such as insomnia, night sweats, tremors, and agitation, can occur when Vicodin is suddenly stopped. To avoid this, your doctor may reduce your dose gradually. Speak with your doctor or pharmacist if you are having any signs of dependence, and report any withdrawal reactions you may have right away

Other Drug Complications

Like any prescription medication, prolonged use or misuse can have consequences, some of them serious. In the case of Vicodin, problems can include:

  • Drowsiness and dizziness, particularly during the initiation of treatment
  • Constipation, which can usually be treated with a high fiber diet, plenty of water, and a laxative, if needed.
  • Liver toxicity is related to a prolonged or excessive use of acetaminophen.
  • Physical tolerance to the drug (which can lead to liver damage), as well as respiratory complications.
  • Drug interactions with MAO inhibitors and tricyclic antidepressants. Do not  take Vicodin if you have used an MAO in the past 14 days.

Treatment Considerations

Before starting Vicodin, inform your doctor if you have any of the following:

  • Liver disease, including cirrhosis or hepatitis
  • A history of alcoholism or drug addiction
  • Kidney disease
  • Asthma, COPD or any breathing disorder
  • Brain disorders, including head injury, seizures, tumors
  • If you drink more than three alcoholic beverages per day

Always read the patient information insert before you starting any medication. If you have any questions, ask your doctor or pharmacist.

​If you are already taking Vicodin and feel you need a longer term solution, speak with your doctor about a strategy that includes some other type of analgesic drug.

If you feel physically or emotionally dependent on Vicodin, seek help from your doctor, a counselor or a substance abuse professional as soon as possible to avoid the potential dangers of Vicodin.


Abbvie. "Vicodin - Indication and Important Safety Information." Accessed November 25, 2016.