Ibuprofen and hydrocodone togetherThere is no drug interaction between hydrocodone and ibuprofen. In fact, there is a prescription product that combines both ingredients (Vicoprofen). However, if you weren't prescribed Vicoprofen and want to take each ingredient separately, it would make sense to allow the hydrocodone time to work prior to taking ibuprofen (or vice versa).


Taking Ibuprofen With Hydrocodone

Hydrocodone is a controlled substance pain medication that typically comes as a combination tablet with acetaminophen (e.g. Norco, Vicodin). As mentioned, hydrocodone and ibuprofen are found in a combination tablet known as Vicoprofen, but it is used much less frequently than Norco. If you are using Vicoprofen, it would generally not be recommended to take additional ibuprofen, as this may cause an overdosage of ibuprofen.


If you are taking a hydrocodone/acetaminophen product, it is sometimes recommended to use ibuprofen in addition to combat different levels of pain. In addition, hydrocodone and ibuprofen have a different mechanism of action and can work synergistically when used together. Generally, ibuprofen works for mild pain and inflammation while hydrocodone is used for more moderate to severe pain.


Opioids, such as hydrocodone, work by binding to the mu-opiate receptor. This works in the central nervous system to decrease perception of pain and the person’s emotional response to pain. Hydrocodone products should start working in about 30 minutes and should reach peak effect in about 90 minutes. Overall, hydrocodone treats pain for about 3-4 hours. Ibuprofen takes about 1 hour to start working and peaks within 2-4 hours.


In order to avoid untoward effects like addiction, constipation, and respiratory depression, the lowest dose for the shortest duration is generally recommended when taking hydrocodone and other opioids. If the pain is mild, ibuprofen may be a good option instead of taking a dose of Norco.


Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that works by inhibiting an enzyme known as cyclooxygenase or COX. The COX enzymes play a significant role in prostaglandin formation which is responsible for inflammation, platelet formation, and fever. There are two types of COX, known as COX-1 and COX-2. COX-1 has a more prominent role in platelet formation, as well as protecting the stomach lining. COX-2 is primarily responsible for inflammation. Ibuprofen inhibits both COX-1 and COX-2.


Summary

Due to the different mechanisms of action of ibuprofen and hydrocodone, they are often recommended to be used together. In most cases however, ibuprofen is for mild pain and hydrocodone for more moderate to severe pain. If you take ibuprofen and the pain relief isn't sufficient, it is okay to take hydrocodone. There is no need to wait a certain amount of time between the two doses as they do not interact with one another.


Source: Norco package insert, Motrin package insert