Taking Tylenol With Hydrocodone/APAP

Tylenol should generally not be taken with hydrocodone/acetaminophen products as the active ingredient in Tylenol is acetaminophen.

Question

Can a person take Tylenol and hydrocodone/acetaminophen 7.5-325 together?

Asked by lady On Nov 13, 2018

Answered by
Medical Content Reviewed By PharmacistAnswers Staff

On Nov 14, 2018
Bottle Of White Pills Spilling

Overview

Taking Tylenol with hydrocodone/acetaminophen products is not recommended. This represents a duplication in therapy as the active ingredient in Tylenol is acetaminophen.

Taking both Tylenol and hydrocodone/acetaminophen simply increases your dose of acetaminophen, increasing your risk of overdose and adverse effects.


Tylenol With Acetaminophen

It is extremely important to be aware of all the active ingredients in the medication you are taking, especially when it comes to combination products.

Hydrocodone/acetaminophen is a good example of a combination product. It contains both the opioid analgesic hydrocodone and acetaminophen. The most common amount of acetaminophen contained in hydrocodone products is 325 mg per pill/capsule.

Although acetaminophen has a long history of safe and effective use, unintentional or intentional misuse is the number one cause of acute hepatic failure in the United States. It is also one of the most common drugs seen in cases of accidental child ingestion.


Acetaminophen Dosing Limits

The maximum daily dose of acetaminophen is set at 4,000 mg per day, but this generally should only be done on the recommendation of your doctor.

Over the counter use of acetaminophen is often recommended at a maximum dose of 3,000 mg per day to reduce the risk of adverse effects.

If you are taking multiple products that contain acetaminophen, it is important to keep track of your daily ingestion of the drug.

Your doctor may recommend taking Tylenol (acetaminophen) for mild pain and only taking your hydrocodone/acetaminophen product as needed for severe pain. As discussed above, since your hydrocodone product does contain acetaminophen, be sure not to go over the maximum daily dose.


About Acetaminophen

Acetaminophen, often abbreviated as APAP, is used as a pain reliever and fever reducer. It does not have anti-inflammatory effects and doesn't affect blood platelets like other over the counter pain relievers such as ibuprofen and naproxen.

Oral doses of acetaminophen reach peak concentrations within 30 to 60 minutes and will last around four to six hours per dose.

Acetaminophen is generally considered to be safe and effective. However, as described above, misuse can cause acute liver failure.


About Hydrocodone

Hydrocodone is an opioid agonist and is most commonly prescribed in combination with acetaminophen (e.g. Vicodin, Norco, hydrocodone/acetaminophen).

Hydrocodone is also available as a single ingredient in products such as Zohydro ER.

Hydrocodone works by acting as a mu-receptor opioid agonist, which alters the perception of pain in the central nervous system.

Hydrocodone may be taken with or without food, but food may reduce nausea. It has an onset of action within 10-30 minutes and duration of action around 4 to 8 hours for immediate-release products.

Summary

Most hydrocodone products already contain acetaminophen, the active ingredient in Tylenol. Therefore, to reduce the risk of overdose, you should not combine Tylenol (acetaminophen) with hydrocodone/acetaminophen products.

References
  1. TYLENOL® Dosage For Adults. Tylenol.com
  2. Acetaminophen Monograph. DailyMed
  3. Tylenol Maximum Daily Dosage To Drop To 3,000mg Per Day From 4,000mg. Medical News Today
  4. Children and poisoning. WHO
  5. Acetaminophen and the U.S. Acute Liver Failure Study Group: lowering the risks of hepatic failure. PubMed

About the Pharmacist

Dr. Brian Staiger Pharm.D

Dr. Brian Staiger is a licensed pharmacist in New York State and the founder of PharmacistAnswers.com. He graduated from the University At Buffalo with a Doctor of Pharmacy degree in 2010. He has been featured in numerous publications including the Huffington Post as well as a variety of health and pharmacy-related blogs. Please feel free to reach out to him directly if you have any inquiries or want to connect! He's answered thousands of medication and pharmacy-related questions and he's ready to answer yours! Brian.Staiger@PharmacistAnswers.com Office: 716-389-3076

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