The misuse of prescription opioids can cause addiction, overdose, or death, as demonstrated by the current opioid crisis. In 2019, an estimated 70,630 people died from overdoses, and 10.1 million people misused prescription opioids in the previous year. In 2017, the HHS declared a public health emergency and announced a 5-Point Strategy to Combat the Opioid Crisis. Despite their efforts, 48,006 people died after overdosing on synthetic opioids in 2019, and another 14,480 deaths were attributed to heroin. 

There have been devastating consequences as a result of the opioid epidemic, which include opioid misuse and related overdoses, as well as the incidence of newborns experiencing withdrawal syndrome due to opioid addiction during pregnancy. In 2016, opioids accounted for 42,000 deaths, the highest number on record. 

With addiction to opioids stealing the focus, one such issue we seem to forget is acetaminophen in drugs like Norco or Vicodin, causing other severe health issues. Hydrocodone and acetaminophen can be a useful drug to treat mild to moderate pain after an injury or surgery, but when abused, can cause liver and kidney failure. 

An overdose of acetaminophen can damage the liver or cause death. If you experience a loss of appetite, pain in your upper stomach, dark urine, or jaundice (yellowing of the skin and eyes), you must immediately call a doctor. 

Fatal side effects may occur if you consume opioids with alcohol or other drugs that cause shallow breathing or drowsiness. You should stop taking hydrocodone and acetaminophen immediately, and contact your doctor, if you notice skin redness or a rash that spreads and can lead to peeling and blistering.

What are Acetaminophen and Hydrocodone?

Hydrocodone is an opioid pain medication, often referred to as a narcotic. Acetaminophen is an over-the-counter medication used to treat pain. The combination of the two medicines is used to relieve pain better. Acetaminophen and hydrocodone may also be used for other purposes not listed here.

What to Discuss with My Doctor Before Using Hydrocodone and Acetaminophen?

If you’re allergic to hydrocodone or acetaminophen, you should refrain from consuming these drugs. You should also avoid if you have any of the following:

  • A blockage in your intestines or stomach
  • Breathing problems or severe asthma
  • Liver disease
  • An alcohol or drug addiction
  • Kidney disease
  • Urination problems
  • A head injury or seizures
  • Problems with pancreas, thyroid, or gallbladder

If you’re using opioid medications while pregnant, there’s a chance your baby will become dependent on the drugs, which will cause life-threatening withdrawal symptoms once the baby is born. Babies that are born dependent on opioids will need medical treatment for several weeks as the drug exits their system.

You should not breastfeed if you’re using opioids. The medication could potentially pass into your breast milk and cause breathing problems, drowsiness, or death in a nursing newborn. 

How Should Acetaminophen and Hydrocodone Be Taken?


You should always seek alternatives to opioids, if possible. However, if your doctor deems it the only remedy for your needs, you should always follow the directions on your prescription label or use it in larger amounts for longer than prescribed. An overdose will cause damage to your liver and could lead to death. If your medication stops working to relieve your pain and you build a tolerance, don’t take more – talk to your doctor first. 

You should always check the bottle and make sure you’ve received the correct pills prescribed by your doctor. You should never share your medication with another person, especially if they have a history of drug abuse or addiction. Misuse can cause addiction, overdose, or death, meaning you should always keep the medication in a safe spot where others can’t find it. Giving away or selling hydrocodone and acetaminophen is illegal. 

If you’ve been prescribed liquid medicine, you should always measure it carefully. Use a dosing syringe or medicine dose-measuring dose – never use a kitchen spoon. 

You should never keep leftover opioid medication. A single dose can cause death in a person who uses it accidentally or improperly without a prescription. If you’re concerned, speak with your pharmacist about where to locate a drug take-back program. If there is no program available in your area, flush the unused medication down the toilet.

What Happens if You Miss a Dose?

Since this is a medication used explicitly for pain, you are not likely to miss a dose. However, in the event that you do, you should wait until your next dose. Do not use two doses simultaneously – this can lead to developing a tolerance or an overdose.

What Happens if I Overdose?

If you suspect an overdose in yourself or someone else of hydrocodone and acetaminophen, you should immediately call the Poison Help line at (800) 222-1222. Hydrocodone and acetaminophen overdose can be fatal, so if you suspect it’s severe, call 911 immediately. 

The first signs of an acetaminophen overdose include nausea, loss of appetite, vomiting, sweating, stomach pain, and confusion or weakness. Symptoms can develop into pain in your upper stomach, yellowing of your skin or the whites of your eyes, or dark urine. Overdose may also cause pinpoint pupils, muscle weakness, extreme drowsiness, slow breathing, or coma. 

What Should I Avoid While Taking Hydrocodone and Acetaminophen?

You should not operate heavy machinery or drive a motor vehicle until you know how the medication will affect you. Drowsiness and dizziness can lead to accidents, falls, or severe injuries. You should never drink alcohol while using these medications. Alcohol can exacerbate the effects of hydrocodone, and it can slow the processing of acetaminophen in the kidneys, which can be extremely damaging. 

Talk with a doctor or pharmacist before using other medication that contains acetaminophen. Certain medications can lead to a fatal overdose if taken with acetaminophen. 

Side Effects of Hydrocodone and Acetaminophen

If you experience any signs of an allergic reaction, including difficulty breathing, hives, swelling of the face, lips, tongue, or throat, seek immediate medical attention. 

Opioid medication may slow or stop breathing, which can be fatal. Someone caring for you should call 911 immediately if you have slow breathing with long pauses, are hard to wake up, or have blue-colored lips. On rare occasions, acetaminophen will cause a severe skin reaction that’s fatal. It can occur even if you’ve used acetaminophen in the past without a reaction. Stop using the medication and call your doctor immediately if you have a rash or skin redness that causes peeling or blistering. 

Contact your doctor right away if you have the following:

  • Feeling light-headed, like you might pass out
  • Noisy breathing, shallow breathing, or sighing
  • Liver problems – upper stomach pain, tiredness, nausea, dark urine, loss of appetite, clay-colored stools, jaundice
  • Low cortisol levels – loss of appetite, worseness tiredness or weakness, nausea, vomiting

What Other Drugs Affect Hydrocodone and Acetaminophen?

You could encounter breathing problems or withdrawal symptoms if you begin or stop using other medications. Always inform your doctor about medications you’re using, especially if it’s an antibiotic, heart or blood pressure medication, antifungal medication, seizure medication, or medicine used to treat hepatitis or HIV.

Opioid medication may interact with other drugs and may cause dangerous side effects or death. Be sure to inform your doctor if you use any of the following:

  • Allergy or cold medicines, diuretics (water pills), or bronchodilator asthma/COPD medication
  • Sedatives like Valium (diazepam), lorazepam, alprazolam, Klonopin, Xanax, Versed, or others
  • Other narcotic medications, such as opioid pain medicine or prescription cough medicine
  • Drugs that cause sleepiness or slow breathing – muscle relaxers, sleeping pills, or medication that treats mental illness or mood disorders
  • Drugs that affect the serotonin levels in your body – medicine for depression, stimulants like Adderall, migraine headaches, Parkinson’s disease, nausea, and vomiting, or severe infections

The list is the most common medications that could cause interactions with hydrocodone and acetaminophen. You should speak with your doctor for a more thorough list prior to using the medicine. 

If you’ve used hydrocodone in the past and developed an addiction, you should not use this medication. Using opioids once can trigger a reaction and lead you back into active addiction. It’s essential to discuss all of this information with medical professionals to determine the best possible treatment for you to lead a normal life.

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