Hydrocodone
DESCRIPTIONHydrocodone bitartrate and acetaminophen is supplied in tablet form for oral administration. Hydrocodone bitartrate is an opioid analgesic and antitussive and occurs as fine, white crystals or as a crystalline powder. It is affected by light. The chemical name is 4,5a-Epoxy-3-methoxy-17-methylmorphinan-6-one tartrate (1:1) hydrate (2:5). It has the following structural formula:
Acetaminophen, 4´-Hydroxyacetanilide, a non-opiate, non-salicylate analgesic and antipyretic. It has the following structural formula:
Hydrocodone Bitartrate and Acetaminophen Tablets USP for oral administration are available in a variety of strengths as described in the following table.
SIDE EFFECTSThe most frequently observed adverse reactions include lightheadedness, dizziness, sedation, nausea, and vomiting. These effects seem to be more prominent in ambulatory than in nonambulatory patients and some of these adverse reactions may be alleviated if the patient lies down. Other adverse reactions include: Central Nervous System: Drowsiness, mental clouding, lethargy, impairment of mental and physical performance, anxiety, fear, dysphoria, psychic dependence, mood changes. Gastrointestinal System: The antiemetic phenothiazines are useful in suppression of the nausea and vomiting which may occur; however, some phenothiazine derivatives seem to be antianalgesic and to increase the amount of narcotic required to produce pain relief, while other phenothiazines reduce the amount of narcotic required to produce a given level of analgesia. Prolonged administration of hydrocodone bitartrate and acetaminophen tablets may produce constipation. Genitourinary System: Ureteral spasm, spasm of vesical sphincters, and urinary retention have been reported. Respiratory Depression: Hydrocodone bitartrate may produce dose-related respiratory depression by acting directly on the brain stem respiratory center. Hydrocodone also affects the center that controls respiratory rhythm and may produce irregular and periodic breathing. If significant respiratory depression occurs, it may be antagonized by the use of naloxone hydrochloride. Apply other supportive measures when indicated. Dermatological: Skin rash, pruritus. DRUG ABUSE AND DEPENDENCE Hydrocodone bitartrate and acetaminophen tablets are subject to the Federal Controlled Substance Act (Schedule III). Psychic dependence, physical dependence, and tolerance may develop upon repeated administration of narcotics; therefore, hydrocodone bitartrate and acetaminophen tablets should be prescribed and administered with caution. However, psychic dependence is unlikely to develop when hydrocodone bitartrate and acetaminophen tablets are used for a short time for the treatment of pain. Physical dependence, the condition in which continued administration of the drug is required to prevent the appearance of a withdrawal syndrome, assumes clinically significant proportions only after several weeks of continued narcotic use, although some mild degree of physical dependence may develop after a few days of narcotic therapy. Tolerance, in which increasingly large doses are required in order to produce the same degree of analgesia, is manifested initially by a shortened duration of analgesic effect and subsequently by decreases in the intensity of analgesia. The rate of development of tolerance varies among patients. DRUG INTERACTIONSPatients receiving other narcotic analgesics, antipsychotics, antianxiety agents, or other CNS depressants (including alcohol) concomitantly with hydrocodone and acetaminophen tablets may exhibit an additive CNS depression. When combined therapy is contemplated, the dose of one or both agents should be reduced. The use of MAO inhibitors or tricyclic antidepressants with hydrocodone preparations may increase the effect of either the antidepressant or hydrocodone. The concurrent use of anticholinergics with hydrocodone may produce paralytic ileus. |
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Lexapro®
Suicidality in Children and
Adolescents
DESCRIPTIONLEXAPRO™ (escitalopram oxalate) is an orally administered selective serotonin reuptake inhibitor (SSRI). Escitalopram is the pure S-enantiomer (single isomer) of the racemic bicyclic phthalane derivative citalopram. Escitalopram oxalate is designated S(+)-1-[3-(dimethyl-amino)propyl]-1-(p-fluorophenyl)- 5-phthalancarbonitrile, with the following structural formula:  The molecular formula is C20H21FN2O • C2H2O4 and the molecular weight is 414.40 Escitalopram oxalate occurs as a fine white to slightly yellow powder and is freely soluble in methanol and dimethyl sulfoxide (DMSO), soluble in isotonic saline solution, sparingly soluble in water and ethanol, slightly soluble in ethyl acetate, and insoluble in heptane. LEXAPRO (escitalopram oxalate) is available as tablets or as an oral solution. LEXAPRO tablets are film coated, round tablets containing escitalopram oxalate in strengths equivalent to 5 mg, 10 mg and 20 mg escitalopram base. The 10 and 20 mg tablets are scored. The tablets also contain the following inactive ingredients: talc, croscarmellose sodium, microcrystalline cellulose/colloidal silicon dioxide, and magnesium stearate. The film coating contains hypromellose, titanium dioxide, and polyethylene glycol. LEXAPRO oral solution contains escitalopram oxalate equivalent to 1 mg/mL escitalopram base. It also contains the following inactive ingredients: sorbitol, purified water, citric acid, sodium citrate, malic acid, glycerin, propylene glycol, methylparaben, propylparaben, and natural peppermint flavor.
Lexapro®
Suicidality in Children and
Adolescents
DESCRIPTIONLEXAPRO™ (escitalopram oxalate) is an orally administered selective serotonin reuptake inhibitor (SSRI). Escitalopram is the pure S-enantiomer (single isomer) of the racemic bicyclic phthalane derivative citalopram. Escitalopram oxalate is designated S(+)-1-[3-(dimethyl-amino)propyl]-1-(p-fluorophenyl)- 5-phthalancarbonitrile, with the following structural formula: The molecular formula is C20H21FN2O • C2H2O4 and the molecular weight is 414.40 Escitalopram oxalate occurs as a fine white to slightly yellow powder and is freely soluble in methanol and dimethyl sulfoxide (DMSO), soluble in isotonic saline solution, sparingly soluble in water and ethanol, slightly soluble in ethyl acetate, and insoluble in heptane. LEXAPRO (escitalopram oxalate) is available as tablets or as an oral solution. LEXAPRO tablets are film coated, round tablets containing escitalopram oxalate in strengths equivalent to 5 mg, 10 mg and 20 mg escitalopram base. The 10 and 20 mg tablets are scored. The tablets also contain the following inactive ingredients: talc, croscarmellose sodium, microcrystalline cellulose/colloidal silicon dioxide, and magnesium stearate. The film coating contains hypromellose, titanium dioxide, and polyethylene glycol. LEXAPRO oral solution contains escitalopram oxalate equivalent to 1 mg/mL escitalopram base. It also contains the following inactive ingredients: sorbitol, purified water, citric acid, sodium citrate, malic acid, glycerin, propylene glycol, methylparaben, propylparaben, and natural peppermint flavor. |
Vicodin
Generic Name: acetaminophen and hydrocodone (a see ta MIN oh fen
and hye droe KOE doan)
What is the most important information I should know about Vicodin?Do not take Vicodin with alcohol, other narcotic pain medications, sedatives, tranquilizers, muscle relaxers, or other medicines that can make you sleepy or slow your breathing. Dangerous side effects may result. Do not take this medication without first talking to your doctor if you drink more than three alcoholic beverages per day or if you have had alcoholic liver disease (cirrhosis). You may not be able to take medication that contains acetaminophen. Hydrocodone may be habit-forming and should be used only by the person it was prescribed for. Vicodin should never be given to another person, especially someone who has a history of drug abuse or addiction. Keep the medication in a secure place where others cannot get to it. Keep track of how many tablets have been used from each new bottle of this medicine. Hydrocodone is a drug of abuse and you should be aware if any person in the household is using this medicine improperly or without a prescription. This medication can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert. Never take more Vicodin than is prescribed. Tell your doctor if the medicine seems to stop working as well in relieving your pain. You may have withdrawal symptoms when you stop using this medication after using it over a long period of time. Do not stop using Vicodin suddenly without first talking to your doctor. You may need to use less and less before you stop the medication completely. What is Vicodin?Hydrocodone is in a group of drugs called narcotic pain relievers. It is similar to codeine. Acetaminophen is a less potent pain reliever that increases the effects of hydrocodone. The combination of acetaminophen and hydrocodone is used to relieve moderate to severe pain. Vicodin may also be used for purposes other than those listed in this medication guide. What should I discuss with my healthcare provider before taking Vicodin?Do not use this medication if you are allergic to acetaminophen or hydrocodone, or other narcotic pain relievers such as fentanyl (Actiq, Duragesic), hydromorphone (Dilaudid, Palladone), methadone (Methadose, Dolophine), morphine (Kadian, MS Contin, Oramorph, and others), oxycodone (Oxycontin), and oxymorphone (Opana). Before using Vicodin, tell your doctor if you are allergic to any drugs, or if you have:
If you have any of these conditions, you may not be able to use Vicodin, or you may need a dosage adjustment or special tests during treatment. Hydrocodone may be habit-forming and should be used only by the person it was prescribed for. Vicodin should never be given to another person, especially someone who has a history of drug abuse or addiction. Keep the medication in a secure place where others cannot get to it. Keep track of how many tablets have been used from each new bottle of this medicine. Hydrocodone is a drug of abuse and you should be aware if any person in the household is using this medicine improperly or without a prescription. FDA pregnancy category C. This medication may be harmful to an unborn baby, and could cause addiction or withdrawal symptoms in a newborn. Tell your doctor if you are pregnant or plan to become pregnant during treatment. Vicodin can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby. Do not give this medicine to anyone younger than 18 years old. Older adults may be more sensitive to the effects of this medicine. How should I take Vicodin?Use this medication exactly as it was prescribed for you. Do not use the medication in larger amounts, or use it for longer than recommended by your doctor. Follow the directions on your prescription label. An overdose of acetaminophen can cause serious harm. The maximum amount of acetaminophen for adults is 1 gram (1000 mg) per dose and 4 grams (4000 mg) per day. Taking more acetaminophen could cause damage to your liver. One Vicodin tablet may contain up to 750 mg of acetaminophen. Know the amount of acetaminophen in the specific product you are taking. If your medicine contains 650 mg of acetaminophen or more per tablet, take no more than 5 tablets in 24 hours. If your medicine contains 500 mg or less of acetaminophen, take no more than 8 tablets in 24 hours. Tell your doctor if the medicine seems to stop working as well in relieving your pain. Take this medicine with a full glass of water. You may take the medication with food or milk if it causes stomach upset. Measure the liquid form of this medication with a special dose-measuring spoon or cup, not a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist where you can get one. Drink 6 to 8 full glasses of water daily to help prevent constipation while you are taking Vicodin. Ask your doctor about ways to increase the fiber in your diet. Do not use a stool softener (laxative) without first asking your doctor. If you need to have any type of surgery, tell the surgeon ahead of time that you are using Vicodin. You may need to stop using the medicine for a short time. You may have withdrawal symptoms when you stop using this medication after using it over a long period of time. Do not stop taking Vicodin suddenly without first talking to your doctor. You may need to take less and less before you stop the medication completely. Store Vicodin at room temperature away from moisture and heat. What happens if I miss a dose?Since Vicodin is sometimes used as needed, you may not be on a dosing schedule. If you are taking the medication regularly, take the missed dose as soon as you remember. If it is almost time for the next dose, skip the missed dose and wait until your next regularly scheduled dose. Do not use extra medicine to make up the missed dose. What happens if I overdose?Seek emergency medical attention if you think you have used too much of this medicine. An overdose of Vicodin can be fatal. Symptoms of an overdose may include extreme drowsiness, muscle weakness, nausea, vomiting, sweating, confusion, cold and clammy skin, shallow breathing, slow heart rate, fainting, or coma. What should I avoid while taking Vicodin?Do not use any other over-the-counter cough, cold, allergy, or pain medication without first asking your doctor or pharmacist. Acetaminophen is contained in many cold and pain medicines available over the counter. If you take certain products together you may accidentally take too much acetaminophen. Read the label of any other medicine you are using to see if it contains acetaminophen. Do not drink alcohol while you are taking Vicodin. Dangerous side effects or death can occur when alcohol is combined with hydrocodone. Check the label of any other medicines you take to be sure they do not contain alcohol. Avoid using other medicines that make you sleepy (such as cold medicine, pain medication, muscle relaxers, and medicine for seizures, depression or anxiety). They can add to sleepiness caused by hydrocodone, which could result in extreme drowsiness or coma. What are the possible side effects of Vicodin?Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Call your doctor at once if you have any of these serious side effects:
Less serious side effects are more likely to occur, such as:
Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome. What other drugs will affect Vicodin?Before taking this medication, tell your doctor if you are using any of the following drugs:
If you are using any of these drugs, you may not be able to use Vicodin, or you may need dosage adjustments or special tests during treatment. There may be other drugs not listed that can affect Vicodin. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor. Where can I get more information?
What does my medication look like?Acetaminophen and hydrocodone is available with a prescription under many brand names such as Vicodin, Lortab, Lorcet, Zydone, Hydrocet, and Co-Gesic. Other brand or generic formulations may also be available. Ask your pharmacist any questions you have about this medication, especially if it is new to you.
Vicodin Vicodin (Hydrocodone or dihydrocodeinone, not to be confused with dihydrocodeine) is a pain killer most commonly seen as a white tablet with the name "Vicodin", "Vicodin ES", or "Vicodin HP" imprinted on one side. It shares its characteristics with many other drugs in chemistry and form; such drugs are also pain killers and may be marketed as Anexsia, Anolor DH5, Bancap HC, Dolacet, Lorcet, Lortab, Norco, T-Gesic, Vicodin, or Zydone. Manufacturers Manufacturers of Vicodin (generic or otherwise) include: Abbott Laboratories, Allscripts Healthcare Solutions LLC, Amerisource Health Services Corp, Cardinal Health, Drx Pharmaceutical Consultants Inc, Eckerd Corp, Hospira Inc, Knoll Laboratories Div Knoll Pharmaceutical Co, Pdrx Pharmaceuticals Inc, Physicians Total Care Inc, Rx Pak Div of Mckesson Corp, Sandhills Packaging Inc and Watson Labs. [1] Aggregated, Vicodin production reportedly approaches 20 tons annually. In the United States, Vicodin production is regulated in part by the Controlled Substances Act of 1970. This guarantees that all manufacturing, importing, possession, and distribution of drugs is to be looked over and regulated by the federal government who are also responsible (along with the Department of Justice and state governments) for the conviction and sentencing of anyone who breaks drug laws. [2] SchedulingVicodin was put into Schedule III along with anabolic steroids, ketamine, paregoric, Xyrem, Marinol, and hydrocodone/codeine (when "compounded with an NSAID" or with paracetamol); these drugs have high psychological dependence and low to medium physical addiction. [3] SurgeryVicodin is most commonly prescribed for persons experiencing pain after surgery or intense pain. It helps calm a person down and increases their ability to relax and forget about painful ailments (which speeds up recovery).[citation needed] Interactions and contraindicationsDrugs that should be avoided in order to decrease the chance of side effects are isocarboxazid (Marplan), phenelzine (Nardil), tranylcypromine (Parnate), or other monoamine oxidase inhibitors (MAOI’s) 14 days prior to use. Acetaminophen should also be avoided so as to decrease chances of destroying the liver. In addition, alcohol increases the drowsiness already caused by Vicodin and may result in a person's becoming unconscious or, much worse, dead. Aside from alcohol, other drugs that induce drowsiness should also be avoided (e.g., antidepressants, antihistamines, pain killers, muscle relaxants, etc.) so as to decrease chances of contracting Vicodin’s severe side effects. Furthermore, if a person experiences Addison’s Disease, kidney disease, gallbladder diseases, liver disease, complications with the thyroid, severe head injuries, asthma, or alcohol abuse, Vicodin should not be taken for fear of worsening the condition. Use during pregnancy and lactationThe Food and Drug Administration (FDA) has put Vicodin in category C. This category includes any and all drugs which have not been tested in pregnancies therefore the effects of the drug on newborns have not been determined. The FDA does ensure a warning to breastfeeding mothers telling them that Vicodin does pass into breast milk, which can have adverse effects on nursing babies. Side effectsSide effects for Vicodin include an allergic reaction, weak breathing, seizures, clammy skin, severe weakness, dizziness, unconsciousness, yellowing of eyes or skin, unusual fatigue, bleeding, or bruising, constipation, dry mouth, nausea, vomiting, decreased appetite, muscle twitches, sweating, itching, tinnitus, hearing loss, decreased urination, and decreased sex drive. [4] Vicodin (in terms of hydrocodone) also has depressant effects on the central nervous system. [5] However, some of the less mundane effects can be desirable effects that are sought after by many drug addict victims. Those effects include a great euphoria and drowsiness, as well as slowing the pulse.[6] Vicodin has also been linked to causing stomach ulcers. Overdose symptomsSymptoms of a Vicodin overdose may include slow breathing, cold and clammy skin, dizziness, weakness, loss of consciousness, confusion, small pupils, tiredness, coma, nausea, vomiting, and sweating, and an overdose may lead to death. AddictionAddiction to Vicodin is similar to other powerful addictions; cravings for the drug take hold of a person and may even supersede a person’s need for food or water.[7] The hydrocodone component of Vicodin is the reason for its abuse. Hydrocodone is derived from an opiate, the chemical effects of which are similar to those of heroin (although not quite as strong) and are highly addictive. It increases the activity of the neurotransmitter dopamine, causing a strong euphoria.[8] Withdrawal symptomsThe symptoms of Vicodin withdrawal include but are not limited to restlessness, muscle pain, bone pain, insomnia, diarrhea, vomiting, cold flashes, goose bumps, involuntary leg movements, watery eyes, runny nose, loss of appetite, irritability, panic, nausea, chills, and sweating. [9][10] Alcohol and abuseVicodin's effects of disorientation, relaxation, and euphoria have been tampered with by mixing them with other drugs, but the most common method has been by mixing them with alcohol. Combined, the drunken effects of alcohol are heightened and brought upon faster. The Do It Now Foundation states that, "Vicodin and other prescription narcotics constitute the most-abused group of prescription drugs, according to the National Household Survey, released in 2001. Of the four million Americans who reported misusing prescription drugs the previous year, nearly 65 percent misused prescription Analgesics. Vicodin use has soared in recent years, partly fueled by the fame of its star user base." The number of 12-17 year-old users jumped 127 percent between 1996 and 2000, according to one national survey. Brand name:Vicodin
Pronounced: VY-koe-din Why is this drug prescribed?Vicodin combines a narcotic analgesic (painkiller) and cough reliever with a non-narcotic analgesic for the relief of moderate to moderately severe pain. Most important fact about this drugVicodin can be habit-forming. If you take this drug over a long period of time, you can become mentally and physically dependent on it, and you may find the drug no longer works for you at the prescribed dosage. How should you take this medication?Take Vicodin exactly as prescribed. Do not increase the amount you take or the frequency without your doctor's approval. Do not take this drug for any reason other than the one prescribed. Do not give this drug to others who may have similar symptoms. --If you miss a dose... If you take Vicodin regularly, take the forgotten dose as soon as you remember. If it is almost time for your next dose, skip the one you missed and go back to your regular schedule. Do not take 2 doses at once. --Storage instructions... Store at room temperature in a tightly closed container, away from light. What side effects may occur?Side effects cannot be anticipated. ( NOT THAT REALLY HELPS A LOT. ) If any develop or change in intensity, inform your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking Vicodin.
If these side effects occur, it may help if you lie down after taking the medication. Why should this drug not be prescribed?If you are sensitive to or have ever had an allergic reaction to hydrocodone, similar narcotic painkillers, or acetaminophen (Tylenol), you should not take this medication. Make sure your doctor is aware of any drug reactions you have experienced. Special warnings about this medicationVicodin may make you drowsy, less alert, or unable to function well physically. Do not drive a car, operate machinery, or perform any other potentially dangerous activities until you know how this drug affects you. Use caution in taking Vicodin if you have a head injury. Narcotics tend to increase the pressure of the fluid within the skull, and this effect may be exaggerated by head injuries. Side effects of narcotics can interfere in the treatment of people with head injuries. Use Vicodin with caution if you have a severe liver or kidney disorder, an underactive thyroid gland, Addison's disease (a disease of the adrenal glands), an enlarged prostate, or urethral stricture (narrowing of the tube carrying urine from the bladder). Older adults and those in a weakened condition should be careful using this drug, since it contains a narcotic. Narcotics such as Vicodin may interfere with the diagnosis and treatment of people with abdominal conditions. Hydrocodone suppresses the cough reflex; therefore, be careful using Vicodin after an operation or if you have a lung disease. High doses of hydrocodone may produce slowed breathing; if you are sensitive to this drug, you are more likely to experience this effect. Possible food and drug interactions when taking this medication |