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What is hydrocodone-ibuprofen?

Hydrocodone is in a group of drugs called narcotic pain relievers.

Ibuprofen is in a group of drugs called nonsteroidal anti-inflammatory drugs (NSAIDs). Ibuprofen works by reducing hormones that cause inflammation and pain in the body.

The combination of hydrocodone and ibuprofen is used short-term to relieve severe pain. This medication is not for treating arthritis pain.

Hydrocodone and ibuprofen may also be used for other purposes not listed in this medication guide.

Precautions

Instructions

Side-effects

Interactions

Precautions

Do not use this medication if you are allergic to hydrocodone or ibuprofen (Advil, Motrin).

Hydrocodone may be habit-forming and should be used only by the person this medicine was prescribed for. This medication should never be shared with 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.

Taking ibuprofen can increase your risk of life-threatening heart or circulation problems, including heart attack or stroke. Do not use this medicine just before or after having heart bypass surgery (also called coronary artery bypass graft, or CABG).

Ibuprofen can also increase your risk of serious effects on the stomach or intestines, including bleeding or perforation (forming of a hole). These conditions can be fatal and can occur without warning at any time while you are taking ibuprofen.

Do not use this medication if you are allergic to ibuprofen (Advil, Motrin) or other NSAIDs such as Aleve, Orudis, Indocin, Lodine, Voltaren, Toradol, Mobic, Relafen, Feldene, and others.

Before using hydrocodone and ibuprofen, tell your doctor if you have:

• heart disease, congestive heart failure, high blood pressure, or a history of heart attack, stroke, or blood clot;
• asthma or other breathing disorders;
• liver or kidney disease;
• a history of head injury or brain tumor;
• stomach or intestinal disorder, history of stomach ulcer or bleeding;
• underactive thyroid, Addison's disease or other adrenal gland disorder;
• curvature of the spine;
• an enlarged prostate or problems with urination; or
• mental illness or a history of drug or alcohol addiction.

If you have any of these conditions, you may not be able to use hydrocodone and ibuprofen, or you may need a dosage adjustment or special tests during treatment.

FDA pregnancy category C. This medication may be harmful to an unborn baby, and could cause breathing problems or addiction/withdrawal symptoms in a newborn. Taking ibuprofen during the last 3 months of pregnancy may result in birth defects. Do not take hydrocodone and ibuprofen during pregnancy unless your doctor has told you to.

Hydrocodone and ibuprofen may pass into breast milk and could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

Older adults may be more sensitive to the effects of this medicine.

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.

Do not use any other over-the-counter cold, allergy, or pain medication without first asking your doctor or pharmacist. Many medicines available over the counter contain ibuprofen or similar medicines. Read the label of any other medicine you are using to see if it contains ibuprofen, ketoprofen, or naproxen.

Avoid drinking alcohol while taking hydrocodone and ibuprofen. Alcohol can increase your risk of stomach bleeding caused by ibuprofen.

Tell your doctor if you regularly use other medicines that make you sleepy (such as cold or allergy medicine, other narcotic pain medicine, sleeping pills, muscle relaxers, and medicine for seizures, depression, or anxiety). They can add to sleepiness caused by hydrocodone.

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Instructions

Seek emergency medical attention if you think you have used too much of this medicine. An overdose of hydrocodone and ibuprofen can be fatal.

Overdose symptoms may include extreme drowsiness, nausea, vomiting, dark urine, jaundice (yellowing of the skin or eyes), black or bloody stools, coughing up blood, urinating less than usual or not at all, confusion, ringing in your ears, pinpoint pupils, weak pulse, slow heart rate, blue lips, shallow breathing, or fainting.

Since hydrocodone and ibuprofen is taken 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.

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Side-effects

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:

• chest pain, weakness, shortness of breath, slurred speech, problems with vision or balance;
• sudden numbness or weakness, headache, confusion, or problems with vision, speech, or balance;
• black, bloody, or tarry stools, coughing up blood or vomit that looks like coffee grounds;
• swelling or rapid weight gain;
• shallow breathing, slow heartbeat;
• confusion, feeling light-headed, fainting;
• easy bruising or bleeding;
• nausea, stomach pain, loss of appetite, itching, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);
• severe blistering, peeling, and red skin rash; or
• fever, headache, neck stiffness, chills, increased sensitivity to light, purple spots on the skin, and/or seizure (convulsions).

Less serious side effects may include:

• headache, dizziness, drowsiness;
• mild nausea, vomiting, upset stomach, constipation, diarrhea;
• blurred vision; or
• dry mouth.

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect.

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Interactions

Before taking this medication, tell your doctor if you are using any of the following drugs:

• antidepressants such as amitriptyline (Elavil, Etrafon) or imipramine (Janimine, Tofranil);
• an MAO inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate);
• aspirin or other NSAIDs (non-steroidal anti-inflammatory drugs) such as diclofenac (Voltaren), etodolac (Lodine), indomethacin (Indocin), naproxen (Aleve, Naprosyn), and others;
• an ACE inhibitor such as benazepril (Lotensin), captopril (Capoten), fosinopril (Monopril), enalapril (Vasotec), lisinopril (Prinivil, Zestril), quinapril (Accupril), and others;
• lithium (Eskalith, Lithobid);
• a bronchodilator (such as Atrovent, Spiriva), diuretics (water pills), steroid medicines, or blood thinners;
• methotrexate (Rheumatrex, Trexall);
• an injected narcotic medication such as pentazocine (Talwin), butorphanol (Stadol), or nalbuphine Nubain);
• atropine (Donnatal), dimenhydrinate (Dramamine), or scopolamine (Transderm-Scop); or
• bowel or bladder medications such as dicyclomine (Bentyl), hyoscyamine (Anaspaz, Cystospaz, Levsin), tolterodine (Detrol) and others.

This list is not complete and there may be other drugs that can interact with hydrocodone and ibuprofen. 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.

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