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NERVOUS SYSTEM › ANALGESICS › OPIOIDS › Opioids in combination with non-opioid analgesics
hydrocodone and ibuprofen
N02AJ23
Forms & Strengths
- Tablet: hydrocodone bitartrate 2.5 mg / ibuprofen 200 mg
- Tablet: hydrocodone bitartrate 5 mg / ibuprofen 200 mg
- Tablet: hydrocodone bitartrate 7.5 mg / ibuprofen 200 mg
- Tablet: hydrocodone bitartrate 10 mg / ibuprofen 200 mg
Adult Dosing
- 1 to 2 tablets every 4 to 6 hours as needed for pain
- Maximum daily dose: 5 tablets
- Limit therapy to shortest duration consistent with individual patient treatment goals
Pediatric Dosing
- Safety and efficacy in pediatric patients have not been established
Indications
- Short-term management of acute moderate to moderately severe pain
Mechanism of Action
- Hydrocodone is a full mu-opioid agonist with primary action in the CNS for analgesia
- Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that inhibits prostaglandin synthesis via cyclooxygenase (COX-1 and COX-2) inhibition
Contraindications
- Known hypersensitivity to hydrocodone, ibuprofen, or any component of the product
- History of asthma, urticaria, or allergic-type reactions after taking aspirin or other NSAIDs
- In the setting of coronary artery bypass graft (CABG) surgery
- Significant respiratory depression
- Acute or severe bronchial asthma in an unmonitored setting or lack of resuscitative equipment
- Known or suspected gastrointestinal obstruction, including paralytic ileus
Adverse Reactions
- Dizziness, lightheadedness, sedation, fatigue
- Nausea, vomiting, constipation, dyspepsia, abdominal pain
- Headache, nervousness
- Rash, pruritus
- Serious: Respiratory depression, GI ulceration/bleeding, hepatotoxicity, renal impairment, cardiovascular thrombotic events
Drug Interactions
- Concomitant use with CNS depressants (alcohol, benzodiazepines, other opioids) increases risk of profound sedation, respiratory depression, coma, and death
- Strong CYP3A4 inhibitors or inducers may alter hydrocodone metabolism
- Anticoagulants (warfarin) and antiplatelet agents (aspirin) increase bleeding risk when combined with ibuprofen
- ACE inhibitors, angiotensin receptor blockers, and diuretics may have reduced efficacy and increased risk of renal impairment when combined with NSAIDs
- Lithium and methotrexate toxicity may be enhanced due to decreased renal clearance caused by ibuprofen
Curated Content: Needs Vetting Before Put to Clinical Use