Hydrocodone/paracetamol
Vicodin is a trademarked brand of narcotic analgesics (painkillers) containing hydrocodone and paracetamol (acetaminophen or, more-completely, para-acetylaminophenol). It is usually found in tablet form with either the names "Vicodin", "Vicodin ES", or "Vicodin HP" imprinted on one side. Analgesics with the same chemical composition and a similar physical appearance are found under many other trade names, including Anexsia, Anolor DH5, Bancap HC, Dolacet, Hydro, Lorcet, Lortab, Norco, T-Gesic, Tramacet and Vadunk. The hydrocodone/paracetamol drug formula is also available under generic brands. The paracetamol in the formula increases the effects of the hydrocodone in relieving pain but also discourages drug abuse since the doses needed for recreation would have toxic amounts of paracetamol. Oral hydrocodone is considered 4-7 times as potent as oral morphine, though the equianalgesic dose varies between patients.[1]
Manufacture
Manufacturers of Vicodin (generic or otherwise) include Abbott Laboratories (makers of trademark Vicodin), Amerisource Health Services Corp, Cardinal Health, Drx Pharmaceutical Consultants Inc, Eckerd Corp, Hospira Inc, Knoll Laboratories Div Knoll Pharmaceutical Co, Mallinckrodt Pharm. Quality Care, Pdrx Pharmaceuticals Inc, Physicians Total Care Inc, Rx Pak Div of Mckesson Corp, Sandhills Packaging Inc, and Watson Pharmaceuticals. Generic Vicodin by some of the aforementioned manufacturers is often substituted by pharmacies for prescriptions for trademark Vicodin from Abbott Labs. The generic prescriptions are much more affordable for consumers.[2] Aggregated, Vicodin production reportedly approaches twenty tons annually.
Regulation and scheduling
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 overseen and regulated by the federal government, which is also responsible (along with the Department of Justice and state governments) for the conviction and sentencing of anyone who breaks drug laws.[3]
In the U.S., Vicodin is on the Schedule III list of drugs. Other drugs on this list include anabolic steroids, dihydrocodeine, dronabinol, ergine, ketamine, paregoric, and Xyrem; codeine and hydrocodone are also Schedule III but only when compounded with paracetamol or with an NSAID. Schedule III drugs are classified by the U.S. government as potentially causing moderate or low physical dependence or a high psychological dependence if abused.
Indications
Vicodin, like other opioid analgesics, is used to manage pain. It is most commonly prescribed for relief of mild to moderate pain of acute, chronic, or post-operative types.
Side effects
Side effects for Vicodin include an allergic reaction, seizures, clammy skin, severe weakness, dizziness, hyperventilation, unconsciousness, Jaundice (yellowing of eyes or skin), unusual fatigue, bleeding, bruising, constipation, dry mouth, nausea, vomiting, decreased appetite, muscle twitches, sweating, hot flashes, 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 some. Those effects include euphoria and drowsiness, as well as slowing of the pulse.[6] Vicodin may also be a cause of stomach ulcers, although this is assumed to be due to the addition of other non-narcotic analgesics to hydrocodone preparations (e.g., aspirin, and ibuprofen). Paracetamol does not cause ulcers, unlike NSAIDS.
Popular Culture
On the medical drama House, the protagonist, Dr. Gregory House is known to have an addiction to Vicodin, which he uses to manage pain caused by the removal of dead leg muscle after he suffered an infarction.