Hydrocodone: what it treats, how to take it, and side effects
Last updated September 6, 2026.
**Hydrocodone is an opioid pain medicine that is sold only in combination with another drug, most often acetaminophen or ibuprofen.** Hydrocodone attaches to opioid receptors in the brain and spinal cord, which changes how your body registers and responds to pain, while the partner drug lowers pain and inflammation through a separate route. The single most important safety point is that hydrocodone slows breathing, and that effect is much stronger when it is combined with alcohol, benzodiazepines, muscle relaxants, sleep medicines, or any other sedating drug.
What does it treat?
Hydrocodone combination products are prescribed for acute moderate to severe pain when non-opioid options such as acetaminophen, ibuprofen, or naproxen have not controlled the pain or are not appropriate for you. Typical situations include pain after dental surgery or a broken bone, pain in the first days after an operation, a significant injury, or a painful kidney stone. The most common product is hydrocodone with acetaminophen, sold under names such as Norco and Lortab, and available in strengths like 5 mg/325 mg, 7.5 mg/325 mg, and 10 mg/325 mg. Hydrocodone with ibuprofen (Vicoprofen, 7.5 mg/200 mg) is another option. Separate hydrocodone cough products combined with chlorpheniramine or homatropine exist for cough in adults, and FDA restricts those to people 18 and older.
How do you take it?
Hydrocodone combinations come as tablets, capsules, and oral solutions, and are taken by mouth as needed rather than on a fixed schedule. For hydrocodone 5 mg/acetaminophen 325 mg tablets, a common adult dose from the label is one or two tablets every 4 to 6 hours as needed, up to 8 tablets in 24 hours; for the 7.5 mg/325 mg and 10 mg/325 mg strengths it is one tablet every 4 to 6 hours as needed, up to 6 tablets in 24 hours. Total acetaminophen from every source combined, including cold medicines and over the counter pain relievers, must stay at or below 4,000 mg in 24 hours. For hydrocodone 7.5 mg/ibuprofen 200 mg, the label dose is one tablet every 4 to 6 hours as needed, no more than 5 tablets in 24 hours, and generally for less than 10 days. You can take these with or without food, and taking them with food or milk helps if they upset your stomach. Because these are as-needed medicines, there is no missed dose to make up: take the next dose when you need it and when the interval has passed, and never double up or take a dose early. Call your doctor if the pain is not controlled at the prescribed dose, if you feel very sleepy or confused, if your breathing feels slow or shallow, or if you have been taking it for more than a few days and want to stop, since stopping suddenly after regular use can cause withdrawal symptoms such as restlessness, sweating, chills, muscle aches, and diarrhea.
Side effects to know
- Common: Common effects include drowsiness, dizziness or lightheadedness when you stand up, nausea, vomiting, constipation, dry mouth, and headache, and constipation is expected enough that many clinicians start a stool softener or laxative at the same time.
- Serious: Stop the medicine and get help right away for slow, shallow, or noisy breathing, extreme sleepiness or being hard to wake, blue or gray lips or fingertips, chest tightness, hives, or swelling of the face, lips, tongue, or throat. Also call your doctor promptly for yellowing of the skin or eyes, dark urine, or right upper belly pain, which can signal acetaminophen liver injury, and for black or bloody stools or vomit that looks like coffee grounds with the ibuprofen combination.
Who should not take it?
Do not take hydrocodone combinations if you have significant breathing problems such as severe asthma, COPD with carbon dioxide retention, or untreated sleep apnea, if you have a blockage in your stomach or intestines, or if you have had an allergic reaction to hydrocodone, acetaminophen, or ibuprofen. Talk to your doctor first if you have liver disease or drink alcohol regularly, kidney disease, heart failure, high blood pressure, a history of stomach ulcers or bleeding, head injury or seizures, adrenal or thyroid problems, an enlarged prostate or trouble urinating, or a personal or family history of opioid or alcohol use disorder. Tell your doctor about every other medicine you take, especially benzodiazepines such as alprazolam or lorazepam, sleep medicines, muscle relaxants, gabapentin or pregabalin, other opioids, MAO inhibitors used in the past 14 days, antidepressants and triptans that raise serotonin, and drugs that change hydrocodone levels such as erythromycin, clarithromycin, ketoconazole, ritonavir, rifampin, and carbamazepine. Check every other product for acetaminophen or ibuprofen so you do not double up. Prolonged use during pregnancy can cause neonatal opioid withdrawal syndrome in the newborn, so use in pregnancy only with a doctor guiding it, and current labeling advises against breastfeeding while taking hydrocodone because the drug passes into breast milk and can make the baby too sleepy or slow the baby's breathing. Do not drink alcohol at all while taking this medicine, and do not drive or operate machinery until you know how it affects you.
When is it an emergency?
Call 911 if someone taking hydrocodone has slow, shallow, or stopped breathing, cannot be woken up, has blue or gray lips or skin, collapses, or has a seizure, and give naloxone (Narcan) if you have it, then stay with them until help arrives. Pinpoint pupils, limp muscles, and cold clammy skin along with heavy sleepiness are the classic overdose picture. Call 911 also for hives with swelling of the face, lips, tongue, or throat, or trouble breathing or swallowing, which can be anaphylaxis. For any suspected overdose or extra dose, including taking too much acetaminophen, call Poison Control at 1-800-222-1222 right away even if the person seems fine, because acetaminophen liver damage can be silent for the first day and treatment works best when it starts early.
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Common questions
What is the maximum amount I can take in a day?
It depends on the strength you were prescribed. For hydrocodone 5 mg/acetaminophen 325 mg tablets, the label allows one or two tablets every 4 to 6 hours as needed, up to 8 tablets in 24 hours. For the 7.5 mg/325 mg and 10 mg/325 mg strengths, it is one tablet every 4 to 6 hours as needed, up to 6 tablets in 24 hours. For hydrocodone 7.5 mg/ibuprofen 200 mg, it is one tablet every 4 to 6 hours as needed, up to 5 tablets in 24 hours. The separate hard ceiling is acetaminophen: no more than 4,000 mg in 24 hours from all sources combined, and your prescriber may set a lower limit if you have liver disease or drink alcohol.
Can I drink alcohol while taking hydrocodone?
No. Alcohol and hydrocodone both slow breathing, and together the effect is larger than either alone, which is how many opioid deaths happen. Alcohol also raises the risk of liver damage from the acetaminophen in the combination and the risk of stomach bleeding from the ibuprofen combination. This applies to beer and wine, not just spirits, and to any amount while the medicine is still in your system. If you drink regularly, tell your doctor before you start, because that changes what is safe for you.
Is it safe during pregnancy or while breastfeeding?
Occasional short-term use in pregnancy is sometimes appropriate, but that is a decision to make with your doctor. Taking hydrocodone for a prolonged period during pregnancy can cause neonatal opioid withdrawal syndrome, where the newborn needs treatment for withdrawal after birth. Current FDA labeling advises against breastfeeding while taking hydrocodone, because the drug passes into breast milk and can cause excess sleepiness and slowed breathing in the baby. If you are nursing and need pain control, ask about acetaminophen or ibuprofen alone, which are compatible with breastfeeding. Tell your doctor if you are pregnant, might be pregnant, or are nursing before you fill the prescription.
Do I need to take it with food?
You can take it with or without food. If it upsets your stomach or makes you nauseated, take it with food, milk, or a snack, which often helps. The hydrocodone and ibuprofen combination is better taken with food, since ibuprofen is easier on the stomach that way. Drink water with each dose and keep drinking fluids through the day, which also helps with constipation. Do not take it with alcohol at any point.
What are the signs of an overdose?
The warning signs are heavy sleepiness or being unable to wake the person, slow or shallow or stopped breathing, loud snoring or gurgling that is new, pinpoint pupils, limp muscles, cold and clammy skin, and blue or gray lips, fingertips, or skin. Call 911 immediately and give naloxone (Narcan) if it is available, then stay with the person. Acetaminophen overdose looks different and can be quiet at first, with only nausea and vomiting before liver damage shows up a day or two later. For any suspected overdose, including one extra dose or a mix-up with another acetaminophen product, call Poison Control at 1-800-222-1222 right away even if the person seems fine.
What other medicines interact with it?
The most dangerous interactions are with other things that sedate you: benzodiazepines such as alprazolam, lorazepam, or clonazepam, sleep medicines, muscle relaxants, gabapentin and pregabalin, other opioids, and alcohol. Any product that also contains acetaminophen, including many cold, flu, and sleep combinations and prescription pain pills, can push you over the 4,000 mg daily limit without your noticing, so read every label. Drugs that change how your body breaks down hydrocodone, such as erythromycin, clarithromycin, ketoconazole, ritonavir, rifampin, and carbamazepine, can raise or lower its effect. MAO inhibitors taken within the past 14 days and serotonergic drugs such as SSRIs, SNRIs, and triptans raise the risk of serious reactions. Give your doctor or pharmacist a full list, including over the counter products and supplements.