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Com Hydrocodone or dihydrocodeinone (marketed as Vicodin, Anexsia, Dicodid, Hycodan, Hycomine, Lorcet, Lortab, Norco, Novahistex, Hydroco, Tussionex, Vicoprofen) is a semi-synthetic opioid derived from two of the naturally occurring opiates, codeine and thebaine. Com Hydrocodone is an orally active narcotic analgesic and antitussive. Sales and production of this drug have increased significantly in recent years, as have diversion and illicit use. Com Hydrocodone is commonly available in tablet, capsule and syrup form.

As a narcotic, Com Hydrocodone relieves pain by binding to opioid receptors in the brain and spinal cord. It may be taken with or without food. When taken with alcohol, it can intensify drowsiness. It may interact with monoamine oxidase inhibitors, as well as other drugs that cause drowsiness. It is in FDA pregnancy category C: its effect on an embryo or fetus is not clearly known and pregnant women should consult their physicians before taking it. Common side effects of Com Hydrocodone include dizziness, lightheadedness, nausea, drowsiness, euphoria, vomiting, and constipation. Some less common side effects are allergic reaction, blood disorders, changes in mood, mental fogginess, anxiety, lethargy, difficulty urinating, spasm of the ureter, irregular or depressed respiration and rash.

Com Hydrocodone can be habit-forming , and can lead to physical and psychological addiction. In the U.S., pure Com Hydrocodone and forms containing more than 15 mg per dosage unit are considered Schedule II drugs. Those containing less than or equal to 15 mg per dosage unit in combination with acetaminophen or another non-controlled drug are called Com Hydrocodone compounds and are considered Schedule III drugs. Com Hydrocodone is typically found in combination with other drugs such as paracetamol (acetaminophen), aspirin, ibuprofen and homatropine methylbromide. The purpose of the non-controlled drugs in combination is often twofold. 1) To provide increased analgesia via drug synergy. 2) To limit the intake of Com Hydrocodone by causing unpleasant and often unsafe side effects at higher than prescribed doses (See Below). In the UK it is listed as a Class A drug under the Misuse of Drugs Act 1971.

Overdosing risks

The presence of acetaminophen in Com Hydrocodone -containing products deters many drug users from taking excessive amounts. However, some users will get around this by extracting a portion of the acetaminophen using hot/cold water, taking advantage of the water-soluble element of the drug. It is not uncommon for addicts to have liver problems from consuming excessive amounts of acetaminophen over a long period of time; taking 10,000 to 15,000 milligrams (10 to 15 grams) of acetaminophen in a period of 24 hours typically results in severe hepatotoxicity, and doses in the range of 15,000-20,000 milligrams a day have been reported as fatal. It is this factor that leads many addicts to use only single entity opiates such as OxyContin.

Daily consumption of Com Hydrocodone should not exceed 40 milligrams in patients not tolerant to opiates. However, it clearly states in the 2006 PDR (Physicians Desk Reference) that Norco 10, containing 10 milligrams of Com Hydrocodone and 325 milligrams of APAP (viz., acetaminophen or paracetamol), can be taken at a dosage of up to twelve tablets per day (120 milligrams of Com Hydrocodone. Such high amounts of Com Hydrocodone are only intended for opiate-tolerant patients, and titration to such levels must be monitored very carefully. This restriction is only limited by the fact that twelve tablets, each containing 325 milligrams of APAP, puts the patient right below the 24-hour FDA maximum of 4,000 mg of APAP. Some specially compounded products are routinely given to chronic pain patients in doses of up to 180 mg of Com Hydrocodone per day. Tolerance to this drug can increase very rapidly if abused. Because of this, addicts often overdose from taking handfulls of pills, in pursuit of the high they experienced very early on in their Com Hydrocodone use. Symptoms of Com Hydrocodone overdosage include respiratory depression, extreme somnolence, coma, stupor, cold and/or clammy skin, sometimes bradycardia, and hypotension. A severe overdose of Com Hydrocodone may involve circulatory collapse cardiac arrest and/or death.

Alcohol

It is not recommended to mix any amount of Com Hydrocodone with any amount of alcohol as doing so could cause health problems. APAP is metabolized solely by the liver. Therefore the risk of fatal overdose due to hepatotoxicity can occur with significantly lower levels of APAP when mixed with ethanol. This fact is often neither known nor given credence as it does not stop people from mixing them due to the feeling of euphoria it provides.

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