Hydrocodone Bitartrate/Ibuprofen, Oral hy-droh-KOH-done bi-TAR-trate eye-byoo-PROH-fen

What are other names for this medicine?

Type of medicine: narcotic analgesic (painkiller); anti-inflammatory

Generic and brand names: hydrocodone bitartrate/ibuprofen, oral; Ibudone; Vicoprofen; Reprexain

What is this medicine used for?

This medicine is taken by mouth to help relieve pain. It contains both a narcotic pain reliever (hydrocodone) and an anti-inflammatory (ibuprofen).

What should my healthcare provider know before I take this medicine?

Before taking this medicine, tell your healthcare provider if you have ever had:

• an allergic reaction to any medicine
• a breathing disorder or lung problem such as asthma
• a head injury, brain tumor, or stroke
• Addison's disease
• bleeding problems or blood disorders
• enlarged prostate gland or trouble urinating
• heart disease or a heart attack
• high blood pressure
• liver or kidney disease
• problems with alcohol or drug abuse
• thyroid problems
• stomach ulcers

Also, tell your healthcare provider if you are taking any medicines to thin your blood.

Females of childbearing age: Talk with your healthcare provider if you are pregnant or plan to become pregnant. This medicine is not recommended for use in late pregnancy because it may harm the baby. Do not breast-feed while taking this medicine without your healthcare provider's approval.

How do I take it?

Check the label on the medicine for directions about your specific dose. Take this medicine exactly as your healthcare provider prescribes. Do not take more or for a longer period of time than prescribed because this medicine may be habit-forming. Usually you will take it for 10 days or less. Also, taking too much of this medicine may increase your risk of side effects. Do not take more than 5 tablets in any one day.

Take this medicine with food, milk or a light snack to lessen the chance the drug will upset your stomach.

What if I overdose?

If you or anyone else has intentionally taken too much of this medicine, call 911 or go to the emergency room right away. If you pass out, have seizures, weakness or confusion, or have trouble breathing, call 911. If you think that you or anyone else may have taken too much of this medicine, call the poison control center. Do this even if there are no signs of discomfort or poisoning. The poison control center number is 800-222-1222.

Symptoms of an acute overdose may include: extreme drowsiness, pinpoint pupils, confusion, breathing that stops, slow heartbeat, nausea, diarrhea, stomach pain, sweating, seizures, irregular heartbeat, dark urine, yellowing of the skin or eyes, muscle weakness, vomiting blood, bloody stools, decreased urination, coma.

What should I watch out for?

Warning: Occasionally, this medicine may cause bleeding, ulcers, or perforation of the stomach or intestines. These problems may occur without warning symptoms. You may be at higher risk if you smoke, are over the age of 65 or in poor health, drink alcohol, or take this medicine for a long time. If you have abdominal pain, a black tarry stool, or a bloody stool, stop taking this medicine and contact your healthcare provider right away.

This medicine has been linked with increased risk for high blood pressure. Also, taking this medicine for a long time may make it more likely that you will have a heart attack or stroke. Talk with your healthcare provider about this.

You may have swelling of the ankles, feet, or hands while taking this medicine. If this becomes bothersome, contact your healthcare provider.

This medicine should not be used right before or after a heart surgery called coronary artery bypass graft (CABG). Talk with your healthcare provider about this.

This medicine increases the effects of alcohol and other drugs that slow down your nervous system. Do not drink alcohol or take other medicines unless your healthcare provider approves.

This medicine may make you dizzy or drowsy. Do not drive or operate machinery unless you are fully alert.

This medicine is a controlled substance. It is illegal for you to give it to anyone else.

If you need emergency care, surgery, or dental work, tell the healthcare provider or dentist you are taking this medicine.

What are the possible side effects?

Along with its needed effects, your medicine may cause some unwanted side effects. Some side effects may be very serious. Some side effects may go away as your body adjusts to the medicine. Tell your healthcare provider if you have any side effects that continue or get worse.

Life-threatening (Report these to your healthcare provider right away. If you cannot reach your healthcare provider right away, get emergency medical care or call 911 for help): Allergic reaction (hives; itching; rash; trouble breathing; tightness in your chest; swelling of your lips, tongue, and throat).

Serious (report these to your healthcare provider right away): Black tarry or bloody stools; swelling of your feet, ankles, or legs; fever; muscle aches and pains; unusual tiredness; unusual bleeding or bruising; skin rash or blisters with fever; yellowing of your skin or eyes; severe or continued stomach pain; vision changes.

Other: Headache, nausea, vomiting, diarrhea, constipation, drowsiness, dizziness, thirst, dry mouth, trouble urinating, trouble sleeping, heartburn, ringing in your ears.

What products might interact with this medicine?

When you take this medicine with other medicines, it can change the way this or any of the other medicines work. Nonprescription medicines, vitamins, natural remedies, and certain foods may also interact. Using these products together might cause harmful side effects. Talk to your healthcare provider if you are taking:

• ACE inhibitors such as benazepril (Lotensin), captopril, enalapril (Vasotec), fosinopril, lisinopril (Prinivil, Zestril), quinapril (Accupril), and ramipril (Altace)
• alcohol
• antianxiety medicines such as alprazolam (Xanax), clonazepam (Klonopin), clorazepate (Tranxene), diazepam (Valium), flurazepam, lorazepam (Ativan), oxazepam, temazepam (Restoril), and triazolam (Halcion)
• anticholinergic medicines such as amantadine (Symmetrel), belladonna, benztropine (Cogentin), dicyclomine (Bentyl), hyoscyamine (Levsin, Levsinex), methscopolamine (Pamine), procyclidine (Kemadrin), propantheline (Pro-Banthine), and trihexyphenidyl
• antiplatelet drugs such as aspirin, aspirin/dipyridamole (Aggrenox), clopidogrel (Plavix), and dipyridamole (Persantine)
• antipsychotic medicines such as chlorpromazine, olanzapine (Zyprexa), prochlorperazine, promazine (Sparine), risperidone (Risperdal), thioridazine, trifluoperazine, and ziprasidone (Geodon)
• antihistamines such as brompheniramine (Dimetane), chlorpheniramine (Chlor-Trimeton), diphenhydramine (Benadryl), and promethazine (Phenergan)
• diuretics such as chlorthalidone (Hygroton), furosemide (Lasix), hydrochlorothiazide, and indapamide (Lozol)
• lithium (Lithobid)
• MAO inhibitor antidepressants such as phenelzine (Nardil), tranylcypromine (Parnate), and isocarboxazid (Marplan) (Do not take this medicine and an MAO inhibitor within 14 days of each other.)
• methotrexate (Rheumatrex, Trexall)
• narcotic pain medicines such as codeine, fentanyl (Duragesic, Actiq), hydrocodone (Vicodin, Lortab), meperidine (Demerol), oxycodone (OxyContin), oxycodone/acetaminophen (Percocet, Tylox), and pentazocine (Talwin)
• natural remedies such as alfalfa, anise, bilberry, garlic, ginger, ginkgo biloba, ginseng, green tea, horse chestnut, licorice, red clover, and SAMe
• nonsteroidal anti-inflammatory medicines (NSAIDs) such as diclofenac (Voltaren, Cataflam), ibuprofen (Motrin, Motrin IB, Advil), indomethacin (Indocin), ketoprofen, ketorolac (Toradol), nabumetone (Relafen), naproxen (Naprosyn, Anaprox, Aleve, Naprelan), oxaprozin (Daypro), piroxicam (Feldene), and sulindac (Clinoril)
• sedatives such as amobarbital (Amytal), butabarbital (Butisol), phenobarbital, triazolam (Halcion), zaleplon (Sonata), and zolpidem (Ambien)
• tricyclic antidepressants such as amitriptyline, desipramine (Norpramin), doxepin, imipramine (Tofranil), and nortriptyline (Pamelor)
• warfarin (Coumadin)

If you are not sure if your medicines might interact, ask your pharmacist or healthcare provider. Keep a list of all your medicines with you. List all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take. Be sure that you tell all healthcare providers who treat you about all the products you are taking.

How should I store this medicine?

Store this medicine at room temperature. Keep the container tightly closed. Protect it from heat, high humidity, and bright light.

This advisory includes selected information only and may not include all side effects of this medicine or interactions with other medicines. Ask your healthcare provider or pharmacist for more information or if you have any questions.

Ask your pharmacist for the best way to dispose of outdated medicine or medicine you have not used. Do not throw medicine in the trash.

Keep all medicines out of the reach of children.

Do not share medicines with other people.