I have summoned Qadgop the Mercotan!!!
Yep, totally useless. In fact, the only effect Vicodin had on me when I was suffering migraines was to drastically increase my nausea.
I’ve taken Vicodin since 91 for my chronic pains and I’ve taken Ibuprofen for inflammation so I wondered why no Hydrocodone/Ibuprofen combo that I hear of.
This. Both these reason. There are some very good studies showing that the combination gives greater pain relief than either separately, and mixing the two and thus punishing those ‘bad people’ who abuse it appeals to the law and order crowd. The first is demonstrated factual, the second is just my opinion.
It’s a real shame that acetaminophen gets prescribed as part of a pair like this.
It’s useless or nearly so as a pain reliever/anti-inflammatory in many cases. Link 1. Link 2. Link 3.
And if you’re taking the combo, then you have to limit taking a more effective OTC drug with it.
Toss in the “it might kill you” aspect and it’s a miracle it’s widely prescribed at all.
I’m going to call BS on everyone who says the acetaminophen in hydrocodone/APAP combo pills is put there to deter abuse.
Find me a cite…
Hydrocodone is also paired with ibuprofen and aspirin.
Hydrocodone is** also** paired with different strengths of acetaminophen. (5/325), (5/500).
Hydrocodone also comes in different strengths with he same dose of acetaminophen.
(5/500), (7.5/500).
ftg’s cites do not show that acetaminophen is not an effective pain medicine. As he/she said, it is not effective for some types of pain.
Well, perhaps the first cite does but it is behind a wall. The second cite states that it is not effective for osteoarthritis. It also says that most other OTCs aren’t effective either.
The third cite says it is also not effective for tension type headaches.
It is recommended for many mild pain conditions.
But I’d really like to see something that shows the acetaminophen in these being used as a deterrent to abuse.
Interesting discussion on opioids/APAP combo meds here: Acetaminophen, Opioids, and Safety
The FDA has been trying to get drug makers to limit how much APAP they put in their combo pills, due to a well-documented history of bad outcomes from such meds.
Nor is the FDA alone in calling for decreased doses of APAP, along with decreased use of combination meds. The American College of Medical Toxicology concurs.
It’s tough to find people in authority who make definitive statements that APAP should be in the combo to “discourage the abuse” of the drug. Which is why I don’t state it as fact in my earlier post. But after decades of prescribing such meds, along with talking with pharmaceutical reps, addiction medicine specialists, liver experts, and DEA personnel, I’ve heard many times from these folks on the front lines that such thinking is still prominent at a lot of levels in the Pharma industry along with the DEA.
Does that make it true? No. But given the history of the War on Drugs in this country, I consider such assertions to be likely to be credible. Definitely, some folks in the manufacturing and regulatory industries believe it to be part of the reason.
Regardless of why it is there, it is a lethal combination. You have an addictive drug that people rapidly build tolerance to paired with a substance that causes liver failure and is dangerous at even moderate overdoses.
I frankly don’t see why this drug is on the market, it’s addictive nature means that people will feel an urge to use more of it, and the acetaminophen is basically a poison included to kill them if they so much as double their daily dose. (8 grams of tylenol per day is enough to cause liver failure in some people)
Addiction is not a good thing, but it doesn’t mean we need to kill addicts.
As I understand it, the safety margin paired with one of the other available OTC painkillers, like ibuprofen, is far higher. Ibuprofen has it’s own negative side effects, but as I understand it, the chance of an overdose being lethal is much lower.
I don’t disagree that this is not a great drug.
But I don’t believe that " the acetaminophen is basically a poison included to kill them".
That is a very strong statement that many posters have repeated on this thread.
I have seen no evidence that the acetaminophen is included as a deterrent to abuse.
That is irrelevant. Asbestos is a lethal poison, even though the people installing asbestos insulation and roofing tiles had good intentions because it’s so fire resistant and inexpensive. Once it was recognized how dangerous it was, eventually they banned it. This is the same thing. I’ve read that tylenol is not technically an NSAID and has advantages over them, and including it with the opiate was a well intentioned move, perhaps. Doesn’t change the fact that this formulation needs to be banned, yesterday. (if not banned, restricted to use in controlled settings)
I ran out of Imitrex once, and had some codeine cough medicine left over, so I took it. It was just codeine-- no Tylenol, and no guaifenesin (the expectorant). It made the headache worse. I called the doctor and confessed what I had done, and that I needed help ASAP. She called in a different strength of Imitrex, and my insurance company (I get nine 50mg/month, period, no more. BUT apparently I can ALSO get nine 100mg/month) approved it, so my husband picked it up, and I was feeling better in an hour.
I found out later that many people experience narcotics as actually making migraines feel worse.
Saw this after replying to the post by SamuelA.
Well sure…maybe. I did notice that you said it was a belief. 
I have seen that the 325 mg strength APAP is almost universally used now, when it used to be 500 mg. Are we trying to kill addicts slower? Or are we not trying to deter abuse as much?
One poster said that they had “read this”. This seems to be a widespread belief as you say. I have never seen proof.
I’m sorry but it is relevant. I’m not defending the drug.
Posters are saying that the acetaminophen is used to DETER abuse. There is no evidence.
The asbestos example is not correct. That would be like saying asbestos was used to prevent people from living in houses as much, or roofers from working as much.
It doesn’t matter why. If right now, half the brands of cereal at your store have rat poison in them, which doesn’t kill you if you only eat 1 bowl for breakfast but if you really like cereal* you die, this is no time to be arguing over why the poison is in there! It’s time to get it pulled!
*some people are going to experience opiates differently and are probably far more vulnerable to addiction than others.
Not disputing that. I’ve taken care of many APAP overdoses. It is a slow and uncomfortable way to die. The vast majority of the straight APAP ODs were more of the “cry for help” variety IMO. They didn’t think they were going to actually die.
Once again, my problem is with the widely repeated theory that this was DONE ON PURPOSE to deter abuse.
I’ve known a few vicodin addicts over the years and it was not unusual for them to claim upwards of 30-40 pills/day. Tolerance or not, I don’t understand how anyone could ingest that much acetaminophen and not die.
That’s half the reason, it also allows stores that don’t care to jump through the ridiculous amount of hoops required to sell booze, to sell what would otherwise be booze.
There’s a restaurant supply store near me that sells cooking wine. When I looked into it further, it’s wine, but full of salt, to the point that it’s undrinkable. While I’ve read that restaurant owners buy it to make sure the cooks/chefs don’t drink it. I think it’s more so that, again, places like restaurant stores or c-stores can sell it without having to worry about everything else that goes with selling liquor.
I see a neurologist for migraines. At some point over the years, they mentioned that they don’t, in general, write narcotics for migraines because of the tendency to cause rebounds. I can also say that if I take narcotics for some non-headache related reason, I do sometimes end up with a headache/migrane the following morning. Luckily Imitrex always knocks it down fairly quickly.
And, regarding the amount of pills, I also get 9 per month (100mg) and I keep a good stock pile of them. I think I have around 40. I, one time, made the mistake of telling the doc ‘no, I’m good, don’t need a refill’ and I happened to have a nasty bout of them a few weeks later and ran out. While it wasn’t that big of a deal to have him call in more, it still meant I was out for a week or so. Now, I always make sure I get it filled, and every time I go to the doctor (about once every 9-12 months), I always get the script re-upped and that usually keeps me pretty well stocked. I can keep most of them at home, but a few in my car, some at work, 1 or 2 in a coat pocket. Always nearby. Having 30+ on hand gives me the ability to have a few shitty weeks between appointments where I need 6 or 8 of them in a week to kill a headache and I don’t run down my supply because I skipped a refill.
I don’t find the notion that it is added to “deter” abuse hard to believe at all. Look at all the alcoholics that got deliberately poisoned during prohibition for their own good. Apparently it was decided that dead, blind or paralyzed was better than drunk. Better for whom, I am unclear.
I’ve known a lot of addicts over the years and I don’t believe a word they say.
Note that I did not link that to anything political. 
I hate to say it, but probably the same religiously motivated people who backed prohibition in the first place. If you believe in a particular version of the deity, and an afterlife, dead, blind, or paralyzed is better than drunk. Drunk can keep you out of heaven, while dead gives you the opportunity to get in, and blind and paralyzed redeem you if you used to be a drunk, and therefore help you get in.
I wish I were making that up.
I can’t say much because of confidentiality, but I have been a sign language interpreter at some Christian services and meetings that shocked the crap out of me.