There are strong suggestions in medical literature that patients with liver dysfunction (hepatic insufficiency) and patients who consume three or more alcoholic drinks per day should lower daily use of acetaminophen. For rapid relief of pain, taking on an empty stomach or with food low in carbohydrates would provide fastest absorption. Many patients find it necessary to take hydrocodone/APAP with food or milk to minimize gastric irritation. Taking hydrocodone/APAP with food decreases the absorption rate of the acetaminophen component although this effect appears most significant when taken with food high in carbohydrates. Similar dosing is recommended for adults and children when used as an antitussive. There are no published dosing data for children under 2 years old.

To deliver exact dosages, use a calibrated measuring cup or syringe. Household teaspoons and tablespoons are not adequate measuring devices. It is very important to measure liquid doses exactly. The 15 milliliter dose provides 7.5 milligrams of hydrocodone and 500 milligrams of APAP. Children 14 years of age and older can be given an adult equivalent dose of 15 milliliters orally every four to six hours, up to six doses per day. This equates to 0.135 milligrams per kilogram of hydrocodone and 9 milligrams per kilogram of acetaminophen. Pediatric dosing using the elixir for children between 2 and 13 years old is 0.27 milliliters per kilogram (weight) given orally every four to six hours as needed up to a maximum of six doses per day. The limiting factor is the APAP - healthy adults should not ingest more than 4 grams (4,000 milligrams) of acetaminophen per day.Īlthough not commonly prescribed, there is a liquid preparation of hydrocodone/APAP available in a standard strength of 7.5 milligrams of hydrocodone and 500 milligrams of APAP in each 15 milliliters of elixir. Dose adjustment is based on pain severity and patient response. Alternatively, one or two 5/500 tablets can be given every four to six hours as needed, also not to exceed eight tablets over 24 hours. The most commonly prescribed strength of hydrocodone/APAP is 7.5/500.ĭosing and Administration - For moderate to moderately-severe pain in adults, initial oral dosing is one 7.5/500 tablet of hydrocodone/APAP every four to six hours as needed, not to exceed eight tablets in any 24-hour period. Dose strengths of hydrocodone/APAP start with the number of milligrams of hydrocodone and follow with the acetaminophen dose.

Every algorithm for pain management emphasizes continuation of non-narcotic agents when escalating to stronger (usually narcotic) drugs. While non-narcotic agents are unlikely to be effective in severe pain, they will always provide additional effectiveness for narcotics given later during the course of patient care. In EMS systems without access to narcotics, protocols often call for administration of acetaminophen or other non-narcotic analgesic agents to patients with pain. While narcotics may offer greater analgesia than non-narcotic agents, combinations of the two nearly always produce better pain control than either agent alone. This combination product emphasizes a commonly overlooked principal in pain management. Explore the uses, administration and side effects of other drugs highlighted by paramedic and EMS1 columnist Mike McEvoy.ĪPAP is also an antipyretic (fever lowering) agent.

Norco pain med