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Hydrocodone and acetaminophen overdose

Definition

This poisoning is from taking too much of a painkiller containing both acetaminophen (Tylenol) and hydrocodone.

Alternative Names

Lorcet overdose; Lortab overdose; Vicodin overdose

Poisonous Ingredient

  • Acetaminophen (Tylenol)
  • Hydrocodone (narcotic)

Where Found

Acetaminophen with hydrocodone is the main ingredient in many prescription painkillers including:

  • Anexsia
  • Anolor DH
  • Lortab
  • Lorcet
  • Norco
  • Vicodin
  • Zydone
Note: This list may not be all inclusive.

Symptoms

  • Bluish skin (fingernails and lips)
  • Breathing slow and labored
  • Breathing shallow
  • Cold and clammy skin
  • Confusion
  • Dizziness
  • Drowsiness
  • Eyes with small (pinpoint) pupils
  • Liver failure due to acetaminophen overdose
  • Loss of consciousness
  • Low blood pressure
  • Respiratory arrest
  • Seizures
  • Spasms of the stomach or intestinal tract
  • Sweating
  • Tiredness
  • Vomiting
  • Weakness

Home Treatment

DO NOT make the person throw up. Seek immediate emergency care. 

Before Calling Emergency

Determine the following:

  • Patient's age, weight, and condition
  • Name of the product (ingredients and strengths, if known)
  • Time it was swallowed
  • Amount swallowed
  • If the medication was prescribed for the patient

Poison Control, or a local emergency number

The National Poison Control Center (1-800-222-1222) can be called from anywhere in the United States. This national hotline number will let you talk to experts in poisoning. They will give you further instructions.

This is a free and confidential service. All local poison control centers in the U.S. use this national number. You should call if you have any questions about poisoning or poison prevention. It does NOT need to be an emergency. You can call for any reason, 24 hours a day, 7 days a week.

Take the container with you to the emergency room.

What to expect at the emergency room

The health care provider will measure and monitor the patient's vital signs, including temperature, pulse, breathing rate, and blood pressure.

The patient may receive:

  • Fluids
  • Medicines to treat symptoms
  • A narcotic antagonist (medicine to reverse the effect of the hydrocodone)
  • N-Acetyl cysteine (medicine to lower acetaminophen levels in the blood)
  • Activated charcoal
  • Laxative
  • A nasogastric (NG) tube thru the nose into the stomach to empty the stomach (gastric lavage)   
  • Artificial respiration

Expectations (prognosis)

If the patient can receive medicines to reverse the overdose, they may get better within 1 to 4 days.

Review Date:3/17/2006
Reviewed By:Janeen R. Azare, PhD, MSPH, Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY. Review provided by VeriMed Healthcare Network.

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