Home Drug Guide Aspirin; Hydrocodone Bitartrate

Drug Guide

Generic Name

Aspirin; Hydrocodone Bitartrate

Brand Names Vicoprin, Azdone, Hydrocodone Bitartrate And Aspirin

Classification

Therapeutic: Analgesic, antipyretic, anti-inflammatory, opioid analgesic

Pharmacological: NSAID (Aspirin), Opioid

FDA Approved Indications

Pain relief
Fever reduction
Anti-inflammatory conditions
Moderate to severe pain associated with these conditions

Mechanism of Action

Aspirin irreversibly inhibits cyclooxygenase (COX-1 and COX-2), reducing prostaglandin synthesis. Hydrocodone binds to mu-opioid receptors in the CNS, altering the perception of and response to pain.

Dosage and Administration

Adult: Typically 5-10 mg of hydrocodone with 325 mg of aspirin every 4-6 hours as needed, not to exceed 4000 mg of aspirin per day.

Pediatric: Not recommended for children under 18 due to risk of Reye's syndrome.

Geriatric: Start at lower doses due to increased risk of GI bleeding and sedation.

Renal Impairment: Adjust dose as needed; use with caution in severe impairment.

Hepatic Impairment: Use cautiously; dose adjustments may be necessary.

Pharmacokinetics

Absorption: Rapidly absorbed from the gastrointestinal tract.

Distribution: Widely distributed throughout body tissues and fluids, crosses the placenta.

Metabolism: Aspirin is rapidly hydrolyzed in the gut and liver to salicylic acid; hydrocodone undergoes extensive first-pass metabolism.

Excretion: Primarily renal excretion of metabolites.

Half Life: Hydrocodone half-life approximately 3.5 hours; aspirin's active salicylate metabolites have a half-life of 2-3 hours.

Contraindications

Hypersensitivity to aspirin, NSAIDs, or opioids
Asthma triggered by NSAIDs
Bleeding disorders
Children/teenagers with viral infections (risk of Reye's syndrome)

Precautions

History of gastric ulcers or bleeding
Liver or kidney impairment
Pregnancy (especially third trimester)
Lactation

Adverse Reactions - Common

Nausea (Common)
Dizziness (Common)
Constipation (Common)

Adverse Reactions - Serious

Gastrointestinal bleeding (Less common)
Hematologic effects such as bleeding or anemia (Less common)
Respiratory depression (Rare)
Serious hypersensitivity reactions including anaphylaxis (Rare)

Drug-Drug Interactions

Warfarin, other anticoagulants
Other CNS depressants
Other NSAIDs

Drug-Food Interactions

Alcohol (increased risk of bleeding)

Drug-Herb Interactions

Echinacea (may increase adverse reactions)

Nursing Implications

Assessment: Monitor for effectiveness and adverse effects; assess pain level, bleeding signs, and respiratory status.

Diagnoses:

Risk for bleeding
Ineffective airway clearance
Pain

Implementation: Administer with food or milk to minimize gastrointestinal irritation; monitor for allergic reactions and bleeding.

Evaluation: Pain relief achieved; absence of adverse effects such as bleeding or respiratory depression.

Patient/Family Teaching

Take with food or milk to reduce stomach upset.
Avoid alcohol and other blood thinners.
Report unusual bleeding, rash, or difficulty breathing.
Do not use in children or teenagers with viral infections due to Reye's syndrome risk.

Special Considerations

Black Box Warnings:

Risk of addiction, abuse, and misuse of hydrocodone.
Serious cardiovascular and gastrointestinal bleeding risks associated with aspirin.

Genetic Factors: Slow acetylators may experience increased hydrocodone effects.

Lab Test Interference: Aspirin can cause positive tests for occult blood or increased bleeding time.

Overdose Management

Signs/Symptoms: Respiratory depression, extreme drowsiness, hypotension, disorientation, vomiting, coma.

Treatment: Supportive care; activated charcoal if within 1 hour of ingestion; naloxone for opioid overdose; gastric lavage; correction of acid-base disturbances.

Storage and Handling

Storage: Store at room temperature away from moisture and heat.

Stability: Stable under recommended storage conditions.