What is Lortab?

Lortab is an opioid pain reliever that consists of both acetaminophen and hydrocodone. Long-term use of Lortab, and other opioid medications, leads to tolerance and the need for higher doses to achieve the same effects. Learn more about the risks here.
Evidence Based
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Lortab is an opioid pain medication that consists of a combination of two different drugs, acetaminophen and hydrocodone. Acetaminophen, an analgesic drug that’s also sold under the brand name Tylenol, increases the effects of the opioid hydrocodone. Lortab relieves moderate to severe pain. It is also used to treat coughs.

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Side Effects of Lortab

Lortab triggers several side effects that range from mild to life-threatening. Most commonly, users of Lortab experience:

  • Lightheadedness or dizziness
  • Nausea
  • Vomiting
  • Sedation

Less common mild to moderate symptoms include:

  • Mental clouding
  • Lethargy
  • Impairment of mental and physical performance
  • Anxiety, fear, or dysphoria
  • Mood changes
  • Constipation
  • Ureteral spasm, spasm of vesical sphincters and urinary retention have been reported with opiates
  • Skin rash

Lortab is also associated with serious, potentially life-threatening side effects, including respiratory depression and liver failure.

Respiratory depression is a risk when Lortab is used in high doses or by sensitive patients. This is because large amounts of hydrocodone act on the brain stem’s respiratory center, which affects respiratory rhythm. This can result in irregular and periodic breathing. Respiratory symptoms tend to be worse when a Lortab user has a head injury, existing intracranial pressure, or other intracranial lesions.

Two pills mixing equals dangerous

Drug Interactions

The FDA warns Lortab is likely to interact with alcohol, benzodiazepines, antidepressants, migraine medication, and other drugs.

According to an FDA review, the combination of opioids and benzodiazepines and other drugs that depress the body’s central nervous system (CNS) can cause potentially fatal breathing problems. As a result of the review, the FDA now requires Boxed Warnings (its strongest type of warning) on Lortab and all prescription opioid medicines and benzodiazepines. 

The agency also encourages medical professionals to limit prescribing opioid pain medications to patients using benzodiazepines and other CNS depressants. 

Additionally, the FDA issued a warning regarding multiple opioid risks. This includes harmful interactions with other medications, including antidepressants and migraine headache medication. It might also decrease sex hormone levels and cause problems with the adrenal glands. 

The use of opioids can also trigger toxic levels of serotonin build up in the brain, known as serotonin syndrome. 

Lastly, Lortab use can also affect the adrenal glands, resulting in inadequate production of cortisol. Long-term use can lead to decreased interest in sex, as well as impotence and infertility.

Combining Lortab and alcohol is extremely dangerous. This is because both substances depress the central nervous systems (CNS), which slows down breathing to dangerously low levels and can lead to loss of muscle control.

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Overdose

It is possible to overdose on hydrocodone or acetaminophen, both of the active ingredients in Lortab. 

Symptoms of hydrocodone overdose include:

  • Signs of respiratory depression (decrease in respiratory rate, Cheyne-Stokes respiration, or cyanosis)
  • Coma
  • Skeletal muscle flaccidity
  • Cold and clammy skin
  • Bradycardia
  • Hypotension
  • Apnea
  • Circulatory collapse
  • Cardiac arrest

Symptoms of Acetaminophen overdose include:

  • Hepatic necrosis, which causes indicated by nausea, vomiting, diaphoresis, and general malaise
  • Renal tubular necrosis
  • Hypoglycemic coma
  • Thrombocytopenia
Graphic human body showing symptoms.

Addiction Symptoms

Lortab has a high addiction risk due to its hydrocodone content.

Long-term use of Lortab, and other opioid medications, leads to tolerance and the need for higher doses to achieve the same effects. This increases the risk of overdose and alters the way your brain functions. As a result, the body needs the drug to function properly and just to feel normal. No longer taking it triggers withdrawal symptoms that vary from mild to severe.

Symptoms of a Lortab addiction might include:

  • Anxiety
  • Bouts of euphoria
  • Frequent mood changes
  • Nausea
  • Vomiting
  • Drowsiness
  • Dizziness
  • Fatigue
  • Weakness
  • Seizures
  • Muscle twitches
  • Convulsions
  • Hearing loss
  • Hyperventilation
  • Itchiness
  • Withdrawal

Stopping the use of Lortab after an addiction develops can trigger symptoms. Early withdrawal symptoms that tend to occur within 24 hours of the last dose include:

  • Muscle aches
  • Restlessness
  • Anxiety
  • Watery eyes
  • Runny nose
  • Excessive sweating
  • Insomnia
  • Excessive yawning

The following symptoms tend to occur after 24 hours without a dose:

  • Abdominal cramping
  • Diarrhea
  • Nausea 
  • Vomiting
  • Goosebumps
  • Dilated pupils
  • Rapid heartbeat
  • Elevated blood pressure

Medical supervision is important for anyone breaking an addiction to Lortab or any other opioid.

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Treatment Options

It is possible to recover from Lortab addiction. It is an unpleasant process, and in some cases, should include medical supervision. Mild withdrawal symptoms might feel like a case of the flu and can be managed in much the same way. This includes the use of over-the-counter medications such as Tylenol, aspirin, or ibuprofen, Imodium, anti-nausea medications, and fluids and rest.

More severe withdrawal symptoms often require medical attention. Prescription medications, including clonidine, ease intense withdrawal symptoms, such as:

  • Muscle aches
  • Cramping
  • Restlessness
  • Sweating
  • Tears
  • Runny nose
  • Anxiety

Suboxone (a mild opioid) and naloxone (an opioid blocker) also make withdrawal easier. Methadone (a synthetic opioid) is a long-term maintenance treatment that is gradually reduced in a controlled manner. It also eliminates withdrawal symptoms and relieves drug cravings. 

Rapid detoxification is also an option, but it is rarely used because many doctors believe the risks outweigh the benefits. 

People addicted to Lortab tend to experience the best recovery results when medically assisted detoxification and pharmaceutically assisted withdrawal are accompanied by therapy and counseling.


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Resources

Center for Drug Evaluation and Research. “Prescription Acetaminophen Products to Be Limited to 325 Mg Per Dosage.” U.S. Food and Drug Administration, 2011, www.fda.gov/drugs/drug-safety-and-availability/fda-drug-safety-communication-prescription-acetaminophen-products-be-limited-325-mg-dosage-unit

“Drug Safety Communication: Opioids Benzos PDF | FDA.” Www.Fda.Gov, www.fda.gov/media/99761

Center for Drug Evaluation and Research. “FDA Drug Safety Communication: FDA Warns about Several Safety Issues with Opioid Pain Medicines; Requires Label Changes | FDA.” U.S. Food and Drug Administration, 2019, www.fda.gov/drugs/drug-safety-and-availability/fda-drug-safety-communication-fda-warns-about-several-safety-issues-opioid-pain-medicines-requires

Case-Lo, Christine. “Withdrawing from Opiates and Opioids.” Healthline, Healthline Media, 25 Sept. 2012, www.healthline.com/health/opiate-withdrawal

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Updated on: June 24, 2020
Author
Addiction Group Staff
About
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Medically Reviewed: March 5, 2020
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Annamarie Coy,
BA, CADACII/ICADC, ICPR, MATS
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