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Updated on August 31, 2021

Lortab Side Effects, Abuse & Addiction

What is Lortab?

Lortab, the brand name for hydrocodone/acetaminophen, is an opioid pain medication and combination drug. It either includes a mixture of acetaminophen and hydrocodone or aspirin and hydrocodone. Lortab relieves moderate to severe pain and coughing.

Acetaminophen, sold under the brand name Tylenol, and aspirin belong to two different drug classes. Tylenol is a fever reducer and analgesic pain reliever that increases the effects of hydrocodone. Aspirin is a non-steroidal anti-inflammatory drug (NSAID).

Lortab ASA contains aspirin. Regular Lortab contains acetaminophen.

Drugs that contain hydrocodone, like Lortab, are classified as Schedule II substances. This means they are habit-forming and have a high risk of misuse, abuse, and addiction. Other hydrocodone/acetaminophen combination drugs that produce similar effects include:

  • Zydone
  • Vicodin
  • Norco
  • Anexsia
  • Anolor DH
  • Lorcet

Side Effects of Lortab

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

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Drug Interactions

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

According to the FDA review, the combination of opioids, benzodiazepines, and other drugs that depress the body’s central nervous system (CNS) can cause potentially fatal breathing problems. Because of this risk, the FDA now requires a Black Box Warning (the strongest type of warning) on Lortab, all prescription opioids, and benzodiazepines. 

The FDA 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, including:

  • Harmful interactions with other medications, including antidepressants and migraine medications
  • Decreased sex hormone levels
  • Impotence and infertility
  • Adrenal gland problems, resulting in inadequate cortisol production
  • Toxic levels of serotonin build up in the brain (serotonin syndrome)
  • Do not take Lortab while breastfeeding, as the drug passes through breast milk and can harm your baby

Combining Lortab and alcohol is extremely dangerous. This is because both substances depress the central nervous system (CNS), which results in shallow breathing and can lead to loss of muscle control or death.

Lortab Overdose Symptoms

It is possible to overdose on hydrocodone or acetaminophen, both of the active ingredients in Lortab. When taken in large doses, a Lortab overdose can occur. If you believe you or a loved one is experiencing a Lortab overdose, call 911 immediately for medical help.

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
  • Sleep apnea
  • Circulatory collapse
  • Cardiac arrest
  • Dry mouth

Symptoms of acetaminophen overdose include:

  • Hepatic necrosis, which causes indicated by nausea, vomiting, diaphoresis, and general malaise
  • Renal tubular necrosis
  • Hypoglycemic coma
  • Thrombocytopenia

Lortab 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 to take higher doses to achieve the same effects. This increases the risk of overdose and alters the way your brain functions.

After just a few weeks of using a highly addictive narcotic, such as Lortab, a mild form of physical dependence can form.

With continued use, the body will become completely physically dependent on the drug. This means you must take more of it in order to function properly. Not taking Lortab after physical dependence forms will trigger withdrawal symptoms that range from mild to severe.

Symptoms of 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
  • Liver damage or acute liver failure (due to overdose)

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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Disorders That Co-Occur With Lortab Abuse

Other disorders are known to co-occur with Lortab abuse.

These disorders include:

  • Anxiety disorders
  • Depressive disorders
  • Conduct disorders
  • Personality disorders
  • Post-traumatic stress disorder
  • Bipolar disorder
  • Schizophrenia
  • Somatization disorder

How Lortab is Sourced

Sourcing drugs can be difficult when using a controlled substance like Lortab. There are various ways that individuals who abuse Lortab manage to find the prescription drug:

Doctor Shopping

People who abuse Lortab usually use more than the recommended dose. This means that using an authentic prescription from one doctor or health care provider is not enough. Instead, Lortab abusers may visit various doctors complaining of pain, so they receive multiple prescriptions.

Typically, they must also visit more than one pharmacy.

Buying From Others With Prescriptions

These prescriptions are usually purchased from people who require them rightfully. Often, they are sold at a significant markup.

Purchasing Lortab off the Street

There is a street drug trade for prescription medications as well as illegal drugs. Unlike buying from friends or people you know with prescriptions, there is a risk purchasing Lortab from drug dealers.

Stealing Medication

Some Lortab abusers try to steal from pharmacies, hospitals, and individuals.

Treatment Options for Opioid Abuse & Addiction

Opioid use disorder is difficult to overcome. Fortunately, there are several options for help. These include:

  • Medication-Assisted Therapy (MAT) When it comes to medication-assisted therapy for opioid use disorder, there are three types approved: buprenorphine, methadone, and naltrexone. Buprenorphine and methadone help manage withdrawal symptoms as you detox. Naltrexone blocks the receptors that opioids bind to, making it impossible to get high from them. Medication-assisted therapy is most effective when combined with other therapies.
  • Inpatient Programs — Inpatient programs are the most intensive addiction treatment options. These programs guide you through medical supervised detoxification, behavioral therapy and other services such as medication-assisted therapy. They typically last 30, 60 or 90 days, but may be longer if necessary.
  • Partial Hospitalization Programs (PHPs) Intensive outpatient programs are the next level of addiction treatment, providing similar services to inpatient programs such as detoxification and behavioral therapy. The difference is that the patient will return home to sleep, and some programs will include transportation and meals. PHPs are ideal for both new patients as well as those who have completed inpatient treatment but still need intensive care.
  • Outpatient Programs Outpatient programs provide a well-rounded treatment program for people with a high motivation to recover. These programs are flexible and can be made around for your schedule, and can be customized to work best for you. These programs work for new patients as well as those that complete an inpatient or partial hospitalization program.

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Resources

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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

Tenayuca, John M, and Arbi Nazarian. “Hydrocodone and morphine possess similar rewarding effects and reduce ERK and CREB phosphorylation in the nucleus accumbens.” Synapse (New York, N.Y.) vol. 66,10 (2012): 918-22. doi:10.1002/syn.21577, ncbi.nlm.nih.gov/pmc/articles/PMC3418391/

Cassidy, T. A., Oyedele, N., Mickle, T. C., Guenther, S., & Budman, S. H. (2017). Patterns of abuse and routes of administration for immediate-release hydrocodone combination products. Pharmacoepidemiology and drug safety, 26(9), 1071–1082, https://doi.org/10.1002/pds.4249, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5637894/

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