Lortab (Hydrocodone/Acetaminophen) - Prices & Where to Buy

What Is Lortab?

Lortab is the brand name for a combination medication containing hydrocodone (an opioid agonist) and acetaminophen (a non-opioid analgesic and fever reducer). This combination provides enhanced pain relief compared to either component alone.

Hydrocodone is one of the most widely prescribed opioids in the United States, and the hydrocodone/acetaminophen combination is one of the most frequently prescribed pain medications overall. It is marketed under several brand names including Lortab, Vicodin, Norco, and others — all containing the same active ingredients but manufactured by different companies.

Lortab is designated as a Schedule II controlled substance. Prior to 2014, hydrocodone combinations were classified as Schedule III, but the DEA reclassified them to Schedule II due to the high rates of abuse and overdose.

How Lortab Works

Lortab works through two complementary mechanisms:

Hydrocodone is an opioid that binds to mu-opioid receptors in the brain and spinal cord, reducing the perception of pain. It is a semi-synthetic opioid derived from codeine and is approximately as potent as oral morphine.

Acetaminophen (paracetamol) works primarily in the central nervous system through mechanisms that are not fully understood. It inhibits prostaglandin synthesis in the CNS and may also interact with the endocannabinoid system and serotonergic pathways. Unlike NSAIDs, it has minimal anti-inflammatory activity but is an effective analgesic and antipyretic.

The combination provides synergistic pain relief — the combination is more effective than either drug alone. The half-life of hydrocodone is approximately 3.8 to 5 hours, and the half-life of acetaminophen is 1 to 4 hours.

FDA Schedule & Classification

FDA-Approved Uses

The hydrocodone/acetaminophen combination is FDA-approved for the management of moderate to moderately severe pain.

• Post-surgical pain: Commonly prescribed after dental procedures, orthopedic surgery, and other surgical interventions
• Injury-related pain: Fractures, sprains, and other acute injuries
• Dental pain: One of the most commonly prescribed medications after dental surgery
• Chronic pain: May be used for chronic pain when non-opioid treatments are insufficient

The combination is intended for short-term use when possible. The CDC recommends limiting opioid prescribing for acute pain to 3 days or less when possible.

Dosage Forms & Strengths

Immediate-Release Tablets and Solution

Side Effects

Common Side Effects

• Drowsiness and sedation
• Dizziness
• Nausea and vomiting
• Constipation
• Headache
• Upset stomach
• Dry mouth
• Blurred vision

Serious Side Effects

Contact your healthcare provider or seek emergency medical attention if you experience:

• Respiratory depression — slow, shallow, or difficulty breathing
• Liver damage — yellowing of skin/eyes, dark urine, upper right abdominal pain (from acetaminophen)
• Severe allergic reaction (anaphylaxis)
• Severe skin reactions — Stevens-Johnson syndrome (rare, with acetaminophen)
• Serotonin syndrome

Drug Interactions

Major Interactions (Avoid or Use Extreme Caution)

• Alcohol — increases both opioid sedation and acetaminophen liver toxicity risk
• MAO inhibitors — potentially fatal interaction with hydrocodone
• Benzodiazepines — profound sedation and respiratory depression
• Other opioids — additive respiratory depression risk
• CYP3A4 inhibitors (ketoconazole, erythromycin, ritonavir) — may increase hydrocodone levels
• Warfarin — acetaminophen may increase anticoagulant effect

Moderate Interactions (Monitor Closely)

• Other acetaminophen-containing products — must track total daily acetaminophen dose
• Carbamazepine, phenytoin, rifampin — CYP inducers that may decrease hydrocodone effectiveness
• Drugs metabolized by CYP2D6 — hydrocodone is converted to hydromorphone via CYP2D6

Precautions & Warnings

• Pregnancy: Opioid use during pregnancy may cause neonatal opioid withdrawal syndrome (NOWS). Use only if benefits outweigh risks.
• Breastfeeding: Opioids pass into breast milk. Hydrocodone is generally not recommended during breastfeeding.
• Liver disease: Acetaminophen is hepatotoxic. Use with caution in patients with liver impairment; lower acetaminophen dose limits apply.
• Kidney disease: Use with caution; dose adjustment may be needed.
• Elderly patients: Increased sensitivity to opioids. Start at lower doses and titrate slowly.
• Respiratory conditions: Use caution in patients with COPD, asthma, or sleep apnea.
• History of substance use disorder: Increased risk of misuse. Use with caution and close monitoring.
• Driving and machinery: May cause drowsiness and dizziness. Do not drive until you know how this medication affects you.

When to Contact a Clinician

• Pain is not improving or worsening after starting the medication
• You notice new or unexpected side effects
• You feel you need to take more medication to achieve the same effect (tolerance)
• You are having difficulty functioning at work or home due to sedation
• You are experiencing mood changes, depression, or thoughts of self-harm
• You are pregnant or planning to become pregnant
• You have questions about how long you should take this medication
• You want to stop the medication — never stop abruptly without medical guidance

Seek emergency care immediately if you experience difficulty breathing, severe allergic reaction, loss of consciousness, yellowing of skin or eyes, or symptoms of overdose.