TSOrocks
Newbie
Reged: 01/28/04
Posts: 38
Loc: Appalachian Foothills of North...
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I'm trying to figure out if there is a "hydro-type" med that does not have acetaminophen in it.....bad for your liver right? I just need something that is going to work that if I have to take lots of to get relief, I'm not gonna mess up my tummy
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NJ_Hoss
Enthusiast
Reged: 10/29/03
Posts: 263
Loc: USA
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If you have to take enough hydrocodone-containing products that their APAP content might affect your liver, you may be better-off discussion other medication options with your prescriber for greater relief.
All brand and generic Hydrocodone-based pain medication does contain APAP, but its content levels vary substantially. Norco 10/325 has the best ratio in terms of APAP content. Pharmacies can prepare specially compounded versions whose content is even lower, but be advised that there is likely to be a substantial cost difference resulting from the labor-intensive compounding process.
I hope this helps!
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TSOrocks
Newbie
Reged: 01/28/04
Posts: 38
Loc: Appalachian Foothills of North...
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Thanks Hoss,
I hear you, the problem is that I can't seem to get enough relief from -anything-. (except oxy) (which I can't get), I guess I'm just looking for something that will work 
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daddyj
Board Addict
Reged: 02/06/03
Posts: 367
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Quote:
All brand and generic Hydrocodone-based pain medication does contain APAP
Sorry, I don't want to be one of those jerks that goes around contradicting people just for the fun of it (I can think of a couple here off-hand), but in this case I think it's important. There is one non-APAP containing Hydrocodone medication (readily available at OP's, but a little expensive) called Vicoprofen (generic is usually refered to as hydroprofen) which is 7.5mg of Hydro and 200mg of ibuprofen. Some people think it's more effective for pain relief than 10/325 Norco. I would guess that could be attributed to the fact that some people's pain is caused by severe inflammation. Again, Ibuprofin causes problems in and of it's own, so it's important to weigh the risks vs. benefits. As far as APAP goes, every definitive source I have seen says that if you keep your intake under about 3.5 grams short-term and 2 grams long term, you should be fine, however you should be aware of the long term effects of APAP on liver. Usually, you only see hepatoxicity when massive amounts of APAP is taken, or if you combine it with alcohol (big no-no). Whatever you do, don't take my word on this.
Also, if you opt for Vicoprofen and the like, you should know the long-term effects of Ibuprofen. Off the top of my head, I think it causes stomach and kidney problems. Again, don't take my word for it. As far as you know, I'm just an idiot with a computer.
Hope this helped and I wish everyone here a pain-free existance.
J.
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Misty morning, clouds in the sky
Without warning, the wizard walks by
Casting his shadow, weaving his spell
Funny clothes, tinkling bell
Edited by daddyj (02/05/04 10:41 AM)
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NJ_Hoss
Enthusiast
Reged: 10/29/03
Posts: 263
Loc: USA
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I stand corrected, and have no idea why it didn't come to mind. Thank you for correcting my error and providing the original poster with the information he sought. I had confined my thinking to those commonly available by OP's. Hell, I even have a cube of Vicoprofen sticky-notes on my desk at the moment. Brain fart.
As for specifying a "safe" level of APAP, I would be very reluctant to do so. Factors such as existing liver health, individual metabolism, and the volume of other items being digested throughout the duration of use can greatly influence hepatic toxicity. I wholeheartedly disagree that only massive amounts can result in liver damage, as its effect may also be cumulative over long term use.
Irreversible liver damage has occured at dosage levels as low as 3 mg's per day consumed over a period of as short as a few months. For many who visit this forum, their long-term chronic intractible pain is more consistent with ongoing use than any single massive and potentially instantly toxic dose. While the vast majority may very never endanger their livers, I think it's very risky business to identify a specific level that is universally safe when used for an indefinite period. I certainly wouldn't want that responsibility.
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yawkaw3
Pooh-Bah
Reged: 03/22/03
Posts: 1193
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Teva actually started making generic Vicoprofen- we all have brain farts from time to time, don't sweat it hehe.
-yawkaw
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rla76
Member
Reged: 09/20/02
Posts: 156
Loc: San Francisco,CA
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There is Loratb ASA. 5MG Hydro/500 Asprin.
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TSOrocks
Newbie
Reged: 01/28/04
Posts: 38
Loc: Appalachian Foothills of North...
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Thanks again to all who have responded, I really appreciate your help!
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daddyj
Board Addict
Reged: 02/06/03
Posts: 367
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Quote:
There is Loratb ASA. 5MG Hydro/500 Asprin.
Wow, that's a new one on me.
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Misty morning, clouds in the sky
Without warning, the wizard walks by
Casting his shadow, weaving his spell
Funny clothes, tinkling bell
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rd89
Stranger
Reged: 12/06/02
Posts: 21
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I believe it was an innocent typo that is confusing us. I think that the term "Loratb" is supposed to be "Lortab". And like what was said, it is 5mg hydro / 500mg aspirin and probably also comes in various strengths as well.
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Trampy
Pooh-Bah
Reged: 04/02/02
Posts: 1230
Loc: Southwest U.S.
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"Lortab 5/500" means apap, not aspirin. If it meant aspirin, it would say ASA.
Who here has an answer to the question: how high can the hydro:apap ratio be without making it C-II? Obviously, if you had 15 mg of hydrocodone and 1 mg of acetaminophen, it would be C-II, because 1 mg of apap is not clinically significant.
I say it's a gray area. Here's some background. When the FDA investigates a NDA, it makes a recommended scheduling decision that goes to the DEA for comment before it reaches the public. But the FDA has the final say for approved drugs. Every time a new strength/mixture enters the market it's only after the FDA approves it. But the FDA never approved a 15/80. I say that it's a C-II. Who makes the decision? DEA, because the FDA never approved the mixture. If there's a 15/325 in C-III, then they'd probably stick to that ratio as the dividing line. Using that kind of thinking would make a 15/80 a C-II.
If you think this is wrong, please offer some proof.
Gardendale was selling 10/100s and they "put a touch" of phenergan in there without listing it on the label. They closed, huh?
Trampy
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Your mileage may vary ...
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Trampy
Pooh-Bah
Reged: 04/02/02
Posts: 1230
Loc: Southwest U.S.
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You can "mess up your tummy" with hydro/ibuprofen instead of apap. Otherwise, you need to move up to O-IR or OxyFast.
I think that anyone who uses so much hydro that that they need to worry about it should be taking a C-II.
It has a bad reputation, but the strongest cheap pain killer is methadone, and it can be used by many for long periods of time without raising the dose. It also has the "advantage" of not causing euphoria, that is, once you get used to it. Dependence is strong, however! It hurts to stop. But don't they all?
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Your mileage may vary ...
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rla76
Member
Reged: 09/20/02
Posts: 156
Loc: San Francisco,CA
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I Meant Lortab ASA hydro/Asprin......
It comes in 5-7.5 mg Hydro and 325-500 ASA....Maybe some one else on this board can help me identify the right compound...Take Care...
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Tred
Enthusiast
Reged: 10/18/03
Posts: 262
Loc: USA
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I may have read the post I'm replying to wrong, but I think a compound med of 15/80 is still a class iii.. ?? There is a pain clinic that prescribes this and I don't think they would be able to do so with telemedicine, if it were a class ii.. Just a thought.
Tred
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Entertainment Specialist!
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night_shade
Threadhead
Reged: 08/26/03
Posts: 907
Loc: The State of Hockey
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Here are the Schedule III requirements for HYDROCODONE...
(3) not more than 300 milligrams of dihydrocodeinone (hydrocodone), or any of its salts, per 100 milliliters or not more than 15 milligrams per dosage unit, with a fourfold or greater quantity of an isoquinoline alkaloid of opium;
(4) not more than 300 milligrams of dihydrocodeinone (hydrocodone), or any of its salts, per 100 milliliters or not more than 15 milligrams per dosage unit, with one or more active, nonnarcotic ingredients in recognized therapeutic amounts;
These are right from the DEA and ALL the state laws I looked at (TX, AZ, MT, MN etc.) were identical. So now the questions is how much is a "recognized therapeutic amount" of acetaminophen?
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Never underestimate the predictability of stupidity.
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