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  • Hydro/Aceto plus Hydro/Chlorpheniram?

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    Old 06-29-2012, 10:09 AM   #1
    chronological
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    Hydro/Aceto plus Hydro/Chlorpheniram?

    I take vicodin (1 or 2 5/500 every 4 to 6 hours as needed) for lower back pain. Have done for years. I average two of the above tablets per day.

    However, I'm currently in the middle of a bout of bronchitis and my ENT has prescribed some cough medicine -- hydrocodone/chlorpheniram suspension. Dose is 5ml every 12 hours as needed. Reading around the subject on google leads me to believe that one 5ml spoonful of the cough medicine is equivalent, in hydro terms, to two of my back tablets. i.e. each contain 10mg of hydrocodone bitartrate.

    Question then is, would I be better to not use my back pills while I'm using the cough medicine?

    On the face of it, I can't see there being too much of a problem, provided I treat a dose of cough medicine as being a *replacement* for one 2-tablet dose of the vicodin. That way, I'd only be consuming the same maximum daily dose of hydro, namely 40mg. In fact it is unlikely I'd want to take both -- as I said, I average 2x5/500 vicodin a day. But that is an average -- some days it's 6 tablets, many others it's none at all.

    As far as I can see, the major issue to be aware of when taking things in addition to vicodin is not so much taking too much hydro, but rather taking too much aceto. But since there's no aceto (as far as I know) in the cough medicine, I don't see a problem.

    I should have asked the pharmacist all this but I'm so miserable with sore throat, aching eyes, and a cough that I forgot.

    Thanks for any advice.

    Last edited by chronological; 06-29-2012 at 10:12 AM. Reason: Typo correction

     
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    Old 06-29-2012, 10:31 AM   #2
    Ilovemycutedog
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    Re: Hydro/Aceto plus Hydro/Chlorpheniram?

    Did you tell the ENT who prescribed the cough medicine that you are also prescribed the Vicodin?

    I would make one more phone call immediately to the Dr. who prescribes the Vicodin that you also were given prescription strength cough medication. Especially if you have signed a pain management contract stating that you will only get opiates from one Dr.

    And even without the contract....it will just look very good to your Dr. that you are notifying them about this and ask if you should use this as a substitute for your back pain or if you are allowed to take your normal dose if needed.

    In 41 states there is the Prescription Monitoring Program which follows any prescription that you fill in the state and alerts if you are filling the same type of medication from two different Drs...So this is also why you want to alert your Dr. to show you aren't trying to hide anything.

    The Pharmacist can only tell you about interactions....they can't advise whether you are allowed to take both the Vicodin and the cough medicine at the same time.

     
    Old 06-29-2012, 10:47 AM   #3
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    Re: Hydro/Aceto plus Hydro/Chlorpheniram?

    I would call your doctor and/or pharmacist about this. However, yes it does seem prudent to ensure while on the cough syrup your total daily dose of hydrocodone does not exceed that of which you are allowed with the Vicodin.

    The strength of the liquid (mg/ml) cough syrup should be noted on the bottle...you shouldn't have to look anything up online. They typically come in different strengths, so what you read online could be different from what you were given. From what you say, you'd expect the bottle to say 10mg/5ml.

    If you take it every 12 hours, that would be 20mg/day of hydrocodone. With the Vicodin, if you took the max of 2 of the 5mg pills every 4 hours, that would be 6*10mg = 60mg. Therefore, if the cough syrup is 10mg per dose, 20mg a day total, you could still take up to 8 of the Vicodin (40mg) without exceeding your 60mg/day max prescribed dose.

    However, that much Vicodin is too much Acetaminophen. Not sure why your doctor allows 1-2 pills every 4-6 hours since with 500mg Acetaminophen each, the max of 2 pills 6 times a day is 12*500mg = 6,000mg!

    As a side note, if you are on a contract for your pain meds, getting the cough medicine from another doctor could violate that. Did the ENT dr know you were already on Vicodin? Sounds odd he would prescribe a hydrocodone containing med since you are already on that. If that happened to me, I would have spoken up to the ENT dr, even if I wasn't on a pain contract. If the cough syrup contained Acetaminophen it would be on the bottle. Its often abbreviated as APAP. Best wishes.
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    Old 06-29-2012, 10:58 AM   #4
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    Re: Hydro/Aceto plus Hydro/Chlorpheniram?

    Thanks tortoisegirl and ilovemycutedog:

    Quote:
    Originally Posted by tortoisegirl View Post
    However, that much Vicodin is too much Acetaminophen. Not sure why your doctor allows 1-2 pills every 4-6 hours since with 500mg Acetaminophen each, the max of 2 pills 6 times a day is 12*500mg = 6,000mg!
    Well, the dosing is slightly more precise than I said. It's 1 to 2 tablets, every 4 to 6 hours, but a maximum of 8 tablets a day -- i.e. 4,000mg of aceto, not 6,000mg. And as I say, I'm rarely anywhere near that.

    Quote:
    Originally Posted by tortoisegirl View Post
    As a side note, if you are on a contract for your pain meds, getting the cough medicine from another doctor could violate that. Did the ENT dr know you were already on Vicodin? Sounds odd he would prescribe a hydrocodone containing med since you are already on that. If that happened to me, I would have spoken up to the ENT dr, even if I wasn't on a pain contract. If the cough syrup contained Acetaminophen it would be on the bottle. Its often abbreviated as APAP. Best wishes.
    I'm not on a contract. But my GP (the one prescribing the vicodin) and I have discussed the whole pain meds for chronic pain thing several times and at length. He knows I'm up front with him and don't doctor shop, and I trust him in the other direction. Also, I only ever fill from one pharmacy, so if I was trying to hide stuff I'm clearly not very good at it :-)

    The issue of opiates never even came up at the ENT. This is our third attempt in two weeks to try to kill off bronchitis coupled with Otitis Exerna. This time she escalated the antibiotic up to levofloxacin, added prednisone, and told me she was also giving me a "cough medicine". I only realized it had an opiate when I saw "hydrocodone" in the name when I picked it up at the pharmacy. Had she told me at the time I'd have immediately told her about the vicodin. In fact on my first visit she asked me if I needed something for the pain in me ear and I declined, primarily because I already have hydro at home and don't want to be accused of doctor shopping.

    I guess I could now call my regular doc but don't you think it's just making a mountain out of a molehill -- a kind of "hmmm, maybe you're 'fessing up to this because you're felling guilty about something". As I say, my doc and I have already spoken about the use of vicodin, and harping on about it just seems disproportionate to me. But shrug, I don't know. Maybe you're right.

    Last edited by chronological; 06-29-2012 at 11:02 AM. Reason: Typos

     
    Old 06-29-2012, 12:22 PM   #5
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    Re: Hydro/Aceto plus Hydro/Chlorpheniram?

    It's certainly up to you...I just think by calling them and letting them know and asking whether you should still take the needed amount of Vicodin is a good idea. As mentioned...hopefully the Pharmacy does not send a notice to your Dr. about filling another prescription from a different Dr. for an opiate. That is why I thought telling your Dr. is appropriate as you don't want the information getting to your Dr. from another source.

    I've known my PM for close to 7 years and even if I didn't have a contract, I let him know of any other Dr. that I see. Just like going to a dentist if they were to prescribe opiates for pain...it's best to tell your Dr. this...

    But again....these are just our opinions and you know your situation best with your Dr...

    Hope the medicine helps to clear out your bronchitis...

     
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