Which drugs or supplements interact with hydrocodone and ibuprofen?

Hydrocodone, like other narcotic pain-relievers, interacts with medications and drugs that slow the brain’s processes, such as alcohol, barbiturates, skeletal muscle relaxants including carisoprodol (Soma), cyclobenzaprine (Flexeril), and benzodiazepines (for example, lorazepam [Ativan], and clonazepam [Klonopin]).

Opioids such as hydrocodone can slow bowel motility. When combined with medications that possess anticholinergic activity, this effect on the bowel may be accentuated, leading to marked constipation. Such drugs include dicyclomine (Bentyl), some antihistamines (for example, carbinoxamine [Rondec], clemastine [Tavist], diphenhydramine [Benadryl], promethazine [Phenergan]); some phenothiazines (for example, thioridazine [Mellaril], triflupromazine [Stelazine]); some tricyclic antidepressants (for example, amitriptyline [Elavil, Endep] amoxapine [Asendin], clomipramine [Anafranil], protriptyline [Vivactil]); clozapine (Clozaril), cyclobenzaprine (Flexeril), and disopyramide (Norpace). The use of antidiarrheals (for example, diphenoxylate [Lomotil], loperamide [Imodium]) in persons taking opioid analgesics such as hydrocodone can lead to severe constipation and possibly greater sedation.

Cimetidine (Tagamet), when used with opiate analgesics such as hydrocodone, can cause confusion, disorientation, seizures or respiratory depression by increasing blood concentrations of the opiate.

Ibuprofen, which has blood thinning (anticoagulant) properties, is used with caution in patients taking other blood thinning anticoagulants such as warfarin (Coumadin), because of an increased risk of bleeding. Concurrent use of ibuprofen and clopidogrel (Plavix) can also lead to increased risk of bleeding. Patients taking lithium (Eskalith, Lithobid) can develop toxic blood lithium levels if ibuprofen is taken at the same time. Ibuprofen may increase methotrexate (Rheumatrex, Trexall) toxicity when used together.

Is hydrocodone and ibuprofen safe to take if I’m pregnant or breastfeeding?

Hydrocodone and ibuprofen crosses the placenta. However, there is not enough information known about the effects of hydrocodone and ibuprofen on the fetus. Physicians may choose to use hydrocodone and ibuprofen if the benefits outweigh potential risks.

It is not known if hydrocodone is secreted in breast milk.

What else should I know about hydrocodone and ibuprofen?

What preparations of hydrocodone and ibuprofen are available?

Tablets: hydrocodone bitartrate 7.5 mg and ibuprofen 200 mg.

How should I keep hydrocodone and ibuprofen stored?

Tablets should be stored at room temperature between 15 C – 30 C (59 F – 86 F).