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Lortab: Uses, Side Effects, Misuse & More

July 2, 2022

Table of Contents

Lortab is a brand-name pharmaceutical. It is a prescription pain medication that contains the opioid drug hydrocodone and the over-the-counter analgesic acetaminophen. It is prescribed for moderate to severe pain in tablet form. 

Opioid drugs can cause sedation, mental alterations, and suppression of the central nervous system. They can potentially interact with other medications and supplements. 

Opioid medications are also habit-forming and have a high rate of misuse, often leading to opioid use disorder (OUD). Misuse of Lortab can lead to a potentially fatal overdose. 

OUD treatment can help to manage opioid dependence. The use of medications and therapies help to support long-term recovery.

What Is Lortab?

Lortab is a combination prescription medication that contains both hydrocodone and acetaminophen. This is a prescription painkiller. 

Hydrocodone has both antitussive (cough suppressing) and analgesic (pain-relieving) properties. 

Opioids are central nervous system (CNS) suppressants that slow down breathing, heart rate, and blood pressure, and lower body temperature, all while blocking pain sensations. Acetaminophen is also a pain-relieving medication.

Lortab is a narcotic drug. As a combination medication, it is classified by the Drug Enforcement Administration (DEA) as a Schedule II controlled substance. This means that it has a high potential for diversion, misuse, dependence, and addiction.

Uses

Lortab is prescribed to treat moderate to severe pain. It is typically prescribed to people for whom other non-opioid methods or medications are either not an option or not working. 

Lortab comes in tablet form to be taken by mouth every four to six hours as needed for pain. It is not to be taken by people who are sensitive to opioids or who have had a previous hypersensitivity to either acetaminophen or hydrocodone.

Lortab Side Effects

Side Effects of Lortab

The following are the most common side effects of Lortab:

  • Nausea and vomiting
  • Lightheadedness
  • Sedation
  • Dizziness

Additional side effects can include the following: 

  • Mental cloudiness
  • Drowsiness
  • Mood changes
  • Anxiety
  • Lethargy
  • Constipation
  • Trouble urinating
  • Rash or itchiness
  • Breathing difficulties

Precautions

Lortab should be used with caution for high-risk patients, including those who are debilitated or elderly and those with significant hepatic or renal function impairment, pulmonary disease, hypothyroidism, or Addison’s disease. 

Lortab can also cause physical and mental impairment. Therefore, it should be used with caution by those operating heavy machinery or motor vehicles. 

Lortab is extremely habit-forming. Caution should be observed to ensure the medication is being used for as short of a time period as possible and only exactly as prescribed.

Lortab Interactions

Lortab can interact with other medications and supplements. It is important to talk to your doctor about anything else you may be taking before starting this medication. 

For example, if you take other medications that contain acetaminophen while taking Lortab, it can lead to liver damage. This is because too much acetaminophen is in the system. 

The following drugs may also interact poorly with Lortab:

  • Other narcotics
  • Antihistamines
  • Antipsychotics
  • Antidepressants
  • Anti-anxiety medications
  • Other central nervous system depressants, including alcohol or sedatives

Lortab Overdose 

Opioid drugs such as Lortab have a high risk for overdose with accidental ingestion, misuse, or when combined with other medications or depressant substances. An overdose is a medical emergency. 

Overdose symptoms from the opioid effect include the following:

  • Pinpoint pupils
  • Nausea and vomiting
  • Breathing problems
  • Trouble staying awake or losing consciousness
  • A bluish tint to skin and being cold to the touch
  • Irregular heart rate and blood pressure
  • Extreme mental confusion
  • Dizziness
  • Loss of balance and coordination

Lortab & Acetaminophen

Because Lortab contains acetaminophen, it has an additional risk of causing death if taken in doses greater than prescribed. Acetaminophen is usually safe when taken as prescribed, but if taken in higher than doctor-recommended doses it can cause permanent, irreversible damage to the liver, liver failure, cirrosis, and death. Like opioids, acetaminophen is highly dangerous if taken in overdose, but for different reasons.

Withdrawal Symptoms

Lortab is habit-forming, which means that the opioid component of the medication can cause physical and psychological dependence. 

With regular use, an opioid drug makes changes to brain circuitry and chemical makeup, causing withdrawal symptoms to set in when the drug is not active in the system. Withdrawal symptoms are often similar to the flu physically. In addition, withdrawal can cause mood swings and emotional distress. 

Withdrawal symptoms can include the following:

  • Nausea, diarrhea, and vomiting
  • Headache
  • Fatigue
  • Goosebumps and chills
  • Dizziness
  • Sleep difficulties
  • Extreme sweating
  • Restlessness
  • Muscle aches
  • Stomach cramps and pain
  • Anxiety
  • Irritability
  • Problems concentrating and thinking straight
  • Depression

Lortab Misuse & Opioid Use Disorder

Hydrocodone products, which includes Lortab, are some of the most commonly prescribed opioids and also some of the most regularly misused. 

Nearly 5 million people in the United States, ages 12 or older, misused a hydrocodone product in 2020. Almost 13% of people taking hydrocodone products misused them.

Over 2.5 million Americans had an opioid use disorder (OUD) in 2020. 

Lortab is a highly addictive medication. Misuse of Lortab increases the risk and rate of opioid use disorder. Lortab contains acetaminophen which is toxic to the liver if taken in overdose.

Signs of Lortab Misuse

Signs of Lortab Misuse

Prescription medications like Lortab are commonly misused. This occurs when someone without a legitimate and necessary prescription for the medication obtains it and takes it illicitly or when someone with a prescription uses the medication in a way other than directed. 

Signs of misuse include the following:

  • Drug diversion (obtaining the drug for illicit use)
  • Doctor “shopping” (seeing more than one doctor to get a prescription)
  • Making up or exaggerating symptoms to get a prescription
  • Taking someone else’s prescription
  • Taking Lortab after the prescription has run out
  • Taking higher doses of Lortab at a time or taking it in between scheduled doses
  • Combining Lortab with other medications or substances
  • Altering the medication (chewing or crushing it and snorting or injecting it)
  • Spending a lot of time working out how to get Lortab, taking it, and recovering from its use
  • Mood swings and a potential personality shift
  • Increased secrecy and social isolation
  • Changes in eating and sleeping habits 

Side Effects of Lortab Misuse

Misusing Lortab can be fatal due to overdose. Lortab can overwhelm the respiratory system and cause the lungs to stop working properly. 

Other potential hazards of Lortab misuse include an increased rate of dependence that can lead to opioid use disorder. Addiction is a compulsive and chronic condition that requires specialized treatment to manage drug cravings, withdrawal, and dangerous drug misuse.

Treatment Options

Treatment for Lortab misuse and OUD will depend on the individual and the level of care required. 

OUD often co-occurs with a mental health disorder. In this case, dual diagnosis treatment is optimal. 

Inpatient, or residential, treatment programs can provide 24/7 care and support in a highly structured and supervised environment.

Outpatient treatment models offer more flexibility, allowing individuals to remain at home while attending counseling, therapy, workshops, and support group meetings at convenient times. 

All levels of care usually include behavioral therapy models that provide group and individual therapy and counseling sessions designed to improve habits, develop healthy life skills, and acquire learning tools and coping mechanisms to manage cravings and potential triggers. 

Medications, often in the form of Medications for Addiction Treatment (MAT), are an important part of OUD treatment. These specialized prescription medications work to diminish cravings and withdrawal symptoms to support a sustained recovery. 

Support group meetings can be a beneficial aspect of recovery. Many comprehensive treatment programs connect patients with support groups that can help sustain ongoing recovery.

Medically Reviewed By Claire Wilcox, MD

Claire Wilcox, MD, is a general and addiction psychiatrist in private practice and an associate professor of translational neuroscience at the Mind Research Network in New Mexico; and has completed an addictions fellowship, psychiatry residency, and internal medicine residency. Having done extensive research in the area, she is an expert in the neuroscience of substance use disorders. Although she is interested in several topics in medicine and psychiatry, with a particular focus on substance use disorders, obesity, eating disorders, and chronic pain, her primary career goal is to help promote recovery and wellbeing for people with a range of mental health challenges.

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Citations

  1. DEA to Publish Final Rule Rescheduling Hydrocodone Combination Products. Drug Enforcement Administration (DEA). https://www.dea.gov/press-releases/2014/08/21/dea-publish-final-rule-rescheduling-hydrocodone-combination-products. August 2014. Accessed March 2022.
  2. Lortab- Hydrocodone Bitartrate and Acetaminophen Tablet. U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=1fb18a80-8ef0-4bce-bb0d-9a86851c5206. October 2006. Accessed March 2022.
  3. Hydrocodone. Drug Enforcement Administration (DEA). https://www.deadiversion.usdoj.gov/drug_chem_info/hydrocodone.pdf. October 2019. Accessed March 2022.
  4. Key Substance Use and Mental Health Indicators in the United States: Results from the 2020 National Survey on Drug Use and Health. Substance Abuse and Mental Health Services Administration (SAMHSA). https://www.samhsa.gov/data/report/2020-nsduh-annual-national-report. October 2021. Accessed March 2022.

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