Comparative Pharmacology
Head-to-head clinical analysis: VICODIN ES versus VICODIN HP.
Peer-Reviewed Evidence
Head-to-head clinical analysis: VICODIN ES versus VICODIN HP.
VICODIN ES vs VICODIN HP
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Hydrocodone is a mu-opioid receptor agonist; acetaminophen inhibits cyclooxygenase (COX) and modulates descending serotonergic pathways.
Hydrocodone is a mu-opioid receptor agonist that inhibits ascending pain pathways; acetaminophen inhibits cyclooxygenase and has antipyretic effects.
Oral: 1 tablet (7.5 mg hydrocodone/300 mg acetaminophen) every 4-6 hours as needed for pain; maximum 6 tablets per day due to acetaminophen limit.
One tablet (hydrocodone bitartrate 10 mg/acetaminophen 660 mg) orally every 4-6 hours as needed for pain; maximum 6 tablets per day.
None Documented
None Documented
Hydrocodone: terminal half-life approximately 3.3-4.5 hours in adults, extended in hepatic or renal impairment. Acetaminophen: terminal half-life about 2-3 hours.
Hydrocodone: 3.8-5.5 hours (mean 4.5 h). Acetaminophen: 2-3 hours. Clinical context: dosing interval every 4-6 hours for acute pain.
Hydrocodone: primarily renal (urine) as unchanged drug and metabolites (O-demethylation and 6-keto-reduction products); ~26% excreted unchanged. Acetaminophen: renal (urine), ~85% as glucuronide and sulfate conjugates, ~2% unchanged.
Primarily renal: hydrocodone is eliminated as conjugated metabolites (glucuronides) ~80%; unchanged drug ~5%. Biliary/fecal: minor, <10%.
Category C
Category C
Opioid Analgesic
Opioid Analgesic