Documented interactions for Vicodin, Vicodin ES, Vicodin HP, Norco, Lortab, Lorcet, Lorcet Plus (Hydrocodone bitartrate and acetaminophen (tablet)). Each entry cites the prescribing information or FDA safety communication it is based on.
| Severity | Interacts with | Class | Concern |
|---|---|---|---|
| Contraindicated | MAO inhibitors (phenelzine, tranylcypromine, linezolid, methylene blue) | Monoamine oxidase inhibitor | Hydrocodone with MAO inhibitors is contraindicated |
| Contraindicated | MAO inhibitors (phenelzine, tranylcypromine, linezolid, methylene blue) | Monoamine oxidase inhibitor | Opioid with MAO inhibitors is contraindicated |
| Major | Alcohol (ethanol) | CNS depressant | Hydrocodone with alcohol: additive respiratory depression |
| Major | Alcohol (ethanol) | CNS depressant | Opioid with alcohol: additive respiratory depression |
| Major | Other acetaminophen-containing products (Tylenol, Excedrin, cold medicines) | Acetaminophen-containing product | Duplicate acetaminophen dosing across combination products |
| Major | Other benzodiazepines (diazepam, clonazepam, lorazepam, alprazolam, temazepam) | Benzodiazepine | Hydrocodone with benzodiazepine: risk of profound sedation, respiratory depression, coma, and death |
| Major | Other benzodiazepines (diazepam, clonazepam, lorazepam, alprazolam, temazepam) | Benzodiazepine | Opioid with benzodiazepine: risk of profound sedation, respiratory depression, coma, and death |
| Major | Other CNS depressants (opioids, benzodiazepines, sleep aids, sedating antihistamines, gabapentinoids, muscle relaxants) | CNS depressant | Opioid with other CNS depressants: additive respiratory depression |
| Major | Other gabapentinoids (gabapentin, pregabalin) | Gabapentinoid | Opioid with gabapentinoid: serious breathing difficulties |
| Major | Other opioids (morphine, fentanyl, methadone, oxycodone, hydromorphone, tramadol) | Opioid | Concurrent opioid therapy increases overdose risk |
With: MAO inhibitors (phenelzine, tranylcypromine, linezolid, methylene blue) Monoamine oxidase inhibitor
MAO inhibitors potentiate opioid effects and impair metabolism.
Severe unpredictable reactions including respiratory depression and death.
Do not combine.
Basis: Hydrocodone-containing product labeling, Contraindications. source
With: MAO inhibitors (phenelzine, tranylcypromine, linezolid, methylene blue) Monoamine oxidase inhibitor
MAO inhibitors potentiate opioid effects and impair metabolism.
Severe unpredictable reactions including respiratory depression and death.
Do not combine.
Basis: Opioid-containing product labeling, Contraindications. source
With: Alcohol (ethanol) CNS depressant
Combined central nervous system and respiratory depression.
Respiratory depression, deep sedation, and death.
Avoid alcohol during hydrocodone therapy.
Basis: Hydrocodone-containing product labeling, Warnings and Precautions. source
With: Alcohol (ethanol) CNS depressant
Both agents depress the central nervous system and breathing.
Respiratory depression, deep sedation, coma, and death.
Avoid alcohol during opioid therapy.
Basis: Opioid-containing product labeling, Warnings and Precautions. source
With: Other acetaminophen-containing products (Tylenol, Excedrin, cold medicines) Acetaminophen-containing product
Acetaminophen from multiple products adds up in the liver, which can be overwhelmed.
Acetaminophen overdose is a leading cause of drug-induced liver injury and acute liver failure.
Total acetaminophen from all sources should stay at or below the labeled maximum daily dose, typically 3,000 mg for combination products. Check every label for hidden acetaminophen.
Basis: Hydrocodone/acetaminophen prescribing information, Warnings and Precautions. source
With: Other benzodiazepines (diazepam, clonazepam, lorazepam, alprazolam, temazepam) Benzodiazepine
Additive depression of the central nervous system and respiratory drive.
FDA requires a boxed warning on hydrocodone-containing products describing this combination.
Avoid where possible; if used, lowest effective doses for the shortest duration with monitoring.
Basis: Hydrocodone bitartrate and acetaminophen tablets prescribing information, Boxed Warning. source
With: Other benzodiazepines (diazepam, clonazepam, lorazepam, alprazolam, temazepam) Benzodiazepine
Additive depression of the central nervous system and respiratory drive.
FDA requires a boxed warning on opioid-containing products describing this combination.
Avoid where possible. If used, lowest effective doses for the shortest duration with monitoring.
Basis: FDA Drug Safety Communication (2016); opioid boxed warning. source
With: Other CNS depressants (opioids, benzodiazepines, sleep aids, sedating antihistamines, gabapentinoids, muscle relaxants) CNS depressant
Additive central nervous system depression and slowed breathing.
Respiratory depression and overdose, particularly in older adults.
Disclose all sedating medications to the prescriber and pharmacist.
Basis: Opioid-containing product labeling, Warnings and Precautions. source
With: Other gabapentinoids (gabapentin, pregabalin) Gabapentinoid
Additive respiratory depression.
FDA warns of serious breathing difficulties and increased risk of death when gabapentinoids are combined with opioids.
Use the lowest effective gabapentinoid dose and monitor for slowed breathing.
Basis: FDA Drug Safety Communication (2021). source
With: Other opioids (morphine, fentanyl, methadone, oxycodone, hydromorphone, tramadol) Opioid
Two opioids additively depress breathing; incomplete cross-tolerance means tolerance to one does not fully protect against the other.
Respiratory depression and overdose. FDA warns that combining prescription opioids with other opioids increases overdose risk.
Use only as directed and tell every prescriber about all opioid use.
Basis: FDA Drug Safety Communication: Risks of using opioids with other opioids. source
We have documented 10 interaction classes for Vicodin, Vicodin ES, Vicodin HP, Norco, Lortab, Lorcet, Lorcet Plus in our dataset. Usually avoided, or used only with explicit prescriber oversight and close monitoring. The most serious items on this page are marked contraindicated or major.
Alcohol interacts with most of the medications on this site because it adds to sedation and slows breathing. For the specific documented risk, see the relevant entry above. The general rule from labeling is to avoid alcohol.
No. An empty result only means our curated dataset has no matching rule. A pharmacist can run a full interaction screen against every medication and supplement you take.
This site provides educational information only and does not sell, prescribe or dispense medications. Always consult a licensed healthcare provider. This page is not medical advice.