What Is Hydrocodone with APAP?

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  • Written By: Christina Hall
  • Edited By: Lauren Fritsky
  • Last Modified Date: 07 October 2019
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Hydrocodone with APAP is an analgesic preparation used to treat moderate to severe pain and, sometimes, severe cough. It contains a semi-synthetic opioid medication, hydrocodone, which is derived from two naturally-occurring opiates, thebaine and codeine. The second component of the preparation stands for N-acetyl-p-aminophenol, found in the over-the-counter analgesic medication acetaminophen, which acts as a potentiator for hydrocodone and also acts by itself as a concurrent pain-reliever and fever-reducer. Hydrocodone with APAP is a schedule III drug, classified by the United States Food and Drug Administration (FDA), because it has a high risk for abuse, addiction, and diversion.

Relieving pain by binding to opioid receptors primarily in the spinal cord and brain, the potency of opioid medications is compared to the potency of the natural opioid morphine. Hydrocodone, while similar in physiological effects to morphine, is significantly less potent. Hydrocodone with APAP comes in a variety of dosages, with differing ratios of each medication. The least-potent strength contains 500 mg of APAP and 5 mg of hydrocodone, and the most potent contains 660 mg of APAP and 10 mg of hydrocodone; the higher dosages can be taken less often while still achieving the same analgesic effects.


The drug is classified in the pregnancy category C, meaning that substantial research has not been done to research its safety, but doctors may still prescribe the painkiller if the benefits outweigh the risks. Among the general population, there is risk associated with the use of hydrocodone and APAP. The drug can cause respiratory depression if more is taken than prescribed, which can lead to coma and death in extreme cases. Another concern is the risk of dependence, as hydrocodone has been proven to be habit-forming and can lead to addictive disease. In cases of addiction, liver toxicity can be a concern because of the high everyday APAP dosage.

The most common side effects when taking hydrocodone with APAP include upset stomach, dizziness, and altered mental status. Some rarer side effects, which may require hospitalization if present, include jaundice, severe bruising, and loss of consciousness. The combination of the drug with alcohol or other sedative medication may increase some side effects, like drowsiness and dizziness. For this reason, patients are cautioned against driving a car or doing other activities that require mental alertness while under its effects. If a patient reacts unfavorably to APAP, hydrocodone is available in preparations that use other over-the-counter analgesics to potentiate the narcotic.


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