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Medication Guide — Hydrocodone Bitartrate And Ibuprofen

Patient-friendly FDA guidance and safety information.

Last updated · May 13, 2026Source: DailyMed ↗
Boxed Warning

Addiction, Abuse, and Misuse

Because the use of hydrocodone bitartrate and ibuprofen exposes patients and other users to the risks of opioid addiction, abuse, and misuse, which can lead to overdose and death, assess each patient’s risk prior to prescribing and reassess all patients regularly for the development of these behaviors and conditions (see WARNINGS).

Life-Threatening Respiratory Depression

Serious, life-threatening, or fatal respiratory depression may occur with use of hydrocodone bitartrate and ibuprofen, especially during initiation or following a dosage increase. To reduce the risk of respiratory depression, proper dosing and titration of hydrocodone bitartrate and ibuprofen are essential (see WARNINGS).

Accidental Ingestion

Accidental ingestion of even one dose of hydrocodone bitartrate and ibuprofen, especially by children, can result in a fatal overdose of hydrocodone (see WARNINGS).

Risks From Concomitant Use With Benzodiazepines Or Other CNS Depressants

Concomitant use of opioids with benzodiazepines or other central nervous system (CNS) depressants, including alcohol, may result in profound sedation, respiratory depression, coma, and death. Reserve concomitant prescribing of hydrocodone bitartrate and ibuprofen and benzodiazepines or other CNS depressants for use in patients for whom alternative treatment options are inadequate (see WARNINGS).

Neonatal Opioid Withdrawal Syndrome  (NOWS)

Advise pregnant women using opioids for an extended period of time of the risk of Neonatal Opioid Withdrawal Syndrome , which may be life-threatening if not recognized and treated. Ensure that management by neonatology experts will be available at delivery (see WARNINGS).

Opioid Analgesic Risk Evaluation and Mitigation Strategy (REMS)

Healthcare providers are strongly encouraged to complete a REMS-compliant education program and to counsel patients and caregivers on serious risks, safe use, and the importance of reading the Medication Guide with each prescription (see WARNINGS).

Cytochrome P450 3A4 Interaction

The concomitant use of hydrocodone bitartrate and ibuprofen with all cytochrome P450 3A4 inhibitors may result in an increase in hydrocodone plasma concentrations, which may cause potentially fatal respiratory depression. In addition, discontinuation of a concomitantly used cytochrome P450 3A4 inducer may result in an increase in hydrocodone plasma concentration. Monitor patients taking hydrocodone bitartrate and ibuprofen and any CYP3A4 inhibitor or upon discontinuation of a CYP3A4 inducer for signs and symptoms of respiratory depression and sedation (see WARNINGS: Risks of Concomitant Use or Discontinuation of Cytochrome P450 3A4 Inhibitors and Inducers, PRECAUTIONS: Drug Interactions).

Cardiovascular Thrombotic Events

  • Nonsteroidal anti-inflammatory drugs (NSAIDs) cause an increased risk of serious cardiovascular thrombotic events, including myocardial infarction and stroke, which can be fatal. This risk may occur early in treatment and may increase with duration of use (see WARNINGS: Cardiovascular Thrombotic Events).
  • Hydrocodone bitartrate and ibuprofen is contraindicated in the setting of coronary artery bypass graft (CABG) surgery (see CONTRAINDICATIONS, WARNINGS: Cardiovascular Thrombotic Events).

Gastrointestinal Bleeding, Ulceration, and Perforation

NSAIDs cause an increased risk of serious gastrointestinal (GI) adverse events including bleeding, ulceration, and perforation of the stomach or intestines, which can be fatal. These events can occur at any time during use and without warning symptoms. Elderly patients and patients with a prior history of peptic ulcer disease and/or GI bleeding are at greater risk for serious GI events (see WARNINGS: Gastrointestinal Bleeding, Ulceration, and Perforation).

Poison Help

If you suspect an overdose or accidental ingestion, call Poison Control: 1-800-222-1222 (free, 24/7, U.S.). For life-threatening symptoms, call 911.

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Medication Guide

This Medication Guide has been approved by the U.S. Food and Drug Administration.

Hydrocodone Bitartrate (hye" droe koe' done bye tar' trate) and Ibuprofen (eye" bue proe' fen) tablets, CII

Hydrocodone bitartrate and ibuprofen tablets are:

  • A strong prescription pain medicine that contains an opioid (narcotic) and a non-steroidal anti-inflammatory drug (NSAID), that is used to manage short-term (acute) pain, when other pain treatments such as non-opioid pain medicines do not treat your pain well enough or you cannot tolerate them.
  • An opioid pain medicine can put you at risk for overdose and death. Even if you take your dose correctly as prescribed you are at risk for opioid addiction, abuse, and misuse that can lead to death.
  • NSAIDs are used to treat pain, redness, swelling, and inflammation.

Important information about hydrocodone bitartrate and ibuprofen tablets:

  • Get emergency help or call 911 right away if you take too much hydrocodone bitartrate and ibuprofen tablets (overdose). When you first start taking hydrocodone bitartrate and ibuprofen tablets, when your dose is changed, or if you take too much (overdose), serious or life-threatening breathing problems that can lead to death may occur. Ask your healthcare provider about medicines like naloxone or nalmefene that can be used in an emergency to reverse an opioid overdose.
  • Taking hydrocodone bitartrate and ibuprofen tablets with other opioid medicines, benzodiazepines, gabapentinoids (gabapentin or pregabalin), alcohol, or other central nervous system depressants (including street drugs) can cause severe drowsiness, decreased awareness, breathing problems, coma, and death.
  • Never give anyone else your hydrocodone bitartrate and ibuprofen tablets. They could die from taking it. Selling or giving away hydrocodone bitartrate and ibuprofen tablets is against the law.
  • Store hydrocodone bitartrate and ibuprofen tablets securely, out of sight and reach of children, and in a location not accessible by others, including visitors to the home.

Hydrocodone bitartrate and ibuprofen tablets contain an NSAID. NSAIDs can cause serious side effects, including:

  • Increased risk of a heart attack or stroke that can lead to death. This risk may happen early in treatment and may increase:
    • with increasing doses of medicine containing NSAIDs
    • with longer use of medicine containing NSAIDs

    Do not take NSAIDS right before or after a heart surgery called a “coronary artery bypass graft (CABG).”

    Avoid taking NSAIDS after a recent heart attack, unless your healthcare provider tells you to. You may have an increased risk of another heart attack if you take NSAIDs after a recent heart attack.

  • Increased risk of bleeding, ulcers, and tears (perforation) of the esophagus (tube leading from the mouth to the stomach), stomach and intestines:
    • any time during use
    • without warning symptoms
    • that may cause death

    The risk of getting an ulcer or bleeding increases with:

    • past history of stomach ulcers, or stomach or intestinal bleeding with use of NSAIDs
    • taking medicines called “corticosteroids,” “anticoagulants,” “SSRIs,” or “SNRIs”
    • increasing doses of NSAIDS
    • older age
    • longer use of NSAIDS
    • poor health
    • smoking
    • drinking alcohol
    • advanced liver disease
    • bleeding problems

Do not take hydrocodone bitartrate and ibuprofen tablets:

  • if you have severe asthma, trouble breathing, or other lung problems.
  • if you have a bowel blockage or have narrowing of the stomach or intestines.
  • if you have had an asthma attack, hives, or other allergic reaction with aspirin, other NSAIDs, or opioid medicine.
  • right before or after heart bypass surgery.

Before taking hydrocodone bitartrate and ibuprofen tablets, tell your healthcare provider if you have a history of:

  • head injury or seizures
  • liver, kidney, or thyroid problems
  • problems urinating
  • pancreas or gallbladder problems
  • high blood pressure
  • asthma
  • abuse of street or prescription drugs, alcohol addiction, opioid overdose, or mental health problems.

Tell your healthcare provider if you:

  • noticing your pain getting worse. If your pain gets worse after you take hydrocodone bitartrate and ibuprofen tablets, do not take more of hydrocodone bitartrate and ibuprofen tablets without first talking to your healthcare provider. Talk to your healthcare provider if the pain that you have increases, if you feel more sensitive to pain, or if you have new pain after taking hydrocodone bitartrate and ibuprofen tablets.
  • are pregnant or planning to become pregnant. Taking NSAIDs at about 20 weeks of pregnancy or later may harm your unborn baby. If you need to take NSAIDs for more than 2 days when you are between 20 and 30 weeks of pregnancy, your healthcare provider may need to monitor the amount of fluid in your womb around your baby. Use of hydrocodone bitartrate and ibuprofen tablets for an extended period of time during pregnancy can cause withdrawal symptoms in your newborn baby that could be life-threatening if not recognized and treated. You should not take NSAIDs after about 30 weeks of pregnancy.
  • are breastfeeding or planning to breastfeed. Hydrocodone bitartrate and ibuprofen passes into breast milk and may harm your baby. Carefully observe infants for increased sleepiness (more than usual), breathing difficulties, or limpness. Seek immediate medical care if you notice these signs.
  • develop any type of rash or fever. Contact your healthcare provider as soon as possible and stop taking hydrocodone bitartrate and ibuprofen tablets.
  • are living in a household where there are small children or someone who has abused street or prescription drugs.
  • are taking prescription or over-the-counter medicines, vitamins, or herbal supplements. Taking hydrocodone bitartrate and ibuprofen tablets with certain other medicines can cause serious side effects that could lead to death.

When taking hydrocodone bitartrate and ibuprofen tablets:

  • Do not change your dose. Take hydrocodone bitartrate and ibuprofen tablets exactly as prescribed by your healthcare provider.
  • For acute (short-term) pain, you may only need to take hydrocodone bitartrate and ibuprofen tablets for a few days. You may have some hydrocodone bitartrate and ibuprofen tablets left over that you did not use. See disposal information at the bottom of this section for directions on how to safely throw away (dispose of) your unused hydrocodone bitartrate and ibuprofen tablets.
  • Use the lowest dose possible for the shortest time needed.
  • Take your prescribed dose every 4 to 6 hours at the same time every day, as needed for pain. Do not take more than your prescribed dose. If you miss a dose, take your next dose at your usual time.
  • Call your healthcare provider if the dose you are taking does not control your pain.
  • If you have been taking hydrocodone bitartrate and ibuprofen tablets regularly, do not stop taking it without talking to your healthcare provider.
  • Dispose of expired, unwanted, or unused hydrocodone bitartrate and ibuprofen tablets by promptly flushing down the toilet, if a drug take-back option is not readily available. Visit www.fda.gov/drugdisposal for additional information on disposal of unused medicines.

While taking hydrocodone bitartrate and ibuprofen tablets DO NOT:

  • drive or operate heavy machinery, until you know how it affects you. Hydrocodone bitartrate and ibuprofen tablets can make you sleepy, dizzy, or lightheaded.
  • drink alcohol or use prescription or over-the-counter medicines that contain alcohol. Using products containing alcohol during treatment with hydrocodone bitartrate and ibuprofen tablets may cause you to overdose and die.

The possible side effects of hydrocodone bitartrate and ibuprofen tablets:

  • constipation, diarrhea, gas, heartburn, nausea, sleepiness, vomiting, tiredness, headache, dizziness, abdominal pain, rash, fever, heart attack, stroke, new or worse high blood pressure, heart failure, liver problems including liver failure, kidney problems including kidney failure, bleeding and ulcers in the stomach and intestine, low red blood cells (anemia), life-threatening skin reactions, life-threatening allergic reactions, asthma attacks in people who have asthma. Call your healthcare provider if you have any of these symptoms and they are severe.

Get emergency medical help or call 911 right away if you have:

  • trouble breathing or shortness of breath
  • fast heartbeat
  • chest pain
  • swelling of your face, tongue, or throat
  • extreme drowsiness
  • lightheadedness when changing positions
  • a fainting spell
  • agitation
  • high body temperature
  • trouble walking
  • stiff muscles
  • mental changes such as confusion
  • weakness in one part or side of your body
  • slurred speech

Stop hydrocodone bitartrate and ibuprofen tablets and call your healthcare provider right away if you have any of the following symptoms:

  • nausea
  • flu-like symptoms
  • more tired or weaker than usual
  • vomit blood
  • diarrhea
  • there is blood in your bowel movement or it is black and sticky like tar
  • itching
  • unusual weight gain
  • your skin or eyes look yellow
  • skin rash or blisters with fever
  • indigestion or stomach pain
  • swelling of the arms and legs, hands and feet

These are not all the possible side effects of hydrocodone bitartrate and ibuprofen tablets. Call your healthcare provider for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088. For more information go to dailymed.nlm.nih.gov.

Other information:

  • Aspirin is an NSAID medicine, but it does not increase the chance of a heart attack. Aspirin can cause bleeding in the brain, stomach, and intestines. Aspirin can also cause ulcers in the stomach and intestines.
  • Do not take other NSAID medicines, even those sold in lower doses without a prescription (over-the-counter) while taking hydrocodone bitartrate and ibuprofen tablets. NSAIDs may be present in over-the-counter medications for treatment of colds, fever, or insomnia.

*All trademarks are the property of their respective owner.

Manufactured by:
Amneal Pharmaceuticals of NY, LLC
Brookhaven, NY 11719

Rev. 10-2025-11

For more information, go to www.amneal.com or call 1-877-835-5472.

Sources

RxCUI: 858770

NDC: 53746-116

Last fetched: May 13, 2026

Source: DailyMed ↗

⚠️ Disclaimer

This information is for educational purposes only and is not medical advice. Always consult your doctor, pharmacist, or other licensed healthcare professional before starting, stopping, or changing any medicine. Read full medical disclaimer.