Vicoprofen Addiction: What Are The Dangers Of Misuse ?

Last Updated: July 30, 2021

Authored by Nena Messina, Ph.D.

Reviewed by Michael Espelin APRN

Vicoprofen is one of the brand name prescription medications that combines a semisynthetic opioid analgesic, Hydrocodone Bitartrate and a nonsteroidal antiinflammatory drug (NSAID), Ibuprofen. It combines the analgesic properties of hydrocodone and analgesic as well as antiinflammatory and antipyretic properties of Ibuprofen to provide short-term relief from acute, severe pain that requires opioid analgesia and for which alternative treatment options have been inadequate. Despite adequate efficacy of Vicoprofen pills in relieving pain, they come with a drawback, a strong predilection for Vicoprofen addiction, abuse, and misuse. Furthermore, the spectrum of Vicoprofen side effects, warning, and contraindications are also large and can even be life threatening if misused. Therefore, this article discusses the essential information that individuals may require regarding indication, side effects, misuse, and recovery from Vicoprofen addiction.

What is Vicoprofen?

Vicoprofen is a brand name for a medication that combines a semisynthetic opioid analgesic, Hydrocodone Bitartrate and a nonsteroidal antiinflammatory drug (NSAID), Ibuprofen. Hydrocodone, being a full opioid agonist with selectivity for the mu-opioid receptor, provides strong analgesia. Ibuprofen, a propionic acid group nonsteroidal antiinflammatory drug (NSAID), has analgesic, anti-inflammatory, and antipyretic properties through inhibition of prostaglandin synthesis, which are compounds that mediate pain, inflammation, and fever. Thus, through the combination of these two compounds, Vicoprofen is a medication that has potent analgesic as well as anti-inflammatory, antipyretic, and antitussive properties.

Currently, under the United States Controlled Substance Act (CSA) Vicoprofen is a schedule II prescription substance. This denotes the fact that this medication has a high potential for abuse, with use potentially leading to severe mental or physical dependence.

In addition to its scheduled control, this medication comes with a black box warning for “Addiction, Abuse, and Misuse” as well as “Life-Threatening Respiratory Depression” and “Dangerous Cytochrome P450 3A4 Interactions” with certain other drugs.

Close up young woman taking out pills from bottle.

What Is Vicoprofen Used For?

According to the labeling information provided by the FDA, the approved indication for Vicoprofen pills are for the short-term(<10 days) management of acute pain severe enough to require an opioid analgesic and for which alternative treatment methods have proven inadequate. This type of acute, severe pain can be associated with trauma, surgery, or in some cases of cancer.

This medication is not indicated/recommended for the long-term treatment of chronic pain that can be associated with conditions such as osteoarthritis or rheumatoid arthritis.

Generic Vicoprofen And Brand Names

Generic Vicoprofen does not exist, as it is not a single medication but a combination of two separate drugs, Hydrocodone and Ibuprofen. Vicoprofen itself is the brand name medication, produced by Knoll Pharmaceutical and co-promoted by Abbott Laboratories.

Other brand name drugs which combine Hydrocodone and Ibuprofen include Ibudone, Reprexain, and Xylon 10.

Vicoprofen Strengths And Dosage Forms

Vicoprofen doses are “fixed dose combinations” that contain 7.5mg of Hydrocodone bitartrate and 200mg of Ibuprofen within each of the Vicoprofen pills. However, additional Vicoprofen strengths may be available with 5 and 10 milligrams of Hydrocodone.

Vicoprofen pills are white, film-coated out curved tablets, etched on one side with the letter “VP” over the Abbot “A” logo. The other side of the pill is blank.

This medication may be dispensed as the bottles of 15, 20, 30, 60, or 100 pills.

Vicoprofen Side Effects

As with any medications, even when used according to prescription, patients may experience some side effects. This is especially true for Vicoprofen, as patients experience not only the side effects of one medication but two, namely Hydrocodone as well as Ibuprofen. Therefore it is essential to monitor Vicoprofen doses and the spectrum of side effects patients may have to it as the elicited Vicoprofen side effects may harm the patient’s health or even be life-threatening.

The spectrum of adverse drug reactions associated with this medication is vast as it relates to the side effects of two different drugs, Hydrocodone and Ibuprofen. Thus, it would be impertinent to list the full spectrum of all possible adverse reactions that may occur.

Instead, Below Are Offered Some of the Most Common Side Effects of This Medication:

  • Insomnia or other sleeping issues
  • Dry mouth
  • Headaches
  • Dizziness and weakness
  • Constipation or diarrhea
  • Stomach issues, such as nausea, vomiting, indigestion and gas
  • Sweating
  • Itching
  • Feeling anxious or nervous

Patients should immediately contact a doctor if they experience any of the following symptoms. They indicate an adverse reaction and can be the sign of something being seriously wrong. These symptoms include:

  • The first signs of a rash, no matter how mild or small
  • Indications of stomach bleeding (such as coughing up blood, vomit that looks like coffee grounds or blood in stool)
  • Weak or shallow breathing
  • Slowed heartbeat
  • Shortness of breath
  • Rapid weight gain or swelling
  • Liver problems (diarrhea, loss of appetite, dark urine, jaundice, upper stomach pain, flu like symptoms)
  • Low cortisol levels (vomiting, tiredness that keeps getting worse, dizziness)
  • Kidney problems (urinating less, or stopping altogether, painful urination, feet and ankles are swollen)
  • Severe skin issues (burning in the eyes, pain followed by a purple or red rash that causes blisters and peeling which spreads {mostly in the face and upper body}, swelling in the face or tongue, sore throat, fever)

This drug may slow mental reaction time, making a patient woozy and drowsy. It is best to not drive, or operate any dangerous machinery until determining how this medication affects a patient. Everyone is different, and some may find that they can function sharply and without a problem, while others may find its sedative effects too strong for that.

One needs to be cautious of using this medication with any other pain, cold or allergy medication, preferably consulting a doctor. The risk is that many over the counter medications contain Ibuprofen so it is important to make sure that patients are not consuming too much through combined medication.

How Long Does It Stay In Your System?

How long Vicoprofen stays in the system is a common question among its users. But there is no single answer to this. It is because a multitude of factors such as age, gender, weight, genetics, concurrent illnesses, and duration of use can all affect the duration that this medication will stay in one’s body fluids or organs. Nonetheless, a medication’s half-life, or the time it takes for the amount of a drug’s active substance in your body to reduce by half, is a good measure. It is generally accepted that after four half-lives a medication has been completely eliminated from your system.

  • The half-life of Hydrocodone is around 3.8 hours, thus after approximately 15 hours the hydrocodone component of this medication should leave one’s system completely.
  • The half-life of Ibuprofen is 1.8 to 2 hours, thus after approximately 8 hours the Ibuprofen component of this medication should leave one’s system completely.
  • Furthermore, metabolites of Vicoprofen components may stay in one’s system for a day or up to ninety days and be detected in various biologic samples such as Hair(90 days), Urine( 3 days) and Blood(<24 hours).

Lastly, neither hydrocodone or Ibuprofen are detectable on standard immunoassays of urine and blood that test for common substances of abuse. However, more specialized tests can detect Hydrocodone and its metabolites if needed.

Sick woman holding sparkling water glass with a pill in another hand.

Overview Of Vicoprofen Abuse And Is the Drug Addictive?

The “trouble” with Vicoprofen is that it contains hydrocodone, an opioid analgesic which exposes consumers to the risks of addiction, abuse, misuse, and possible criminal diversion.  What is even more concerning is the fact that Vicoprofen abuse and subsequent addiction may occur in those patients who are appropriately prescribed this medication and use the recommended Vicoprofen doses. As such, those patients prescribed this medication should be monitored for behavioral, mental, and physiological signs of misuse.

What Makes Vicoprofen Abuse And Addiction So Frequent?

This is a difficult question to answer, and is mostly multivariable. One possible reason for the frequency of Vicoprofen abuse as well as other prescription drug abuse is their overprescription. According to the United States Centers for Disease Control and Prevention (CDC), in 2019 alone 153,260,450 prescriptions were written for opioid analgesics. This resulted in a dispensing rate of  roughly  46.7 per 100 persons.

Other possible reasons could include a “medication culture” that tries to fix all problems with pills, or overprescription of opioid analgesics due to poor management strategies of pain by prescribing physicians.

Who Is Most at Risk Of Addiction?

The risk factors for substance abuse and addiction are generally shared among the frequent substances of abuse. The following individuals may be at a higher risk Vicoprofen addiction:

  • Those patients who have a personal or family history of substance use disorder related but not limited to alcohol, benzodiazepines, barbiturates, other opioids etc
  • Patients who have a history of mental illness such as Major Depressive Disorder or Anxiety Disorders.
  • Patients who have medical conditions associated with chronic pain

These are just some of the “factors” which may promote the development of misuse and subsequent Vicoprofen addiction. Furthermore, the potential risks for misuse and addiction should not prevent a patient from receiving justified management of pain. Instead those patients who may be at an increased risk for substance use disorder should be counseled and monitored when prescribed opioid-containing medications.

Signs and Symptoms Of Addiction and Abuse

Vicoprofen addiction causes a wide range of behavioral, cognitive, and physical symptoms and signs. While some of them may be all too obvious, others may be more easily missed as they are subtle in nature. Regardless, monitoring patients for the following signs and symptoms of Vicoprofen addiction is the first step in the right direction.

  • A strong desire to take the drug
  • Difficulties in controlling its use
  • Persisting in its use despite harmful consequences to personal or professional life
  • High priority given to drug use and acquisition than to other activities and obligations
  • Development of tolerance, manifested by the need of higher and higher doses to achieve the same pharmacologic effect.
  • Development of physical withdrawal upon cessation or dose alteration
  • “Drug seeking” behavior manifested by tactics such as emergency calls or visits near the end of office hours, refusal to undergo appropriate examination, repeated “loss” of or tampering with prescriptions,
  •  “Doctor shopping” which refers to visiting multiple doctors  to obtain multiple prescriptions.
  • Changes in mood or behavior such as aggression, especially when confronted about drug use.
  • Changes in appearance, weight, food habits, and skin.

The signs of Vicoprofen addiction mentioned above may not all be present in a person. This is because addiction affects different individuals in different ways. Therefore, one should observe all the signs closely. In addition, use the judgment before making a confirmation of the addiction. If a patient senses anything abnormal, seek immediate help from an addiction counselor. That way, they will most probably be able to free themselves from the addiction.

A doctor man holding a pill bottle and writing while talking with a patient and reviewing his medication at office room.

Possible Dangers Of Vicoprofen Abuse And Addiction

Researchers are still trying to figure out the effects of long-term opioid use regarding brain damage. Some find that it affects decision-making abilities, behavioral regulation, emotional regulation, and responses to stressful situations. Furthermore, overdose with life-threatening respiratory depression is a very real and likely health risk for opioid users. As is withdrawal, which too can pose serious health risks to the patient.

Vicoprofen Overdose

Overdose may occur when taking larger doses of this medication than recommended. This is especially common in those patients with Vicoprofen addiction, who aim to achieve an intense high. Overdose or acute intoxication in this case is related to both drugs, Hydrocodone and Ibuprofen.

Hydrocodone Intoxication Manifests With:

  • Respiratory depression and bradypnea with partial or complete airway obstruction and atypical snoring.
  • Decrease in the patient’s mental status progressing from drowsy to somnolent to stuporous and finally to coma.
  • Skeletal muscle flaccidity and variably decreased deep tendon reflexes.
  • Cold and clammy skin
  • Myosis also known as constricted pupils or pinpoint pupils that will progress to Mydriasis or pupillary dilation as severe hypoxia sets in.
  • In cases of severe intoxication pulmonary edema or fluid in the lungs will occur.
  • Cardiovascular manifestations are not prominent, but may include bradycardia and hypotension.

Ibuprofen Intoxication Manifests With:

  • Lethargy
  • Drowsiness
  • Nausea and/or vomiting
  • Epigastric pain
  • Gastric bleeding

Acute intoxication/overdose is an emergency that poses serious risk to the patient’s health. Furthermore, this situation is often complicated by co-ingestion of other substances such as benzodiazepines, alcohol, etc which may further complicate the picture and promote deterioration of the patient’s health. Thus, emergency medical services should be immediately contacted as they have resources for the institution of antidotal therapy if applicable and for the stabilization of their airway and other vital signs.

Vicoprofen Withdrawal

The withdrawal phenomenon is a common manifestation of Vicoprofen abuse. Withdrawal develops due to the presence of physiologic dependence, and can be instigated by abrupt cessation or a significant dosage reduction of an opioid, administration of an opioid antagonist especially in chronic abusers, and administration of other medications which are either partial or mixed antagonists of opioids.

The Symptoms And Signs Of Withdrawal Can Include:

  • Feeling restless and anxious or jittery
  • Teary eyes and runny nose
  • Yawning
  • Sweating
  • Chills
  • Bone, Muscle, and Joint pain
  • Mydriasis
  • Irritability and mood swings
  • Abdominal cramps and diarrhea
  • Insomnia
  • Anorexia, Nausea, Anorexia,
  • Tachycardia and Hypertension
  • Tachypnea

Withdrawal phenomenon requires medical management, especially in chronic users, as it too can pose dangers to the patient’s health and well being. Furthermore, management of withdrawal of other drugs or alcohol the patient may also be addicted to also requires attention

Vicoprofen Alternatives

Below are some alternatives to the combination of Hydrocodone and Ibuprofen, which have the same indication for relief of moderate to severe pain as Vicoprofen but contain Acetaminophen also known as Paracetamol instead of Ibuprofen.

Vicoprofen vs Norco & Vicodin

Norco and Vicodin contain a combination of Hydrocodone Bitartrate and Acetaminophen. The indication is absolutely the same, management of moderate to severe pain. The only difference is in the comparison of Ibuprofen and Acetaminophen. Both of these agents are analgesics and antipyretic, but the antiinflammatory properties of Ibuprofen are far superior.

Vicoprofen vs Percocet

Percocet offers a combination of Oxycodone with Acetaminophen. The only difference between Oxycodone and Hydrocodone, is that Hydrocodone has mild antitussive properties retained as it is a derivative of codeine.

How can Vicoprofen Addiction be Treated?

Vicoprofen is considered to be a powerful drug, and those individuals who abuse and become addicted to it will find it hard to quit. Users who stopped taking this drug will have to undergo a difficult withdrawal process from the physical and psychological dependence on it. This means they can’t function normally without it.

Detoxification is the first-line of treatment for people with addiction to this drug. This medical procedure is done at a hospital or any accredited drug treatment facility where medical resources are available and under the strict supervision of medical professionals. After detoxifying, all the harmful toxins of Hydrocodone/Ibuprofen and any other substances such as benzodiazepines, alcohol, etc are removed from the system.

Patients undergoing abuse treatment are also given synthetic opioids to help manage withdrawal symptoms. In addition, the dosage is slowly tapered to reduce the discomfort and withdrawal symptoms. There are addiction treatment resources that will recommend minimal sedation to numb the patient during the withdrawal process. Patients are given the freedom to choose between inpatient and outpatient drug rehab services to help them get the right treatment and care for a complete recovery from the opioid addiction.

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Page Sources

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Published on: January 24th, 2017

Updated on: July 30th, 2021

About Author

Nena Messina, Ph.D.

Nena Messina is a specialist in drug-related domestic violence. She devoted her life to the study of the connection between crime, mental health, and substance abuse. Apart from her work as management at addiction center, Nena regularly takes part in the educational program as a lecturer.

Medically Reviewed by

Michael Espelin APRN

8 years of nursing experience in wide variety of behavioral and addition settings that include adult inpatient and outpatient mental health services with substance use disorders, and geriatric long-term care and hospice care.  He has a particular interest in psychopharmacology, nutritional psychiatry, and alternative treatment options involving particular vitamins, dietary supplements, and administering auricular acupuncture.