Hydrocodone 10/650mg

⚠️ Critical Safety Alert

• NOT AVAILABLE in U.S. since 2014 – All opioid/APAP combos now limited to ≤325mg APAP per unit

• Extreme Hepatotoxicity Risk:

  • Just 6 tablets = 3,900mg APAP (exceeds daily max)

  • 8 tablets = 5,200mg (acute liver failure range)

If Encountering This Product:

1. DO NOT ADMINISTER – Likely counterfeit/foreign

2. REPORT to FDA MedWatch

3. SWITCH IMMEDIATELY to safer alternatives

Current FDA-Approved Alternatives

Why 650mg APAP Was Banned:

• #1 Cause of Acute Liver Failure in U.S. (2000s)

• Fatal Overdoses from unintentional APAP stacking

• No Therapeutic Benefit over 325mg formulations

Proper 10mg Hydrocodone Dosing Today

1. Standard 10/325mg:

   • Max 6 tabs/day (1,950mg APAP)

2. APAP-Free Options:

   • Hysingla ER (pure hydrocodone)

   • Combine hydrocodone IR with separate APAP

Patient Counseling Points

✔ Never combine with other APAP products
✔ Watch for hidden APAP in cold/flu meds
✔ Early OD signs: Nausea, RUQ pain, confusion

Need legitimate pain management?
Consult a physician for:

• Non-APAP opioids

• Multimodal therapies

• Personalized risk assessment