Maxidone

Doctors prescribe Maxidone to relieve a patient’s moderate to moderately severe pain.

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Other, off label uses for this medicine

The ingredients in Maxidone also soothe a dry cough, and reduce fever and inflammation.

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Administration/Dosage

Watson Pharma, Inc., makes Maxidone in tablet form for oral administration. Each Maxidone tablet contains 10 mg of hydrocodone bitartrate and 750 mg acetaminophen.

The usual adult dosage is one tablet every four to six hours as needed, not to exceed five tablets in a 24-hour period. Physicians will prescribe the initial dose according to the severity of the patient’s pain then adjust dosing according to the patient’s response to treatment.

Taking large doses of Maxidone may result in increased tolerance and a higher risk for side effects.

Researchers have not yet established the safety and efficacy of using Maxidone in pediatric patients.

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Action

The hydrocodone in Maxidone works with the central nervous system, or CNS, to change the way the brain perceives pain. Hydrocodone acts on the CNS to cause sedation, calm anxiety and create a pleasant euphoric sensation.

The hydrocodone in Maxidone depresses the cough reflex in the area of the brain responsible for breathing. Hydrocodone acts on smooth muscles, like those in the gastrointestinal system to slow digestion.

Acetaminophen reduces pain and inflammation by blocking the production of prostaglandins, natural compounds that send pain messages to the brain and stimulate cells to release fluid.

Acetaminophen reduces fever by acting on the hypothalamus, the temperature-regulating center of the brain.

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Warnings

Hepatotoxicity

Acetaminophen use is associated with acute liver failure, sometimes resulting in liver transplant and death. Most of these cases are associated with the consumption of more than 4,000 mg of acetaminophen in a day, often as the result of taking multiple products containing this popular medication. Someone may take a high dose intentionally to cause self-harm or accidently use too much acetaminophen in an effort to relieve stubborn pain.

Allergic Reaction and Anaphylaxis

People who are allergic to hydrocodone, acetaminophen or any other ingredient in Maxidone should not use this medication. Cases of anaphylaxis have been reported after Maxidone consumption; anaphylaxis is a severe, potentially fatal, form of allergic reaction.

Symptoms of anaphylaxis include swelling of the face, mouth, and throat, trouble breathing, hives, rash, itching and vomiting. Transport all suspected victims of anaphylaxis to the nearest medical treatment center.

Respiratory Depression

Opioids, including the hydrocodone in Maxidone, depress breathing centers in the brain. This action may result in respiratory depression, a common but dangerous respiratory side effect where the lungs do not adequately exchange oxygen for carbon dioxide and other gases. Symptoms of respiratory depression include slow or shallow breathing, irregular breathing patterns and a bluish tint around the eyes, mouth and fingertips.

Head Injury and Increased Intracranial Pressure

Hydrocodone and other opioids increase intracranial pressure, or the amount of pressure surrounding the brain. This effect, along with the respiratory depressive effects, may be enhanced by head injury, brain lesions or pre-existing increase intracranial pressure. Using Maxidone may make it difficult for physicians to diagnose or monitor the progression of a head injury.

Abdominal Conditions

Maxidone use may obscure the diagnosis or progression of acute abdominal conditions.
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Contraindications

People who are hypersensitive to hydrocodone or acetaminophen should not use Maxidone. Individuals who are hypersensitive to other opioids, such as morphine or codeine, may exhibit cross-sensitivity to hydrocodone.

Precautions

Elderly or debilitated individuals should use Maxidone with care, as should those with kidney or liver problems, hypothyroidism, Addison’s disease or prostate or urinary problems. Because of the way hydrocodone suppresses the cough reflex, physicians should prescribe Maxidone with care postoperatively or to patients with pulmonary disease.

Maxidone may cause CNS effects such as dizziness, drowsiness or impair mental performance. A consumer should not drive a car or operate heavy machinery until she knows how Maxidone will affect her. Alcohol and other CNS depressants may enhance this effect.

The hydrocodone in Maxidone may be habit-forming.

Pregnancy and Breastfeeding

Maxidone is an FDA pregnancy category C, meaning there are no adequate and well-controlled studies in pregnant women. Maxidone should only be used when the benefit to the mother clearly outweigh the risk to the unborn child.

Using Maxidone regularly late in pregnancy will cause the baby to be born dependent on hydrocodone, suffering withdrawal symptoms during the first few hours of life, including irritability and excessive crying, tremors, hyperactive reflexes, increased respiratory rate, increased stools, sneezing, yawning, vomiting and fever. The severity of withdrawal symptoms in the baby does not reflect the dosage or duration of drug use by the mother.

Maxidone use during labor and delivery may cause respiratory depression in the newborn, especially if high doses are used.

Scientists are not yet sure if hydrocodone passes into breast milk and onto a nursing baby. Small amounts of acetaminophen pass into breast milk but the significance of acetaminophen’s affects on a nursing baby is not yet known. Nursing mothers should only use Maxidone when the benefits clearly outweigh the risks.
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Drug Interactions

Maxidone may interact in unsafe or undesirable ways with other medications. Consumers should supply to their physicians a list of all medications, including prescriptions, over-the-counter drugs, vitamins, supplements and herbal remedies. Maxidone consumers should not start, stop or change the way they take any medications without first consulting a physician.

Some medications enhance the CNS depressive effects of Maxidone, including other opioids or CNS depressants, antihistamines, antipsychotics and anti-anxiety agents.

Using Maxidone concurrently with MAO inhibitors or tricyclic antidepressants may enhance the effects of either the antidepressant or the hydrocodone in this drug.

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Laboratory Testing

Physicians should use laboratory blood tests monitor the effects of Maxidone therapy for patients suffering from serious liver and kidney dysfunction.

Acetaminophen may cause false-positive laboratory test results for urinary 5-hydroxyindoleacetic acid, sometimes called the 5-HIAA test.

Side effects

Maxidone, like all medications, may cause side effects. Most consumers experience no or only minor side effects after using Maxidone. These side effects usually subside after a few days of continued use at therapeutic doses. Some adverse reactions are serious, requiring immediate medical attention.

The most frequently reported side effects include dizziness, lightheadedness, sedation, nausea and vomiting. Ambulatory consumers are more likely to experience these side effects than are patients confined to bed rest or a wheelchair. Lying down usually alleviates these side effects.

Maxidone may cause psychological side effects including anxiety, fear, psychic dependence, mood changes and the emotional opposite of euphoria, dysphoria.

Maxidone may cause cognitive side effects such as mental clouding and impairment of mental performance.

Non-serious side effects:

  • Drowsiness
  • Constipation

Serious Side effects:

  • Urinary retention
  • Respiratory depression
  • Hearing loss

Acetaminophen use may cause allergic reactions, rash, low platelet counts leading to clotting problems and low white cell counts.

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Overdose

It is possible to overdose on either the hydrocodone or the acetaminophen in Maxidone, or both. Overdose is a serious, potentially fatal medical emergency. Overdose of prescription painkillers including Maxidone kills nearly 15,000 people every year in the United States. Acetaminophen overdose is one of the most common poisonings worldwide and is the leading cause of acute liver failure in the United States.

Symptoms of hydrocodone overdose include respiratory depression, extreme sleepiness progressing to stupor or coma, weak and flaccid muscles and cold, clammy skin. Sometimes the victim will have a slow heartbeat or very low blood pressure. In cases of severe overdose, the victim may stop breathing, suffer a collapse of the circulatory system, have a heart attack or die.

Symptoms of acetaminophen overdose appear in two phases. Early symptoms following an acetaminophen overdose severe enough to cause liver damage include nausea, vomiting, profuse sweating and general malaise. Physical signs and laboratory evidence of acetaminophen overdose may not appear for 48 to 72 hours after ingestion.

Transport all potential overdose victims to the nearest medical center or contact poison control center at 1-800-222-1222. Since signs and symptoms of a serious acetaminophen overdose may not appear immediately after ingestion, take all suspected victims of acetaminophen overdose to the hospital immediately even if the consumer does not feel ill.

While at the hospital, doctors will administer naloxone to counteract the effects of hydrocodone, or give the patient the antidote to acetaminophen, N-acetylcysteine. Nurses will establish an airway to help the victim breath. Nurses will pump the patient’s stomach or introduce charcoal into the stomach to absorb excess Maxidone, and start IVs to control fluid and electrolyte levels.

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Abuse

Doctors prescribe Maxidone to relieve pain but recreational users abuse the hydrocodone in Maxidone to get high. Hydrocodone is the most widely prescribed medication in the United States. Hydrocodone is available only in combination with acetaminophen or some other analgesic. The most common combination is hydrocodone and acetaminophen, like that in Maxidone.

Hydrocodone products are associated with more drug abuse than any other legal or illegal drug. The U.S. Drug Enforcement Agency, or DEA, ranks drugs according to their relative risk for abuse. Heroin is a schedule I narcotic, meaning it poses a much stronger risk for abuse than the schedule V cough syrup, Robitussin AC. According to this system, Maxidone is a schedule III drug, posing the same relative risk for abuse as anabolic steroids. To reduce this risk, Maxidone is available by prescription only.

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Withdrawal

Using Maxidone continually for several weeks may cause the consumer to become opioid-dependent and suffer withdrawal symptoms when he stops taking Maxidone. Rarely, patients become dependent after using Maxidone for only a few days. Withdrawal symptoms last five or more days with the most severe withdrawal symptoms appearing around the fourth day. Withdrawal symptoms disappear by themselves and do not reappear unless the individual become opioid-dependent again.

Early symptoms of withdrawal include:

  • Agitation
  • Anxiety
  • Muscle aches
  • Increased tearing
  • Insomnia
  • Runny nose
  • Sweating
  • Yawning

Late symptoms of withdrawal include:

  • Abdominal cramping
  • Diarrhea
  • Dilated pupils
  • Goose bumps
  • Nausea
  • Vomiting

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Detox

Many institutions offer inpatient detoxification services. During detoxification, physicians administer drugs to counteract the effects of hydrocodone along with a variety of drugs to relieve withdrawal symptoms.

Rapid detox is the most humane and efficient detoxification procedure available. During rapid detox, board-certified anesthesiologists administer sedatives and anesthesia alongside the standard detoxification and anti-withdrawal drugs. The rapid detox patient rests comfortably in a “twilight sleep,” unaware of the grueling and demoralizing detoxification process.

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Storage

Maxidone should be stored between 68 degrees Fahrenheit and 77 degrees Fahrenheit, away from light.

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