what to do about a vicodin overdose

October 16, 2008 1:41 PM

Took 21 500mg(i believe) Vicodin in a 24 hour period. this was on monday. threw up 3 times on tuesday. oh but wait there's more...

I had a reconstructive operation on my nose to cure my sleep apnea on friday. i was is a lot of pain, so they gave my percocet in addition to the antibiotics, and when that ran out on monday, they called in a perscription for vicodin that morning,and by the next day i had taken 21. bad move, i know, i don't need any lectures on addiction or irresponsibility. that night, i threw up three times. no pills, just bile. today is thursday. i finished the antibiotics yesterday, and today i feel like hell, very run down, like i have a bad cold, and my legs hurt.

main question is- should i be concerned about any lasting effects from taking that many vicodin in such a short period of time? no family doctor or anything like that to go to.

posted by assasinatdbeauty to health & fitness (43 comments total)

Your liver just went 10 rounds with Tyson. See your physician immediately.
posted by Inspector.Gadget at 1:47 PM on October 16, 2008

I'll amend that to "a physician".
posted by Inspector.Gadget at 1:48 PM on October 16, 2008

Vicodin contains acetaminophen which can be toxic to your liver. Inspector Gadget is right - get to a doctor.
posted by TorontoSandy at 1:54 PM on October 16, 2008

Geez. Get thee to a doctor; doesn't matter if you have to go to a clinic, but SEE ONE.
posted by twiki at 1:54 PM on October 16, 2008

Yep, go to yer dr.
Could you also have an infection?
posted by Echidna882003 at 1:56 PM on October 16, 2008

Your body is probably just upset that you're not giving it more drug. My brother got "accidentally" addicted to vicodin after having his tonsils removed, and he'd only been taking it for about 3 days. His comedown was similar - body pains, etc - but also a considerable amount of angst. I think you'll be fine tomorrow. Nobody ever feels good the day after abusing drugs.
posted by sacrifix at 1:56 PM on October 16, 2008

Please go to the ER, or to an emergency clinic. Call an ambulance if you have no other means of transportation.
posted by muddgirl at 1:56 PM on October 16, 2008

If you are not currently on your way to see a doctor at the emergency room, then you should be. The signs of overdose can take up to 72 hours to show up.

Go to the emergency room right now.
posted by Saydur at 1:57 PM on October 16, 2008

A doctor cannot undue what you did. She can advise a proper course going forward. I would call a local drug overdose hotline and see if they have an opinion, unless it is easy to get to a doctor of course.
posted by JohnnyGunn at 1:58 PM on October 16, 2008

Vicodin is mostly acetominaphin/paracetamol, which "has a severe liver toxicity as of 8g per day or even 4g with renal insufficiency."(wiki) You consumed 11 grams (or more, if prescribed Vicodin ES).

This is not withdrawal. Please go to a hospital.
posted by muddgirl at 2:00 PM on October 16, 2008

Vicodin contains acetominophen. Depending on the formulation, it can between 500 mg and 750 mg per tablet.

Acetominophen is very easy to overdose.

In adults, single doses above 10 grams or 200 mg/kg of bodyweight, whichever is lower, have a reasonable likelihood of causing toxicity.

You took more than that. It can destroy your liver and/or your kidneys. It may be possible to prevent that but only if treatment starts immediately! Go see a doctor right now.
posted by Class Goat at 2:01 PM on October 16, 2008

In adults, hepatic toxicity has rarely been reported with acute overdoses of less than 10 grams and fatalities with less than 15 grams.

Symptoms of a Vicodin overdose include:
Blood disorders, bluish tinge to skin, cold and clammy skin, extreme sleepiness progressing to a state of unresponsiveness or coma, general feeling of bodily discomfort, hearing impairment, heart problems, heavy perspiration, kidney problems, limp muscles, liver failure, low blood pressure, nausea, slow heartbeat, troubled or slowed breathing, vomiting
posted by Exchequer at 2:02 PM on October 16, 2008

You can also call the poison control hotline if you're not convinced. 1-800-222-1222
posted by jessamyn at 2:04 PM on October 16, 2008

I'm sorry that you feel so awful. I'm not a doctor, but I 2nd JohnnyGunn's suggestion of calling the local Poison Controll Center. They are a fantastic and under-used resource. As I understand it they are anonymous, they offer valuable information, and the data they collect helps shape helathcare policy (for say, regulations regarding the safety of highly marketed drugs like Vicodin).

I also suggest using this experience as motivation to seek out a primary care physician. Having someone who knows your history, and who you feel comfortable talking to makes all the difference in the world. The ER is excellent for preventing people from dying (particularly in the case of trauma), but nothing compares to the care of a physician who knows you as a person, knows your complete medical history and can help you accordingly.
posted by abirae at 2:06 PM on October 16, 2008

just looked at my bottle and it says 5-375mg. not sure what that is. i would think 375 but then why the "5-"?
posted by assasinatdbeauty at 2:06 PM on October 16, 2008

Advice following an acute overdosage of Vicoden or acetaminophen.
posted by Exchequer at 2:07 PM on October 16, 2008

i would think 375 but then why the "5-"?

5 mg of hydrocodone, 375 of acetaminophen. So, in addition to seeing a physician for Tylenol overdose, plan on picking up some laxatives because sudden heavy narcotic use slows your bowels down to the point you'll be crapping concrete for the next few days.
posted by Inspector.Gadget at 2:10 PM on October 16, 2008

IANAD. 5mg of hydrocodone, 375mg of acetaminophen. So 21 pills is 7.875g of acetaminophen. Less than the 10g mentioned above, but still very much a cause for concern - go to a doctor, now.
posted by spaceman_spiff at 2:11 PM on October 16, 2008

5-375 means 5 mg of hydrocodone, 375 mg of acetaminophen. That puts you at 7.8 grams of APAP in 24 hours. I would definitely suggest seeing a doctor.

For future reference - there are medications similar to Vicodin that have a smaller amount of acetaminophen, such as Lortab and Norco. You should consult with your doctor for the correct maximum daily dosage.
posted by Orrorin at 2:13 PM on October 16, 2008

Stop looking at the bottle and go to the emergency room. Really, I often tell people to stop freaking out in these medical what-if AskMes. This is not one of those situations.

You took WAY too much acetaminophen. You don't even know exactly how much acetaminophen you took. Your liver may well be damaged. You can be treated but the treatment has to start right away.

5-375 means 5 mg of hydrocodone with 375 mg of acetaminophen. That's a percocet bottle not a Vicodin bottle, AFAIK. But that doesn't matter.

GO. TO. THE. ER.
posted by Justinian at 2:18 PM on October 16, 2008

Would it be possible to see your surgeon who operated on you? Surgeons are not just slicers and dicers but they are at least in partially responsible for your care post-op. Since you are feeling terrible after surgery, it's possible that you are feeling the effects of the drugs, or possibly surgical complications. The doctor who treated you might have the best insight into your current state. If I were in your shoes, I would call up the office of your surgeon, tell them what's going on and ask what to do next.
posted by abirae at 2:19 PM on October 16, 2008 [1 favorite has favorites]

I would not assume that the OP took "only" 7.8 grams of acetaminophen. First, he described what I believe is a Percocet bottle but says the one he took 21 pills in 24 hours was Vicodin. Second, he took all those pills on top of an entire prescription of Percocet which he went through in less than 3 days. My guess was, given he took 21 Vicodins in 24 hours that he was not taking the Percocet as prescribed either. So the real total could be quite a bit higher, and taking multiple high doses over a period of days is considerably more likely to cause damage than doing so on only one day.

And that's not even taking into account of any alcohol or whatever was consumed.

Which is why he needs to see a doctor immediately.
posted by Justinian at 2:22 PM on October 16, 2008

of=if
posted by Justinian at 2:23 PM on October 16, 2008

Justinian's right. Kidneys and livers are too important to fuck around with.
posted by abirae at 2:26 PM on October 16, 2008

OP: Please post back in this thread when you get back from the doctor so we know you're ok.
posted by crapmatic at 2:27 PM on October 16, 2008 [1 favorite has favorites]

Also: when you go see a doctor, it's not a bad idea to bring the bottles of all the drugs you've taken this week to help them understand your situation. Bring whatever you can find. Tell them everything you know. Even if they don't ask, let them know all your symptoms. And if they ask pointed questions answer them truthfully. Doctors are sometimes brilliant but they are neither magic nor psychic. The more information they have, the better they can treat you.
posted by abirae at 2:33 PM on October 16, 2008

Don't listen to anyone who is telling you to just mosey around on the phone with your surgeon, or whatever. Go to the emergency room immediately, and tell them how much medication you've taken, and do not lie. What you have done could kill you, if you put this off (LIVER FAILURE) Hopefully, it won't. But do not delay a SECOND LONGER going to the hospital.
posted by Coatlicue at 2:35 PM on October 16, 2008

For future reference - there are medications similar to Vicodin that have a smaller amount of acetaminophen, such as Lortab and Norco.

Vicodin, Norco and Lortab are all simply trade names for a compound of acetaminophen and hydrocodone. Common dosages are 5 mg (hyrdocodone) / 375 mg (acetaminophen) and 10-650.
posted by iknowizbirfmark at 2:44 PM on October 16, 2008

If you're not seeing a doctor by now, I'm a tad worried.
posted by damnjezebel at 3:04 PM on October 16, 2008

First, he described what I believe is a Percocet bottle

Percocet contains oxycodone; vicodin contains hydrocodone.

Regardless, Nthing the call to get yourself to the E.R. right away. Call 911 if you can't drive or get someone to drive you right now.
posted by cerebus19 at 3:07 PM on October 16, 2008

cerebus: you're correct, percocet is oxycodone. So a 5/375 is 5 mg OXYcodone, 375mg acetaminophen. I was making a point about the acetaminophen though. Vicodins usually come in 5/500 or bigger so I'm thinking the bottle labeled "5/375" is probably Percocet as that does come commonly in a 5/375.

The point being that people shouldn't multiply 375 by 21 to guess how much acetaminophen the OP took. Because we just don't know. It was a lot and that's all we can see.
posted by Justinian at 3:13 PM on October 16, 2008

Go to the emergency room now.
posted by grouse at 3:33 PM on October 16, 2008

Look. This is the reason why I AskMe regarding medical questions is CRAP.
#1: I AM A BOARD-CERTIFIED DOCTOR, in the USA of A.
#2: MY STRONGEST ADVICE IS FOR YOU TO GO TO AN ER ASAP.
#3: YOU COULD DIE VERY SOON.


Or, hey, let's kinda sit around a chit chat about the possible doses this fellow's taken, and take the time to educate him on arcane side effects. And hey, maybe at some point we'll be able to put together a complete history and physical exam! Or maybe make corrections on what it was exactly may have taken. Spend a few minutes correcting doses, or even medicine name types, and ask about what other meds or drugs you've been taking. Are you drinking alcohol? Are you interested in this or that herbal remedy?

NONE OF THIS MATTERS.

ABANDON SHIT AND GO TO THE ER.

YOU MAY NOT BE THINKING STRAIGHT: 5/325 = PERCOCET, 5/500 = VICODIN.

POTENTIAL LASTING EFFECTS WITH TAKING A LOT OF VICODIN IN A SHORT PERIOD OF TIME IS DEATH AND DYING, NEITHER OF WHICH FUN.
posted by herrdoktor at 7:48 PM on October 16, 2008 [7 favorites has favorites]

Piling on:

IF YOU HAVEN'T ALREADY, GO TO THE ER AND TELL THEM EVERYTHING.

You can tell the ER everything ASAP, or you can tell Charles Darwin he was right a short time from now. Possibly both. But the ER will improve your chances. Go, go, go.

NOW.
posted by eritain at 9:54 PM on October 16, 2008

And bring the bottles.
posted by eritain at 10:00 PM on October 16, 2008

I am a registered pharmacist. This might be late, but I'm Nthing the "GO TO A DOCTOR NOW" advice. Take the bottles with you. We advise never consuming more than 4 grams of acetaminophen per day, and consider toxicity a real danger after 6 grams. You have apparently consumed at least 6.8 grams. GO TO A DOCTOR OR ER. Better safe than sorry.

FWIW, Vicodin/Norco/Lortab are all trade names for preparations of HYDROcodone + tylenol. The combinations can be any of these: 5/325, 5/500, 5/750, 7.5/325, 7.5/500, 7.5/750, 10/325, 10/500, 10/650, 10/750. There's a good possibility I left some out, too. LOTS of combos.

Percocet is the trade name for OXYcodone + acetaminophen, 5/325, 7.5/325, or 10/325. Tylox is the trade name for Oxycodone + acetaminophen 5/500 capsules.

What I'm getting at is just because something is N/325 doesn't mean it is percocet. (I don't know where this poster got the number 5-375: I've never seen that strength... although that doesn't mean it doesn't exist somewhere, I guess.) Know what you're talking about before you respond... people should be careful about giving medical advice when they are just guessing.

Also, a good lesson: know what you are taking before you take it. Ask questions to your doctor and pharmacist.
posted by keribear at 11:33 PM on October 16, 2008

Go to a doctor. Now. For the n-th time :D

Doctor House, is that you?!
posted by mebibyte at 1:01 AM on October 17, 2008

Look. This is the reason why I AskMe regarding medical questions is CRAP.

Look at it this way: the OP either didn't know she (?) had to go to the doctor, or required a ton of convincing to go to the doctor. Without AskMe, she may have stayed on the passive course of sitting around waiting for her liver to fall out.

This is assuming she eventually got to an emergency room or a doctor.

At any rate, having a bunch of strangers yell at you on the internet to get to a doctor is far better than having no one direct you to get to the doctor, assuming getting your ass to the doctor after you've taken a whole bunch of Vicodin isn't something you do without a crowd yelling at you to do it.
posted by A Terrible Llama at 9:34 AM on October 17, 2008

Oh my God. Please please please please go to the ER. Now.
posted by limeonaire at 10:50 AM on October 17, 2008

If, that is, you didn't go early this morning. God, I hope you went early this morning.
posted by limeonaire at 10:50 AM on October 17, 2008

Hi, i spoke to a doctor and they said that if i was feeling alright by now, then everything is alright. they did, however, say i that yes, i could have died, but again, it's friday afternoon and everything is feeling just fine, so i'm in the clear.

So, thanks for the concern everyone, but i'm alright.

Also, to the person saying i probably OD'd on the percocet and then incinuated that i also consumed alcohol? that was a bit insulting, as i said before, i do not have an addiction problem. i generally do just fine, i've had surgeries before. i had not, however, taken vicodin before, and my body/mind reacted very strongly to it. the reason i ended up taking so many was that once the effects started to happen, i would forget that i had already taken one, and in my altered state of mind, take another. Once i finally came down and realized this had happened, i immedialte flushed the rest of the pills and will not be taking anything with hydrocodone in it anymore.
posted by assasinatdbeauty at 2:33 PM on October 17, 2008

Oh wow. That's scary—but good to know you're OK!
posted by limeonaire at 2:57 PM on October 17, 2008

I think I speak for many lurkers that are very relieved. Thanks for checking in, and I'm really glad that you're okay!
posted by malocchio at 6:45 PM on October 17, 2008