Description: Hydrocodone is a narcotic analgesic (pain reliever) closely related to codeine that is most effective for dental pain when given in combination with acetaminophen (as in Vicodin and Lortab preparations) or ibuprofen (as in Vicoprofen).

Dental Uses: Hydrocodone is most commonly prescribed for relief of pain following dental surgery and for temporary relief of toothache. It occasionally is prescribed for chronic pain of the jaw (temporomandibular joint pain) or face. Hydrocodone is approximately six times more powerful than codeine, so that 10 milligrams of hydrocodone produces the same pain relief and side effects as 60 milligrams of codeine. This does not mean that hydrocodone is a better drug than codeine. It is simply "stronger," so your dentist has to prescribe less of it.

Dosages for dental purposes: Generally effective hydrocodone prescriptions include:

• Acetaminophen 500 milligrams plus hydrocodone 5 milligrams (Vicodin or Lortab 5/500), one or two tablets every four to six hours
• Acetaminophen 750 milligrams plus hydrocodone 7.5 milligrams (Vicodin ES), one tablet every six hours
• Ibuprofen 200 milligrams plus hydrocodone 7.5 milligrams (Vicoprofen), one tablet every four to six hours.

The duration of therapy for post-surgical pain varies but is usually less than five days.

Concerns and possible side effects: Hydrocodone and other oral narcotics (codeine, oxycodone and propoxyphene) produce relatively high incidences of dizziness, drowsiness, nausea, vomiting and constipation in dental-surgery patients. Dental patients prescribed drugs containing oral narcotics should not operate dangerous machinery or drive automobiles. Alcohol consumption must be avoided while taking narcotics because the combination greatly increases the risk of drowsiness, impaired thinking and unconsciousness. Alcohol consumption also increases the risk of stomach bleeding and ulcers from ibuprofen/hydrocodone combinations and liver damage from acetaminophen/hydrocodone combinations.

Short-term use of narcotic analgesics (a few days) for post-surgical dental pain does not lead to drug addiction. Concern among some health professionals about the ability of chronic narcotic therapy (of weeks or months duration) to cause addiction in some patients is largely unfounded, but it is still the subject of debate.

Patients with allergies to codeine should avoid hydrocodone. Patients with allergies to acetaminophen should not consume the Vicodin or Lortab preparations.

Patients with allergies to aspirin, ibuprofen or other nonsteroidal anti-inflammatory drugs should avoid Vicoprofen. Allergic reactions can range from a mild rash to life-threatening closure of the airway and a fall in blood pressure.