Hydrocodone/Ibuprofen (Vicoprofen, Reprexain, Ibudone) - Uses, Side Effects, and More

What are the most common side effects of hydrocodone/ibuprofen?

The most common side effects of hydrocodone/ibuprofen are listed below. Tell your health care provider if you have any of these side effects that bother you.

• Headache
• Constipation (see below)
• Dizziness
• Drowsiness
• Heartburn, upset stomach, stomach pain, nausea, diarrhea, or vomiting
• Feeling unusually weak or tired
• Infection
• Anxiety or nervousness
• Trouble sleeping
• Dry mouth
• Gas
• Fluid retention
• Itching
• Sweating

There may be other side effects of hydrocodone/ibuprofen that are not listed here. Contact your health care provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088. In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of hydrocodone/ibuprofen?

While less common, the most serious side effects of hydrocodone/ibuprofen are described below, along with what to do if they happen.

Severe Allergic Reactions. Hydrocodone/ibuprofen can cause allergic reactions, including a specific type of allergic reaction called DRESS. DRESS stands for drug reaction with eosinophilia and systemic symptoms. It is also sometimes called multiorgan hypersensitivity. This is a reaction that can affect multiple parts of the body, including your liver, kidneys, and heart. Stop taking the medicine and get help right away if you have any of the following symptoms of a serious allergic reaction.

• Breathing problems or wheezing
• Racing heart
• Fever or general ill feeling
• Swollen lymph nodes
• Swelling of the face, lips, mouth, tongue, or throat
• Trouble swallowing or throat tightness
• Itching, skin rash, or pale red bumps on the skin called hives
• Nausea or vomiting
• Dizziness, feeling lightheaded, or fainting
• Stomach cramps
• Joint pain
• Dark-colored urine
• Your skin or the whites of your eyes turning yellowish in color (also called jaundice)

Risk of Misuse and Addiction. Misusing hydrocodone/ibuprofen can lead to serious side effects like coma or death. Misuse means taking a medicine in a way other than how it was prescribed. Take hydrocodone/ibuprofen exactly as prescribed. Tell your health care provider if you feel that hydrocodone/ibuprofen is not working. Call your health care provider right away or go to the nearest emergency room if you have any of the following serious symptoms.

• Sudden confusion or feeling disoriented
• Feeling paranoid
• Suicidal thoughts or actions
• Seizures
• Trouble breathing

Breathing Problems. Hydrocodone/ibuprofen may cause slow or shallow breathing, especially if you have breathing problems from another condition or take other medicines that can slow your breathing. Tell your health care provider if you develop severe sleepiness or trouble breathing, especially when you start hydrocodone/ibuprofen or when your dose is increased. Get emergency help if you have any of the following symptoms.

• Changes in the color of your skin, including bluish color to your lips and fingernails
• Confusion
• Shortness of breath
• Feeling dizzy, lightheaded, or fainting
• Changes in your heart rate or rhythm, such as a fast, slow, pounding or skipping heartbeat
• Slow or shallow breathing
• Excessive sleepiness or trouble staying awake

Increase in Pain Sensitivity (Hyperalgesia). Hydrocodone/ibuprofen can cause an increased sensitivity to pain. It can cause things that normally cause pain to feel more painful than usual. Hydrocodone/ibuprofen can also cause allodynia. This happens when things that normally do not cause pain, such as wearing glasses or brushing your hair, become painful. If your pain increases, do not take extra doses of hydrocodone/ibuprofen. This could cause you to overdose or develop other serious side effects. Call your health care provider right away if your pain increases, you feel more sensitive to pain, or if you develop pain in other areas of the body.

Reduced Adrenal Function. Long-term use of hydrocodone/ibuprofen can cause your body’s adrenal glands to stop making as much cortisol (the stress hormone). This is known as adrenal insufficiency. Adrenal insufficiency can get worse if your body is under stress because of fever, surgery, or trauma. Tell your health care provider if you have any of the following symptoms of adrenal insufficiency.

• Nausea and vomiting
• Weakness, tiredness, or lack of energy
• Low blood pressure
• Loss of appetite
• Dizziness

Low Blood Pressure (Hypotension). Hydrocodone/ibuprofen may cause low blood pressure. If you feel faint or dizzy, lie down. Tell your health care provider right away if you have any of the following symptoms of low blood pressure.

• Dizziness, feeling lightheaded, or fainting
• Confusion
• Feeling weak or tired

Sphincter of Oddi Spasm. The sphincter of Oddi is a muscular valve in your body that controls the flow of bile and digestive juices from the pancreas into the small intestine. When this valve spasms, it may feel like getting a tight muscle cramp, causing pain and blocking the flow of these juices, which can lead to discomfort and digestive problems. This is more likely to happen if you do not have a gallbladder. Stop taking hydrocodone/ibuprofen and get emergency help if you have new or worse stomach pain or pain in the upper right side of your stomach area that travels to your back or shoulder, with or without nausea and vomiting. 

Heart Attack and Stroke. Hydrocodone/ibuprofen can increase your risk of a heart attack or stroke that can lead to death. This risk is increased in people with existing heart disease and with longer use of hydrocodone/ibuprofen and higher doses. Do not take hydrocodone/ibuprofen if you have had a recent heart attack without talking to your health care provider. This could increase your risk of having another heart attack. Get emergency help if you have any of the following symptoms of a heart attack or stroke.

• Chest pain or pressure
• Fast or abnormal heartbeat
• Trouble breathing
• Pain in your back, jaw, throat, or arm
• Sweating, upset stomach, vomiting, or dizziness
• Sudden weakness on one side of your body
• Sudden and severe headache
• Slurred speech or trouble understanding speech

Stomach Bleeding. Hydrocodone/ibuprofen can increase your risk of bleeding, ulcers, and tears (perforation) in your gut. The risk is higher if you have a history of stomach ulcers, bleeding problems, take higher doses of hydrocodone/ibuprofen or take it for longer than directed, have poor health, are age 60 or older, have liver disease, smoke, drink alcohol, or take certain other medicines. Stop taking hydrocodone/ibuprofen and get emergency help if you have any of the following symptoms.

• Vomit blood
• Black or tarry poop
• Stomach pain that does not go away
• Upset stomach
• Feel faint

Liver Damage. Liver damage, also called hepatotoxicity, can happen when taking hydrocodone/ibuprofen. Stop hydrocodone/ibuprofen, and call your health care provider right away if you have any of the following symptoms of liver damage.

• Nausea or vomiting
• Stomach or belly pain
• Fever
• Weakness or unusual tiredness
• Itching
• Loss of appetite
• Light-colored poop
• Dark-colored urine (pee)
• Your skin or the whites of your eyes turning yellowish in color (also called jaundice)

Increased Blood Pressure (Hypertension). Hydrocodone/ibuprofen may increase your blood pressure or make it worse if you have a history of high blood pressure. Call your health care provider if your blood pressure increases while taking this medicine.

If you measure your blood pressure and the top number (systolic) is 180 or higher or the bottom number (diastolic) is 120 or higher, get medical attention right away. Increases in blood pressure may not be noticeable, but look out for and tell your health care provider right away if you have any of the following symptoms of severely high blood pressure.

• Sudden severe headache
• Chest pain
• Dizziness or confusion
• Trouble breathing
• Nausea or vomiting
• Blurry or other changes to vision
• Anxiety
• Buzzing in the ears
• Nosebleed
• Feeling of skipped heartbeats

Fluid Retention (Edema) and Heart Failure. Hydrocodone/ibuprofen can cause fluid retention, also called edema, which can lead to heart failure. Fluid retention can also cause serious issues in people who already have heart failure. Stop hydrocodone/ibuprofen, and call your health care provider right away if you have any of the following symptoms. 

• Chest pain
• Irregular heartbeat
• Shortness of breath
• Stretched or shiny skin
• Swollen body parts, such as the belly or ankles
• Unusually fast weight gain
• Unusual tiredness

Kidney Damage. Kidney damage can happen when taking hydrocodone/ibuprofen. Call your health care provider right away if you have any of the following symptoms of kidney damage.

• Reduced need to pee
• Swelling in your feet, ankles, or legs
• Weakness or unusual tiredness
• Difficulty catching your breath or chest pain/pressure
• Confusion
• Nausea
• Seizures

High Potassium Levels (Hyperkalemia). Hydrocodone/ibuprofen can cause a high potassium level (hyperkalemia), which can be serious and may lead to death. Your health care provider may check your potassium levels, especially if you take certain other medicines. Call your health care provider right away if you have any of the following symptoms of a high potassium level. 

• Muscle weakness or unusual tiredness
• Slow heartbeat or feeling of skipped heartbeats 
• Nausea or vomiting
• Trouble breathing
• Abnormal heart rhythm

Severe Skin Reactions. Hydrocodone/ibuprofen can cause severe skin reactions, called Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN), that can lead to death if not treated. If you develop a rash, stop hydrocodone/ibuprofen and call your health care provider right away. Get emergency help if you have any of the following symptoms of SJS or TEN.

• Painful red or purple skin that looks burned and peels off
• Flat red rash or blisters on your skin, mouth, nose, and genitals
• Red, painful, watery eyes

Anemia. Hydrocodone/ibuprofen may cause anemia, which is when you have low levels of red blood cells. Tell your health care provider if you have any of the following symptoms of anemia.

• Unusual weakness or tiredness
• Cold hands and feet
• Fast or abnormal heartbeat
• Pale or yellowish skin 
• Dizziness, lightheadedness, or feeling like you are about to pass out
• Shortness of breath

Meningitis. Hydrocodone/ibuprofen may cause a condition called meningitis. People with meningitis have inflammation of the membranes that surround the brain and spinal cord. Sometimes medicines like ibuprofen can cause meningitis. You may be at higher risk of this happening if you have a connective tissue condition, such as lupus. Call your health care provider right away if you have any of the following symptoms of meningitis.

• Fever
• Headache
• Nausea and vomiting
• Stiff neck
• Light sensitivity
• Confusion
• Joint pain
• Drowsiness
• Seizures

Eye Problems. Hydrocodone/ibuprofen can sometimes affect your vision. Stop taking hydrocodone/ibuprofen and talk to your health care provider if you have any of the following symptoms.

• Blurred or decreased vision
• Blind spot
• Change in the way you see colors

Constipation. Some people taking hydrocodone/ibuprofen may develop severe constipation or a blockage of the gut (bowel obstruction). Stop taking hydrocodone/ibuprofen and call your health care provider right away if you have any of the following symptoms of a blockage in your intestines.

• Nausea or vomiting
• Stomach pain or bloating
• Loss of appetite 
• Unable to pass gas