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Lortab Addiction, Withdrawal | Hydrocodone Side Effects, Alternatives, Tapering

Last Updated on August 15, 2022 by Carol Gillette

Alternative to Meds Editorial Team
Medically Reviewed by Dr Michael Loes MD

This article discusses Lortab (hydrocodone) alternatives, side effects, withdrawal, and other FAQs. Hydrocodone is a medication for moderate to severe level pain relief, combining the narcotic drug hydrocodone and a second non-opioid analgesic, acetaminophen. Another name for acetaminophen is Tylenol. Children under the age of 6 years should not be given Lortab due to risks of respiratory impairment and other severe side effects.

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What is Lortab?

Lortab (hydrocodone plus acetaminophen) is one of a host of combined opioid analgesic medications that came under FDA and DEA scrutiny in 2011.

Quite apart from the addictive nature of Lortab, there was an additional concern because the high content of acetaminophen is linked to liver damage, renal impairment, and even liver failure. In 2014, hydrocodone products were the most prescribed drugs in America.

In a statement from the FDA’s Office of New Drugs, Sandra Kweder said:

“Overdose from prescription combination products containing acetaminophen account for nearly half of all cases of acetaminophen-related liver failure in the United States; many of which result in liver transplant or death.” 1

All of these hydrocodone compound medications were required to be reformulated by 2014, to contain a maximum of 325 mg acetaminophen per tablet. All products containing more than 325 mg acetaminophen were either discontinued or banned and pulled from the market by July of 2014.2,3

As mentioned, there is another problem with hydrocodone combined products, also called HCPs such as Lortab, Vicodin, Norco, and others, because they are very addictive. Lortab and similar products are also very expensive compared to heroin, and their effects are similar. The DEA found an enormous rise in heroin addiction from 2011 and on, and attributed the phenomena to the number of addicted users of these legal opioid drugs turning to heroin as a cheaper alternative. Heroin use doubled from 2011 to 2014.4

More information is provided below on other important topics that may assist you in making informed decisions regarding starting or stopping opioid medications or HCPs such as Lortab.

What Is Lortab Used for?

Lortab is a pain reliever, for the relief of moderate to moderately severe pain. In liquid formulations, it has also been used in cough suppressant products. Under new FDA regulations, Lortab should only be prescribed for a maximum of 4 weeks before a refill prescription is preceded by another in-person visit to the doctor, not giving a refill over the phone.4,5

Lortab Alternative Names and Slang

Lortab is sometimes referred to as “hydro” or “tabs.” All hydrocodone drugs have developed a presence as a diverted product for street sale or via internet purchases on the illicit market. There has also been a concern about the risk to young people using products such as Lortab or Vicodin recreationally, possibly retrieving them from the family medicine chest. Because the drug has similar euphoric effects as heroin, it is sometimes sold as an alternative to heroin.

Lortab Side Effects

Lortab has a similar set of side effects to heroin, with the additional risk for liver impairment.

Other common side effects can include:
  • Lowered respiration and heartbeat
  • Stomach pain
  • Dry mouth
  • Headache
  • Fatigue, drowsiness, nodding off
  • Back pain
  • Stiff or tightened muscles
  • Difficult or painful urination, frequent urination
  • Swollen legs, ankles, feet
  • Insomnia
  • Shaking, tremors
  • Pain in chest
  • Sexual dysfunction, loss of interest, loss of libido
  • Tinnitus
  • Swollen eyes, lips, tongue, throat, face
  • Menstruation irregularities
  • Hives
  • Itching
  • Rash
  • Trouble swallowing, hoarseness in the throat
  • Twitching
  • Vomiting, nausea
  • Constipation
  • Irritability, agitation, mood swings
  • Anxiety
  • Tachycardia
  • Shivering
  • Sweating
  • Confusion, cognitive impairment
  • Loss of coordination, weakness
  • Hallucinations
  • Diarrhea

Lortab Withdrawal Symptoms

Stopping Lortab, as is the case with virtually all prescription medications, is safest when done using a gradual tapering approach, not “cold turkey” or abruptly. Lortab withdrawal symptoms generally start within a few hours of the last dose and are similar to other opioid withdrawals.

Lortab withdrawals can include:
  • Drug cravings
  • Anxiety
  • Fevers
  • Profuse sweating
  • Shaking, uncontrollable tremors, restless legs
  • Chills
  • Trouble sleeping, disturbed or interrupted sleep
  • Pain in muscles and bones
  • Diarrhea
  • Nausea
  • Vomiting, severe, can lead to dehydration
  • Dysphoria
  • General malaise
  • Depression
  • Tachycardia

Discontinuing/Quitting Lortab

Hydrocodone is an opiate that tends to deplete or shut down the body’s own manufacture of natural endorphins. In part, this is one of the reasons why Lortab withdrawals are difficult to endure. Pain relief is absent until the body restores its supply of natural endorphin chemicals.

The body can be significantly assisted by providing the exact precursors and nutrients that can accelerate the process of regenerating these natural pain-relieving chemicals. Also providing a short course of bridge medications may ease the withdrawal process, so it becomes more tolerable.

It is the pain and intense discomfort of Lortab withdrawal that often leads to relapse and failure. A strategy can be planned and executed which can greatly ease these roadblocks to success. More information is given below on this topic in the section called “Treatment for Lortab Abuse and Addiction.”

Lortab Withdrawal and Addiction FAQs

Below we have summarized information about some of the most frequently asked questions about Lortab. These are important issues in regards to Lortab and similar hydrocodone medications. Discuss any concerns or questions with your doctor before starting or stopping a prescription of pain medication. Some of the things to talk to your doctor about include any history of addiction, if you are unable to restrict alcohol consumption, if you have a history of liver or kidney disease, if you suffer from asthma, if you have ever had a head injury, and any other medical history that might be important to determine whether Lortab is the best choice for your situation.

If other questions arise or more detailed information would help, please reach out and we will assist in any way we possibly can.

Is Lortab an Opioid?

Lortab contains a semi-synthetic opioid, hydrocodone which is synthesized from codeine which is derived from opium poppies. Acetaminophen is a non-opioid analgesic agent added to boost the effectiveness of pain relief. In another version, Lortab ASA is combined with acetylsalicylic acid, also called aspirin, instead of Tylenol.2

In 2014 the FDA changed the classification of hydrocodone/acetaminophen products to Schedule II from Schedule III. This reclassification reflects the high level of risk for abuse, addiction, and diversion of hydrocodone products compounded with acetaminophen. Hydrocodone products were the most prescribed medications in the US in 2014.5

Does Melatonin Help with Lortab Withdrawal and Addiction Recovery?

Clinical studies have found that melatonin has a beneficial effect on healing from neuroinflammation caused by chronic use of opioids.6

Where does Hydrocodone Come From?

Hydrocodone is synthesized from codeine. Codeine is synthesized from morphine. Morphine comes from the opium found in opium poppies. Heroin is also made from morphine.7,8

How to Stay Hydrated During Lortab Withdrawal?

About 2 to 3 liters of water should be consumed daily during opioid withdrawal to prevent the risk of dehydration. Extreme dehydration can occur from excessive nausea and diarrhea associated with opioid withdrawal.9

How to Correct Nutritional Deficiencies During and After Lortab Withdrawal?

It is recommended to get lab testing done to know what deficiencies need to be corrected during and after Lortab withdrawal or any drug withdrawal. Especially important are B complex and Vitamin C and omega-three fatty acids to reduce cravings and help restore the gut microbiome. Correction can also be attained through diet modification.10

How to Correct Intestinal Dysfunction During and After Lortab Withdrawal?

Natural fiber products can help restore the function of the intestines. Opiate use over time creates dysfunction (constipation, diarrhea) in the intestines and it is important for cardiovascular and other health issues to improve gut and intestinal functioning as part of recovery.11

Treatment for Lortab Abuse and Addiction?

holistic treatments for addictionThe withdrawals that Lortab users experience when stopping the drug reflect the body’s built-in cleansing mechanisms, which attempt to clear the residues and poisons through the natural elimination channels of sweating, vomiting, urination, and typically, diarrhea. These reactions demonstrate the body attempting to rebalance itself. This elimination process can be assisted and made significantly more tolerable through the use of sauna therapy, adequate hydration, providing targeted nutrition to restore endorphins and correct nutritional deficiencies associated with opioid use, and physical comfort therapies such as therapeutic massage and Reiki, yoga, nebulized glutathione treatments, and many other techniques that provide comfort and healing relief. We understand the intense sensitivity to pain when a person is undergoing opiate withdrawal, at least until the rehabilitated neurochemistry can rebound once again. These re-building strategies give the person the opportunity for lasting and sustainable abstinence, instead of having to “white-knuckle” through their drug-free life. Please see our services explained in more detail on our services overview pages.

Contact us at Alternative to Meds Center for details on our program. Each segment is designed individually for the maximum benefits possible. Ask us for more information about how we can help you or a loved one achieve sobriety that is free from pain and suffering, for a healthy and vibrant life free from addiction.

1. Regulatory Focus (Alexander Gaffney, RAC) 16 July 2014 [accessed 2018 Oct 19],-fda-bans-last-high-dose-aceptaminophen-products [cited 2022 Aug 14]

2. Habibi M, Kim PY. Hydrocodone and Acetaminophen. [Updated 2022 May 2]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: [cited 2022 Aug 14]

3. Cardia L, Calapai G, Quattrone D, Mondello C, Arcoraci V, Calapai F, Mannucci C, Mondello E. Preclinical and Clinical Pharmacology of Hydrocodone for Chronic Pain: A Mini Review. Front Pharmacol. 2018 Oct 1;9:1122. doi: 10.3389/fphar.2018.01122. PMID: 30327606; PMCID: PMC6174210. [cited 2022 Aug 14]

4. U.S. Food & Drug Administration (FDA). FDA drug safety communication: Prescription acetaminophen products to be limited to 325 mg per dosage unit; boxed warning will highlight potential for severe liver failure. [cited 2022 Aug 14]

5. DEA Final Rule of Aug. 22, 2014, [cited 2022 Aug 14]

6. Onaolapo OJ, Onaolapo AY. Melatonin in drug addiction and addiction management: Exploring an evolving multidimensional relationship. World J Psychiatry. 2018 Jun 28;8(2):64-74. doi: 10.5498/wjp.v8.i2.64. PMID: 29988891; PMCID: PMC6033744. [cited 2022 Aug 14]

7.  National Center for Biotechnology Information (2022). PubChem Compound Summary for CID 5284569, Hydrocodone. Retrieved August 14, 2022 from

8. National Center for Biotechnology Information (2022). PubChem Compound Summary for CID 5284371, Codeine. Retrieved August 14, 2022 from

9. Clinical Guidelines for Withdrawal Management and Treatment of Drug Dependence in Closed Settings. Geneva: World Health Organization; 2009. 4, Withdrawal Management. Available from: [cited 2022 Aug 14]

10. Hakimian JK, Dong TS, Barahona JA, Lagishetty V, Tiwari S, Azani D, Barrera M, Lee S, Severino AL, Mittal N, Cahill CM, Jacobs JP, Walwyn WM. Dietary Supplementation with Omega-3 Polyunsaturated Fatty Acids Reduces Opioid-Seeking Behaviors and Alters the Gut Microbiome. Nutrients. 2019 Aug 14;11(8):1900. doi: 10.3390/nu11081900. PMID: 31416242; PMCID: PMC6723154. [cited 2022 Aug 14]

11. Lang-Illievich K, Bornemann-Cimenti H. Opioid-induced constipation: a narrative review of therapeutic options in clinical management. Korean J Pain. 2019 Apr 1;32(2):69-78. doi: 10.3344/kjp.2019.32.2.69. PMID: 31091505; PMCID: PMC6549585. [cited 2022 Aug 14]

Originally Published Sep 13, 2018 by Diane Ridaeus

This content has been reviewed and approved by a licensed physician.

Dr. Michael Loes, M.D.


Dr. Michael Loes is board-certified in Internal Medicine, Pain Management and Addiction Medicine. He holds a dual license in Homeopathic and Integrative Medicine. He obtained his medical doctorate at the University of Minnesota, Minneapolis, MN, 1978. Dr. Loes performed an externship at the National Institute of Health for Psychopharmacology. Additionally, he is a well-published author including Arthritis: The Doctor’s Cure, The Aspirin Alternative, The Healing Response, and Spirit Driven Health: The Psalmist’s Guide for Recovery. He has been awarded the Minnesota Medical Foundation’s “Excellence in Research” Award.

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Lortab Addiction, Withdrawal | Hydrocodone Side Effects, Alternatives, Tapering
Medical Disclaimer:
Nothing on this Website is intended to be taken as medical advice. The information provided on the website is intended to encourage, not replace, direct patient-health professional relationships. Always consult with your doctor before altering your medications. Adding nutritional supplements may alter the effect of medication. Any medication changes should be done only after proper evaluation and under medical supervision.

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