Hydrocodone Bitartrate and Acetaminophen side effects: what 56,016 FDA adverse event reports show
Drug class
Not stated in label
Label matched
Hydrocodone Bitartrate (Hydrocodone Bitartrate)
Who reports
56,016 reports · 86% serious · 8,227 with death outcome · 49% female
Used for
Hydrocodone bitartrate extended-release tablets are indicated for the management of severe and persistent pain that requires an opioid analgesic and that cannot be adequately treated with alternative options, including immediate-release opioids. Limita.
What it is
Hydrocodone bitartrate extended-release tablets are supplied in 20 mg, 30 mg, 40 mg, 60 mg, 80 mg, 100 mg and 120 mg film-coated tablets for oral administration. The tablet strengths describe the amount of hydrocodone per tablet as the bitartrate salt. Hydrocodone bitartrate is an opioid agonist.
Boxed warning
SERIOUS AND LIFE-THREATENING RISKS FROM USE OF HYDROCODONE BITARTRATE EXTENDED-RELEASE TABLETS Addiction, Abuse, and Misuse Because the use of hydrocodone bitartrate extended-release tablets exposes patients and othe.
Causality screen of the 40 strongest signals
What the badges mean
- Labeled adverse reaction The exact term appears in the label's warnings or adverse-reactions sections: a known, expected effect. The FAERS signal confirms the label rather than discovering anything.
- Labeled (related wording) The label describes this effect under different wording (e.g. 'neutropenia' for 'neutrophil count decreased'). Treated as known.
- Reporting / coding artifact An administrative, monitoring or exposure term (product issue, off-label use, 'test normal', overdose...). Not a biological reaction; a high PRR here reflects how reports are coded.
- Lab value / disease marker A laboratory result, investigation or disease-activity marker (antibody positive, CRP abnormal, swollen joint count) not described in the label. These usually mirror the monitored disease or testing protocol rather than a drug effect; not screened further.
- Not in label — unassessed Not found in the label text, not an artifact pattern. This is a genuine candidate for a formal causality assessment (Bradford Hill / WHO-UMC); it has NOT had one here.
Strongest disproportionality signals
Flagged terms (PRR ≥ 2, χ² ≥ 4, n ≥ 10), ranked by PRR; infinite PRRs (no comparator reports) excluded. The EBGM column is a second, shrinkage-based estimate (MGPS) with its 5th percentile EB05 and the BCPNN IC025; a pair flagged by PRR alone is marked PRR-only and should be read as fragile. The strata column recomputes the PRR on serious reports only (and, for the 300 most-reported drugs, adjusted for age band), and flags pairs whose reports are unusually skewed by sex or come mostly from consumers. Each row also shows the PRR against the other drugs of the same FDA class, which removes most confounding by the condition being treated, and a calibrated p-value: on validation, known non-causes average an ROR of about 2, so significance is judged against that empirical null (✓ = p < 0.05 after calibration). 1,120 further terms are in the interactive explorer. Reaction links open the term's cross-drug page.
| Reaction | Reports | PRR 95% CI · ROR · χ²/p | EBGM EB05 · IC025 | Label screen | Serious-only & strata | Trial cross-check |
|---|---|---|---|---|---|---|
| Vision abnormal neonatal | 228 | 442.0 364.7–535.8ROR 443.8 · calibrated p 3e-13 ✓ | 198.1 EB05 177.5 · IC025 +6.9 3/3 methods agree | Not in label — unassessed | serious n=228 · 100% consumer | no trial arm names this drug |
| Neonatal hypoacusis | 109 | 326.4 252.3–422.4ROR 327.1 · calibrated p 9e-12 ✓ | 168.5 EB05 143.5 · IC025 +6.3 3/3 methods agree | Not in label — unassessed | serious n=109 · 100% consumer | no trial arm names this drug |
| Learning disability | 2,407 | 303.9 288.1–320.5ROR 317.5 · calibrated p 6e-12 ✓ | 166.7 EB05 161.2 · IC025 +7.3 3/3 methods agree | Not in label — unassessed | serious n=2,403 · 99% consumer | no trial arm names this drug |
| Developmental delay | 2,240 | 122.4 116.8–128.3ROR 127.5 · calibrated p 2e-8 ✓ | 92.1 EB05 88.9 · IC025 +6.4 3/3 methods agree | Not in label — unassessed | serious PRR 62.2 · 99% consumer | no trial arm names this drug |
| Drug dependence | 33,295 | 96.4 95.6–97.2ROR 236.1 · calibrated p 9e-11 ✓ | 76.6 EB05 75.9 · IC025 +6.2 3/3 methods agree | Reporting / coding artifact | serious PRR 52.1 · 98% consumer | no trial arm names this drug |
| Drug withdrawal syndrome neonatal | 2,213 | 65.0 62.1–67.9ROR 67.6 · calibrated p 2e-6 ✓ | 55.3 EB05 53.4 · IC025 +5.7 3/3 methods agree | Labeled (related wording) related wording | serious PRR 37.0 · 100% consumer | no trial arm names this drug |
| Imprisonment | 207 | 48.8 42.2–56.4ROR 49.0 · calibrated p 2e-5 ✓ | 43.1 EB05 38.4 · IC025 +5.1 3/3 methods agree | Not in label — unassessed | serious n=207 · ♀ 28% (drug 49%) · 97% consumer | no trial arm names this drug |
| Disability | 1,767 | 36.7 34.9–38.5ROR 37.8 · calibrated p 7e-5 ✓ | 33.4 EB05 32.1 · IC025 +5.0 3/3 methods agree | Not in label — unassessed | serious PRR 23.0 · 95% consumer | no trial arm names this drug |
| Emotional distress | 10,842 | 36.6 36.0–37.3ROR 45.2 · calibrated p 3e-5 ✓ | 33.4 EB05 32.9 · IC025 +5.0 3/3 methods agree | Not in label — unassessed | serious PRR 23.6 · 94% consumer | no trial arm names this drug |
| Drug tolerance increased | 67 | 34.9 27.1–44.8ROR 34.9 · calibrated p 1e-4 ✓ | 31.7 EB05 25.8 · IC025 +4.3 3/3 methods agree | Labeled (related wording) related wording | serious n=65 · 100% consumer | no trial arm names this drug |
| Alcoholic | 16 | 32.4 19.4–54.0ROR 32.4 · calibrated p 4e-4 ✓ | 28.9 EB05 18.9 · IC025 +3.2 3/3 methods agree | Not in label — unassessed | serious n=16 | no trial arm names this drug |
| Spina bifida | 163 | 31.4 26.7–36.8ROR 31.5 · calibrated p 2e-4 ✓ | 28.9 EB05 25.4 · IC025 +4.5 3/3 methods agree | Not in label — unassessed | serious n=163 · 100% consumer | no trial arm names this drug |
| Post-traumatic stress disorder | 517 | 31.2 28.5–34.1ROR 31.4 · calibrated p 2e-4 ✓ | 28.8 EB05 26.8 · IC025 +4.7 3/3 methods agree | Not in label — unassessed | serious n=513 · 96% consumer | no trial arm names this drug |
| Overdose | 14,511 | 26.8 26.4–27.2ROR 35.9 · calibrated p 1e-4 ✓ | 25.1 EB05 24.7 · IC025 +4.6 3/3 methods agree | Reporting / coding artifact | serious PRR 21.1 · 97% consumer | no trial arm names this drug |
| Multiple congenital abnormalities | 91 | 24.9 20.2–30.8ROR 25.0 · calibrated p 8e-4 ✓ | 23.3 EB05 19.6 · IC025 +4.0 3/3 methods agree | Labeled (related wording) related wording | serious n=91 · 100% consumer | no trial arm names this drug |
| Drug withdrawal syndrome | 5,345 | 24.0 23.3–24.6ROR 26.4 · calibrated p 5e-4 ✓ | 22.6 EB05 22.0 · IC025 +4.4 3/3 methods agree | Labeled adverse reaction exact term | serious PRR 18.8 · 95% consumer | no trial arm names this drug |
| Detoxification | 21 | 23.9 15.4–37.2ROR 24.0 · calibrated p 0.001 ✓ | 22.1 EB05 15.2 · IC025 +3.2 3/3 methods agree | Not in label — unassessed | serious n=21 | no trial arm names this drug |
| Mental disability | 33 | 22.6 15.9–32.1ROR 22.6 · calibrated p 0.002 ✓ | 21.1 EB05 15.7 · IC025 +3.5 3/3 methods agree | Not in label — unassessed | serious n=33 · 100% consumer | no trial arm names this drug |
| Drug tolerance | 286 | 22.3 19.8–25.1ROR 22.4 · calibrated p 0.001 ✓ | 21.0 EB05 19.1 · IC025 +4.2 3/3 methods agree | Labeled (related wording) related wording | serious n=276 · 94% consumer | no trial arm names this drug |
| Judgement impaired | 74 | 19.9 15.7–25.1ROR 19.9 · calibrated p 0.002 ✓ | 18.8 EB05 15.5 · IC025 +3.7 3/3 methods agree | Not in label — unassessed | serious n=74 · 100% consumer | no trial arm names this drug |
| Congenital anomaly | 389 | 19.6 17.7–21.7ROR 19.7 · calibrated p 0.002 ✓ | 18.7 EB05 17.1 · IC025 +4.0 3/3 methods agree | Labeled (related wording) related wording | serious PRR 12.4 · 100% consumer | no trial arm names this drug |
| Exposure via father | 50 | 14.7 11.1–19.5ROR 14.7 · calibrated p 0.009 ✓ | 14.0 EB05 10.9 · IC025 +3.2 3/3 methods agree | Reporting / coding artifact | serious n=48 · 100% consumer | no trial arm names this drug |
| General physical condition abnormal | 241 | 13.7 12.1–15.6ROR 13.8 · calibrated p 0.010 ✓ | 13.2 EB05 11.9 · IC025 +3.5 3/3 methods agree | Lab value / disease marker | serious n=240 · 100% consumer | no trial arm names this drug |
| Substance use disorder | 107 | 13.5 11.1–16.3ROR 13.5 · calibrated p 0.011 ✓ | 12.9 EB05 11.0 · IC025 +3.3 3/3 methods agree | Labeled adverse reaction exact term | serious n=106 · 100% consumer | no trial arm names this drug |
| Mental disorder | 1,496 | 13.3 12.6–14.0ROR 13.6 · calibrated p 0.010 ✓ | 12.8 EB05 12.3 · IC025 +3.6 3/3 methods agree | Labeled adverse reaction exact term | serious PRR 10.1 · 95% consumer | no trial arm names this drug |
| Tobacco abuse | 18 | 12.9 8.0–20.6ROR 12.9 · calibrated p 0.018 ✓ | 11.5 EB05 7.2 · IC025 +2.5 3/3 methods agree | Reporting / coding artifact | serious n=18 | no trial arm names this drug |
| Theft | 22 | 12.7 8.3–19.4ROR 12.7 · calibrated p 0.018 ✓ | 11.6 EB05 7.6 · IC025 +2.6 3/3 methods agree | Not in label — unassessed | serious n=21 | no trial arm names this drug |
| Rebound acid hypersecretion | 100 | 12.6 10.3–15.4ROR 12.6 · calibrated p 0.015 ✓ | 12.1 EB05 10.2 · IC025 +3.2 3/3 methods agree | Not in label — unassessed | serious n=100 | no trial arm names this drug |
| Hyperparathyroidism secondary | 81 | 12.3 9.9–15.4ROR 12.4 · calibrated p 0.016 ✓ | 11.8 EB05 9.7 · IC025 +3.1 3/3 methods agree | Not in label — unassessed | serious n=81 | no trial arm names this drug |
| Nephrogenic anaemia | 148 | 12.2 10.4–14.4ROR 12.2 · calibrated p 0.016 ✓ | 11.8 EB05 10.2 · IC025 +3.2 3/3 methods agree | Not in label — unassessed | serious n=148 | no trial arm names this drug |
| Social anxiety disorder | 20 | 11.7 7.5–18.3ROR 11.7 · calibrated p 0.024 ✓ | 10.4 EB05 6.7 · IC025 +2.4 3/3 methods agree | Not in label — unassessed | serious n=20 | no trial arm names this drug |
| Antisocial behaviour | 30 | 11.5 8.0–16.5ROR 11.5 · calibrated p 0.024 ✓ | 10.5 EB05 7.5 · IC025 +2.6 3/3 methods agree | Not in label — unassessed | serious n=30 · ♀ 27% (drug 49%) · 100% consumer | no trial arm names this drug |
| Gallbladder non-functioning | 17 | 11.4 7.0–18.4ROR 11.4 · calibrated p 0.028 ✓ | 9.9 EB05 6.1 · IC025 +2.3 3/3 methods agree | Not in label — unassessed | serious n=17 | no trial arm names this drug |
| Attention deficit hyperactivity disorder | 121 | 11.2 –ROR 11.2 · – | – | Not in label — unassessed | serious n=121 · 92% consumer | no trial arm names this drug |
| Self esteem decreased | 70 | 11.0 8.7–14.0ROR 11.0 · calibrated p 0.025 ✓ | 10.5 EB05 8.5 · IC025 +2.9 3/3 methods agree | Not in label — unassessed | serious n=70 · 100% consumer | no trial arm names this drug |
| Biliary dyskinesia | 49 | 11.0 8.3–14.6ROR 11.0 · calibrated p 0.026 ✓ | 10.3 EB05 8.0 · IC025 +2.8 3/3 methods agree | Not in label — unassessed | serious n=49 · ♀ 100% (drug 49%) | no trial arm names this drug |
| Foetal exposure during pregnancy | 2,312 | 10.9 10.5–11.4ROR 11.4 · calibrated p 0.020 ✓ | 10.6 EB05 10.3 · IC025 +3.3 3/3 methods agree | Reporting / coding artifact | serious PRR 7.3 · 100% consumer | no trial arm names this drug |
| Drug abuse | 2,252 | 10.3 9.9–10.8ROR 10.7 · calibrated p 0.025 ✓ | 10.1 EB05 9.7 · IC025 +3.3 3/3 methods agree | Reporting / coding artifact | serious PRR 6.8 · 78% consumer | no trial arm names this drug |
| Cholecystitis chronic | 182 | 10.3 8.9–11.9ROR 10.3 · calibrated p 0.030 ✓ | 9.9 EB05 8.8 · IC025 +3.0 3/3 methods agree | Not in label — unassessed | serious PRR 6.7 · ♀ 100% (drug 49%) | no trial arm names this drug |
| Hepatitis c | 306 | 9.6 8.6–10.7ROR 9.6 · calibrated p 0.037 ✓ | 9.3 EB05 8.5 · IC025 +3.0 3/3 methods agree | Not in label — unassessed | serious PRR 6.6 · 96% consumer | no trial arm names this drug |
Trial evidence (ClinicalTrials.gov)
Most frequently reported reactions
By raw co-report count, regardless of disproportionality. Common terms here are often the illness itself or generic outcomes.
| Reaction | Reports | PRR 95% CI · ROR · χ²/p | EBGM EB05 · IC025 | Label screen | Serious-only & strata | Trial cross-check |
|---|---|---|---|---|---|---|
| Drug dependence | 33,295 | 96.4 95.6–97.2ROR 236.1 · calibrated p 9e-11 ✓ | 76.6 EB05 75.9 · IC025 +6.2 3/3 methods agree | Reporting / coding artifact | serious PRR 52.1 · 98% consumer | no trial arm names this drug |
| Overdose | 14,511 | 26.8 26.4–27.2ROR 35.9 · calibrated p 1e-4 ✓ | 25.1 EB05 24.7 · IC025 +4.6 3/3 methods agree | Reporting / coding artifact | serious PRR 21.1 · 97% consumer | no trial arm names this drug |
| Pain | 12,050 | 7.5 7.3–7.6ROR 9.2 · calibrated p 0.042 ✓ | 7.3 EB05 7.2 · IC025 +2.8 3/3 methods agree | Likely indication confounding term in indications; also in warnings | serious PRR 7.0 · 80% consumer | no trial arm names this drug |
| Emotional distress | 10,842 | 36.6 36.0–37.3ROR 45.2 · calibrated p 3e-5 ✓ | 33.4 EB05 32.9 · IC025 +5.0 3/3 methods agree | Not in label — unassessed | serious PRR 23.6 · 94% consumer | no trial arm names this drug |
| Drug withdrawal syndrome | 5,345 | 24.0 23.3–24.6ROR 26.4 · calibrated p 5e-4 ✓ | 22.6 EB05 22.0 · IC025 +4.4 3/3 methods agree | Labeled adverse reaction exact term | serious PRR 18.8 · 95% consumer | no trial arm names this drug |
| Anxiety | 4,203 | 5.6 5.4–5.7ROR 6.0 · calibrated p 0.153 | 5.5 EB05 5.4 · IC025 +2.4 3/3 methods agree | Labeled adverse reaction exact term | serious PRR 4.6 · 85% consumer | no trial arm names this drug |
| Death | 3,181 | 1.4 1.3–1.4ROR 1.4 · calibrated p 0.580 | 1.4 EB05 1.3 · IC025 +0.4 | Outcome field, not a reaction boxed warning mentions mortality | serious PRR 0.9 · 70% consumer | no trial arm names this drug |
| Depression | 2,728 | 4.5 4.3–4.7ROR 4.7 · calibrated p 0.271 | 4.5 EB05 4.3 · IC025 +2.1 3/3 methods agree | Labeled — boxed warning exact term | serious PRR 4.0 · 89% consumer | no trial arm names this drug |
| Learning disability | 2,407 | 303.9 288.1–320.5ROR 317.5 · calibrated p 6e-12 ✓ | 166.7 EB05 161.2 · IC025 +7.3 3/3 methods agree | Not in label — unassessed | serious n=2,403 · 99% consumer | no trial arm names this drug |
| Foetal exposure during pregnancy | 2,312 | 10.9 10.5–11.4ROR 11.4 · calibrated p 0.020 ✓ | 10.6 EB05 10.3 · IC025 +3.3 3/3 methods agree | Reporting / coding artifact | serious PRR 7.3 · 100% consumer | no trial arm names this drug |
| Drug abuse | 2,252 | 10.3 9.9–10.8ROR 10.7 · calibrated p 0.025 ✓ | 10.1 EB05 9.7 · IC025 +3.3 3/3 methods agree | Reporting / coding artifact | serious PRR 6.8 · 78% consumer | no trial arm names this drug |
| Developmental delay | 2,240 | 122.4 116.8–128.3ROR 127.5 · calibrated p 2e-8 ✓ | 92.1 EB05 88.9 · IC025 +6.4 3/3 methods agree | Not in label — unassessed | serious PRR 62.2 · 99% consumer | no trial arm names this drug |
| Drug withdrawal syndrome neonatal | 2,213 | 65.0 62.1–67.9ROR 67.6 · calibrated p 2e-6 ✓ | 55.3 EB05 53.4 · IC025 +5.7 3/3 methods agree | Labeled (related wording) related wording | serious PRR 37.0 · 100% consumer | no trial arm names this drug |
| Disability | 1,767 | 36.7 34.9–38.5ROR 37.8 · calibrated p 7e-5 ✓ | 33.4 EB05 32.1 · IC025 +5.0 3/3 methods agree | Not in label — unassessed | serious PRR 23.0 · 95% consumer | no trial arm names this drug |
| Completed suicide (death by suicide) | 1,750 | 7.9 7.6–8.3ROR 8.2 · calibrated p 0.063 | 7.8 EB05 7.5 · IC025 +2.9 3/3 methods agree | Outcome field, not a reaction boxed warning mentions mortality | serious PRR 5.2 · 91% clinician | no trial arm names this drug |
Unlabeled candidate signals
These flagged terms were not found in the FDA label text and do not match an artifact pattern. They are the pairs that would merit a structured assessment (temporality, dose-response, biological plausibility, consistency across databases, trial or cohort evidence). The screen has not done that; string-matching misses label wording, and a strong PRR can still be stimulated reporting, co-medication, or the disease itself.
- Vision abnormal neonatal — n=228, PRR 442.0
- Neonatal hypoacusis — n=109, PRR 326.4
- Learning disability — n=2,407, PRR 303.9
- Developmental delay — n=2,240, PRR 122.4
- Imprisonment — n=207, PRR 48.8
- Disability — n=1,767, PRR 36.7
- Emotional distress — n=10,842, PRR 36.6
- Spina bifida — n=163, PRR 31.4
- Post-traumatic stress disorder — n=517, PRR 31.2
- Detoxification — n=21, PRR 23.9
✓ A hand-written Bradford Hill causality assessment exists for this drug: Hydrocodone Bitartrate And Acetaminophen ↔ Drug Dependence.
Want to assess one of these properly? The runbook describes the Bradford Hill / trial-evidence workflow used on the assessment page, and handoff_top1000_signals.csv lists the strongest unassessed pairs across all drugs.
Common questions
What are the most reported side effects of Hydrocodone Bitartrate and Acetaminophen?
In FDA FAERS, the most frequently co-reported reaction terms for Hydrocodone Bitartrate and Acetaminophen are pain, emotional distress, drug withdrawal syndrome, anxiety, depression, learning disability. These are report counts, not rates: FAERS has no denominator, reporting is voluntary and uneven, and a term can be reported because of the illness being treated rather than the drug.
Does Hydrocodone Bitartrate and Acetaminophen have an FDA boxed warning?
Yes. The current FDA label carries a boxed warning: SERIOUS AND LIFE-THREATENING RISKS FROM USE OF HYDROCODONE BITARTRATE EXTENDED-RELEASE TABLETS Addiction, Abuse, and Misuse Because the use of hydrocodone bitartrate extended-release tablets exposes patients and othe.
Do FAERS signals prove that Hydrocodone Bitartrate and Acetaminophen causes these side effects?
No. A disproportionality signal (PRR, ROR) means a reaction is reported more often with this drug than with others in the database. That can reflect a real effect, but also the disease being treated, stimulated reporting after news or litigation, co-medications, or how reports are coded. Causality needs temporality, dose-response, biological plausibility, consistency across data sources and, ideally, trial or cohort evidence. This page screens each term against the FDA label and ClinicalTrials.gov results; it does not establish causation.
Sources & methods
- FDA label via openFDA (set ID f7b55d14-0980-b680-8ceb-7489ff65455e, effective 20251007; matched on
openfda.generic_name.exact:"HYDROCODONE BITARTRATE") - Bayesian shrinkage measures computed offline over all 1,317,300 cached pairs: BCPNN information component (IC, with Norén closed-form IC025) and MGPS empirical-Bayes geometric mean (EBGM, EB05) with a two-component gamma prior fitted by maximum marginal likelihood (α₁=0.57, β₁=0.02, α₂=1.42, β₂=0.70, w=0.17); unstratified
- FAERS pair statistics from the OpenPV build of 2026-09-14 (openFDA
count=aggregation, fieldpatient.drug.openfda.generic_name.exact, 1,160 reaction terms, min 3 co-reports); PRR/ROR with 95% CI, chi-square with Yates correction - Serious-only and stratified counts (serious:1, patient.patientsex, primarysource.qualification) from openFDA count queries; serious-only PRR uses the drug serious report total and the term global serious total (N_serious=11,882,979); strata shown only when n ≥ 20
- Seriousness and sex counts from openFDA
count=serious,patient.patientsex,seriousnessdeath - ClinicalTrials.gov API v2 (query
HYDROCODONE BITARTRATE, results-bearing studies sorted by enrollment)
Page generated 2026-10-14. Label and PubChem text are retrieved automatically and may lag the current label; always check the current prescribing information. OpenPV is a beta research tool of the Open Source Medicine Foundation.