HYDROCODONE BITARTRATE AND IBUPROFEN- hydrocodone bitartrate and ibuprofen tablet, film coated 
Actavis Pharma, Inc.

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 MedicationGuide
Hydrocodone Bitartrate (hye” droe koe’ done bye tar’ trate) and Ibuprofen (eye" bue proe' fen) Tablets), CII
 Hydrocodone bitartrate and ibuprofen tablets are:
  • A strong prescription pain medicine that contains an opioid (narcotic) and a non-steroidal anti-inflammatory drug (NSAID), that is used to manage short-term (acute) pain, when other pain treatments such as non-opioid pain medicines do not treat your pain well enough or you cannot tolerate them.
  • An opioid pain medicine can put you at risk for overdose and death. Even if you take your dose correctly as prescribed you are at risk for opioid addiction, abuse, and misuse that can lead to death.
  • NSAIDs are used to treat pain, redness, swelling, and inflammation.
 Important information about hydrocodone bitartrate and ibuprofen tablets:
  • Get emergency help right away if you take too much hydrocodone bitartrate and ibuprofen tablets (overdose). When you first start taking hydrocodone bitartrate and ibuprofen tablets, when your dose is changed, or if you take too much (overdose), serious or life-threatening breathing problems that can lead to death may occur.
  • Taking hydrocodone bitartrate and ibuprofen tablets with other opioid medicines, benzodiazepines, alcohol, or other central nervous system depressants (including street drugs) can cause severe drowsiness, decreased awareness, breathing problems, coma, and death.
  • Never give anyone else your hydrocodone bitartrate and ibuprofen tablets. They could die from taking it. Store hydrocodone bitartrate and ibuprofen tablets away from children and in a safe place to prevent stealing or abuse. Selling or giving away hydrocodone bitartrate and ibuprofen tablets is against the law.
Hydrocodone bitartrate and ibuprofen tablet contains an NSAID. NSAIDs can cause serious side effects, including:
  •  Increased risk of a heart attack or stroke that can lead to death. This risk may happen early in treatment and may increase:
    ○ with increasing doses of medicine containing NSAIDs
    ○ with longer use of medicine containing NSAIDs
Do not take NSAIDS right before or after a heart surgery called a coronary artery bypass graft (CABG).”
Avoid taking NSAIDS after a recent heart attack, unless your healthcare provider tells you to. You may have an increased risk of another heart attack if you take NSAIDs after a recent heart attack.
  • Increased risk of bleeding, ulcers, and tears (perforation) of the esophagus (tube leading from the mouth to the stomach), stomach and intestines:
    o any time during use
    o without warning symptoms
    o that may cause death
The risk of getting an ulcer or bleeding increases with:
 ○ past history of stomach ulcers, or stomach or intestinal bleeding with use of NSAIDs ○ taking medicines called “corticosteroids,” “anticoagulants,” “SSRIs,” or “SNRIs”
 ○ increasing doses of NSAIDS ○ older age
 ○ longer use of NSAIDS ○ poor health
 ○ smoking ○ advanced liver disease
 ○ drinking alcohol ○ bleeding problems
 Do not take hydrocodone bitartrate and ibuprofen tablets:
  • if you have severe asthma, trouble breathing, or other lung problems.
  • if you have a bowel blockage or have narrowing of the stomach or intestines.
  • if you have had an asthma attack, hives, or other allergic reaction with aspirin, other NSAIDs, or opioid medicine.
  • right before or after heart bypass surgery.
 Before taking hydrocodone bitartrate and ibuprofen tablets, tell your healthcare provider if you have a history of:
  head injury or seizures  liver, kidney, or thyroid problems
  problems urinating  pancreas or gallbladder problems
  high blood pressure  asthma
  abuse of street or prescription drugs, alcohol addiction, or mental health problems.
 Tell your healthcare provider if you are:
  • pregnant or planning to become pregnant. Talk to your healthcare provider if you are considering taking hydrocodone bitartrate and ibuprofen tablets during pregnancy. Prolonged use of hydrocodone bitartrate and ibuprofen tablets during pregnancy can cause withdrawal symptoms in your newborn baby that could be life-threatening if not recognized and treated. You should not take NSAIDs after 29 weeks of pregnancy.
  • breastfeeding or planning to breastfeed. Hydrocodone bitartrate and ibuprofen passes into breast milk and may harm your baby.
  • taking prescription or over-the-counter medicines, vitamins, or herbal supplements. Taking hydrocodone bitartrate and ibuprofen tablets with certain other medicines can cause serious side effects that could lead to death.
 When taking hydrocodone bitartrate and ibuprofen tablets:
  • Do not change your dose. Take hydrocodone bitartrate and ibuprofen tablets exactly as prescribed by your healthcare provider.
Use the lowest dose possible for the shortest time needed.
  • Take your prescribed dose every 4 to 6 hours, as needed. Do not take more than your prescribed dose. If you miss a dose, take your next dose at your usual time.
  • Call your healthcare provider if the dose you are taking does not control your pain.
  • If you have been taking hydrocodone bitartrate and ibuprofen tablets regularly, do not stop taking it without talking to your healthcare provider.
  • After you stop taking hydrocodone bitartrate and ibuprofen tablets, flush any unused tablets down the toilet or contact the Drug Enforcement Agency (DEA) to find the location of an authorized collector (1-800-882­9539) after you stop taking hydrocodone bitartrate and ibuprofen tablets.
 While taking hydrocodone bitartrate and ibuprofen tablets DO NOT:
  • drive or operate heavy machinery, until you know how it affects you. Hydrocodone bitartrate and ibuprofen tablets can make you sleepy, dizzy, or lightheaded.
  • drink alcohol or use prescription or over-the-counter medicines that contain alcohol. Using products containing alcohol during treatment with hydrocodone bitartrate and ibuprofen tablets may cause you to overdose and die.
 The possible side effects of hydrocodone bitartrate and ibuprofen tablets:
  • constipation, diarrhea, gas, heartburn, nausea, sleepiness, vomiting, tiredness, headache, dizziness, abdominal pain, heart attack, stroke, new or worse high blood pressure, heart failure, liver problems including liver failure, kidney problems including kidney failure, bleeding and ulcers in the stomach and intestine, low red blood cells (anemia), life-threatening skin reactions, life- threatening allergic reactions, asthma attacks in people who have asthma. Call your healthcare provider if you have any of these symptoms and they are severe.
 Get emergency medical help if you have:
  trouble breathing or shortness of breath  agitation
 fast heartbeat  high body temperature
 chest pain  trouble walking
 swelling of your face, tongue, or throat  stiff muscles
 extreme drowsiness  mental changes such as confusion
 lightheadedness when changing positions  weakness in one part or side of your body
 a fainting spell  slurred speech
 Stop hydrocodone bitartrate and ibuprofen tablets and call your healthcare provider right away if you have any of the following symptoms:
  nausea  flu-like symptoms
  more tired or weaker than usual  vomit blood
  diarrhea  there is blood in your bowel movement or it is black and sticky like tar
  itching  unusual weight gain
  your skin or eyes look yellow  skin rash or blisters with fever
  indigestion or stomach pain  swelling of the arms and legs, hands and feet
 These are not all the possible side effects of hydrocodone bitartrate and ibuprofen tablets. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088. For more information go to dailymed.nlm.nih.gov.
 Other information:
  • Aspirin is an NSAID medicine, but it does not increase the chance of a heart attack. Aspirin can cause bleeding in the brain, stomach, and intestines. Aspirin can also cause ulcers in the stomach and intestines.
  • Do not take other NSAID medicines, even those sold in lower doses without a prescription (over-the-counter) while taking hydrocodone bitartrate and ibuprofen tablets. NSAIDs may be present in over-the-counter medications for treatment of colds, fever, or insomnia.
 Manufactured by:
Actavis Laboratories FL, Inc.
Fort Lauderdale, FL 33314 USA
Distributed by:
Actavis Pharma, Inc.
Parsippany, NJ 07054 USA

This Medication Guide has been approved by the U.S. Food and Drug Administration.

Revised: January 2017

Revised: 1/2017
Actavis Pharma, Inc.