by Nicole Evans M.D.

Created on: March 26, 2010

Lortab and Vicodin are two medications used to relieve moderate to severe pain.  Both medications contain the prescription narcotic pain reliever known as hydrocodone, as well as the over-the-counter pain relieving agent known as acetaminophen.

Despite the fact that Lortab and Vicodin contain the same active medicinal agents, there are differences between these prescription medications.  In fact, there are many other formulations, in addition to Lortab and Vicodin, that also contain acetaminophen and hydrocodone as the active agents.

Here is a sample of the medications that are comprised of a mix of hydrocodone and acetaminophen (also called Paracetamol): Co-Gesic®; Lorcet®; Lortab®; Margesic® H; Maxidone®; Norco®; Stagesic™; Vicodin®; Xodol®; Zamicet™; Zydone®.

Lortab specifically uses a compound called Hydrocodone bitartrate.  Lortab comes in both a liquid elixir formulation and as tablets.

The Lortab liquid elixir contains 7.5 mg of hydrocodone and 500 mg of acetaminophen per 15 mL of liquid.  The other ingredients in the Lortab elixir are ethanol 7%, propylene glycol and a tropical fruit punch flavor.

The tablet form of Lortab can contain varying amounts of hydrocodone and acetaminophen.  A physician will write a prescription for Lortab and then indicate specifically how much hydrocodone each tablet should contain.  The acetaminophen component of Lortab stays at 500mg no matter the strength of hydrocodone used.

For example, Lortab 10 indicates 10mg of Hydrocodone and 500mg of acetaminophen.  Lortab 5 contains 5mg of Hydrocodone and 500mg of acetaminophen.

Vicodin also uses the Hydrocodone bitartrate compound in combination with acetaminophen.  However, Vicodin is not available in a liquid elixir formulation. 

In comparison to Lortab, Vicodin has specifically lettered tablets that indicate the amount of hydrocodone and acetaminophen the tablets will contain.  Vicodin, Vicodin ES, and Vicodin HP are the available formulations.

Vicodin has hydrocodone bitartrate in 5 mg and acetaminophen in 500 mg amounts. Vicodin ES has Hydrocodone bitartrate in 7.5 mg and acetaminophen in 750 mg amounts. Finally, Vicodin HP has Hydrocodone bitartrate in 10 mg and acetaminophen in 660 mg amounts.

Additional differences between Vicodin and Lortab exist in the costs of the available tablets.  Here is a sample of costs as noted from the drug database Lexi-Comp Online.  The dosages indicate amount of hydrocodone to amount of acetominophen:

Tablets (Lortab 10) 10-500 mg (30 pills): $55.10

Tablets (Lortab 2.5) 2.5-500 mg (30 pills): $28.99

Tablets (Lortab 5) 5-500 mg (30 pills): $49.04

Tablets (Lortab 7.5) 7.5-500 mg (30 pills): $53.59

Tablets (Vicodin) 5-500 mg (30 pills): $51.14

Tablets (Vicodin ES) 7.5-750 mg (30 pills): $49.43

Tablets (Vicodin HP) 10-660 mg (30 pills): $54.35

There are several differences between Vicodin and Lortab.  Be particularly careful about the acetaminophen component of these medications.  Acetominophen is highly toxic to the liver in high doses.  Work with your physician to determine whether Lortab or Vicodin is right for you.  

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