5/325 Hydrocodone Acetaminophen: Uses, Side Effects, and Safe Use

What Does 5/325 Mean on Hydrocodone Acetaminophen?

"5/325" means each tablet contains 5 mg of hydrocodone bitartrate and 325 mg of acetaminophen. A 5 325 hydrocodone acetaminophen tablet pairs an opioid pain reliever with a second pain reliever in one pill, and it is available only with a prescription.

The 325 mg figure is not random. In 2011 the FDA asked manufacturers to cap acetaminophen at 325 mg per tablet in prescription combination products and added a boxed warning about severe liver injury. Hydrocodone combination products are Schedule II controlled substances, and MedlinePlus notes that these prescriptions are not refillable, so continuing treatment needs a new prescription from your clinician.

What Is 5/325 Hydrocodone Acetaminophen Used For?

It is prescribed to relieve severe pain. According to MedlinePlus, the U.S. National Library of Medicine's drug guide, hydrocodone relieves pain by changing the way the brain and nervous system respond to it. Acetaminophen adds a second, separate pain-relieving and fever-reducing effect. The tablet does not heal the cause of the pain. It makes pain less noticeable while the body recovers.

The CDC's 2022 opioid prescribing guideline puts this in context. For many common short-term problems, such as low back pain, dental pain, kidney stone pain, and minor surgery, it finds that non-opioid treatments work at least as well. It reserves opioids for severe injuries, invasive surgeries, and other severe pain when other options can't be used, and it advises the lowest effective dose for no longer than the pain requires.

How Is Hydrocodone Acetaminophen 5/325 Taken?

Exactly as your prescription label says. MedlinePlus describes the tablets as taken every 4 to 6 hours as needed, but your own schedule and dose come from your prescriber, and the label on your bottle is the rule to follow. Don't take extra tablets, and don't take it more often than directed.

As needed, not by the clock. The CDC guideline prefers taking an opioid only when needed over a fixed schedule, and advises a taper if it has been taken around the clock for more than a few days.

Missed dose. This medicine is usually taken as needed. If your doctor set a regular schedule and you miss a dose, skip it and continue as planned. Never double up.

Count every acetaminophen product. The FDA tells clinicians to advise patients not to exceed 4,000 mg of acetaminophen a day from all sources, and your prescriber may set a lower limit. The Tylenol Regular Strength label on DailyMed states that it should not be used with any other drug containing acetaminophen, prescription or nonprescription. Cold, flu, and sleep products often contain it too, so ask your pharmacist before adding anything.

What Are the Side Effects of 5/325 Hydrocodone Acetaminophen?

Common side effects are usually manageable. MedlinePlus lists drowsiness, dizziness or lightheadedness when standing up, constipation, nausea, vomiting, stomach pain, and increased sweating. Tell your doctor if they are severe or don't go away, and ask about preventing constipation early. The CDC guideline notes that preventive treatment may be needed if an opioid is used for more than a few days.

Call your doctor or get emergency help right away for:

• Slowed breathing, long pauses between breaths, or shortness of breath. The risk is greatest in the first 24 to 72 hours and after any dose increase.
• Swelling of the face, mouth, tongue, or throat, difficulty breathing or swallowing, hives, itching, or a rash
• Extreme drowsiness, or being unable to wake
• Agitation, hallucinations, fever, sweating, confusion, fast heartbeat, shivering, severe muscle stiffness or twitching, or loss of coordination
• Seizures, chest pain, or changes in heartbeat
• Yellow skin or eyes, which can signal liver injury

If you or your doctor notice a serious reaction, you can report it to the FDA's MedWatch program or by phone at 1-800-332-1088.

Who Should Be Careful, and What Interacts With It?

Tell your doctor and pharmacist before starting if you have any of these, as MedlinePlus advises:

• Slowed breathing, asthma, COPD, or other lung problems
• A blocked or narrowed stomach or intestine
• A brain tumor, raised pressure in the brain, or seizures
• Thyroid, liver, pancreas, gallbladder, heart, or kidney disease
• Heavy alcohol use, street drug use, overuse of prescription medicines, a past overdose, depression, or another mental illness
• An allergy to hydrocodone, acetaminophen, or any ingredient in the tablet

Interactions. Alcohol, street drugs, and certain other medicines raise the risk of serious breathing problems, sedation, or coma. Mention any use in the past two weeks of isocarboxazid, linezolid, methylene blue, phenelzine, selegiline, or tranylcypromine, and tell your prescriber about St. John's wort or tryptophan. MedlinePlus also suggests asking your doctor about grapefruit and grapefruit juice.

Pregnancy. Regular use during pregnancy can cause life-threatening withdrawal symptoms in a newborn. Tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding.

Frequently Asked Questions About 5/325 Hydrocodone Acetaminophen

Is 5/325 hydrocodone acetaminophen strong?

It is a Schedule II opioid, so it should be treated as a serious medicine at any strength. The CDC converts opioids to morphine milligram equivalents (MME) to track total daily exposure. Hydrocodone has a factor of 1.0, so each 5 mg tablet counts as 5 MME, and the CDC's own example is that four tablets a day equal 20 MME. For long-term use, the CDC found that harm rises with dose and that no clear threshold exists below which there is no risk.

Can I take Tylenol with it?

Not without checking first. Both contain acetaminophen, and the FDA warns against taking more than one acetaminophen product at the same time. Ask your pharmacist or prescriber what, if anything, is safe to add.

Can I drink alcohol while taking it?

No. MedlinePlus says alcohol can worsen the side effects of hydrocodone, and the FDA advises against alcohol with any acetaminophen-containing prescription medicine.

What brand names come in 5/325?

The FDA's 2011 product list shows Norco and Anexsia in a 5 mg/325 mg tablet. MedlinePlus notes that many hydrocodone/acetaminophen brands are no longer sold, so your pharmacy may supply a generic labeled "hydrocodone bitartrate and acetaminophen."

Can I stop taking it suddenly?

If you have taken it regularly, don't. MedlinePlus lists withdrawal symptoms such as restlessness, runny nose, sweating, chills, muscle pain, anxiety, stomach cramps, and trouble sleeping. Ask your prescriber for a taper plan.

Can someone else take my tablets?

Never. A dose that is right for you can be dangerous for someone else, especially a child, and giving away a controlled medicine is illegal.

How Should You Store and Dispose of 5/325 Hydrocodone Acetaminophen?

Keep it in the original container, tightly closed, in a locked place out of reach of children and visitors, away from heat and moisture (not in the bathroom). The best way to dispose of leftovers is a drug take-back program, and the DEA's Take Back Day page has a collection site locator. Hydrocodone medicines, including Norco and Vicodin, are on the FDA's flush list, so if no take-back site or mail-back envelope is available, the FDA says to flush them, because even one dose can be fatal to someone it wasn't prescribed for. Don't flush medicines that aren't on that list.

What Are the Signs of an Overdose?

Call 911 if the person has collapsed, had a seizure, has trouble breathing, or can't be woken. Other signs include slow, shallow, or stopped breathing, cold or clammy skin, blue lips or fingertips, tiny pupils, and extreme sleepiness. Because the tablet also contains acetaminophen, a person can recover from the opioid effects and still suffer serious liver injury, so medical care is needed even if they seem fine.

For poisoning questions, Poison Help is free and open 24 hours a day at 1-800-222-1222. Naloxone can reverse the opioid effects: MedlinePlus says someone should give the first dose, call 911, and stay with the person until help arrives. If you or someone you know is struggling with opioid use, SAMHSA's National Helpline at 1-800-662-HELP (4357) offers free, confidential referrals.

About this article. The facts here were checked on October 23, 2026 against NIH MedlinePlus, FDA drug safety and disposal guidance, the CDC's 2022 opioid prescribing guideline, and the DailyMed Tylenol label. It is general education for U.S. readers, not medical advice. Have a licensed pharmacist or physician review it before publishing, and always follow your own prescriber's instructions.