The following uses to the ingredients:Cyclobenzaprine (found in Flexeril) and also Hydrocodone (found in Norco)

Using drug pain or cough medications together with other medications that additionally cause central nervous device depression deserve to lead to major side results including respiratory distress, coma, and also even death. Talk to your physician if friend have any type of questions or concerns. Your doctor may have the ability to prescribe choices that execute not interact, or you may need a dose adjustment or an ext frequent surveillance to safely usage both medications. Execute not drink alcohol or self-medicate v these medicines without your doctor"s approval, and do no exceed the doses or frequency and duration of use prescribed by her doctor. Also, since these medicines may reason dizziness, drowsiness, an obstacle concentrating, and impairment in judgment, reaction speed and motor coordination, you need to avoid control or operating hazardous machinery till you know exactly how they impact you. The is essential to tell her doctor around all other drugs you use, including vitamins and herbs. Do not avoid using any type of medications without very first talking to your doctor.

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The following applies to the ingredients:Hydrocodone (found in Norco)

Do not usage alcohol or medications that save on computer alcohol if you are receiving treatment through HYDROcodone. This may increase nervous system side results such together drowsiness, dizziness, lightheadedness, challenge concentrating, and also impairment in thinking and also judgment. In severe cases, low blood pressure, respiratory tract distress, fainting, coma, or even fatality may occur. If you space taking details long-acting formulations of hydrocodone, intake of alcohol may likewise cause rapid release the the drug, resulting in high blood levels that may be potentially lethal. Likewise, you have to avoid spend grapefruit and grapefruit juice, as this may increase the blood levels and also effects that hydrocodone. Speak to your doctor or pharmacist if you have questions on exactly how to take this or other medicines you room prescribed. Carry out not use more than the recommended dose of HYDROcodone, and avoid activities requiring mental alertness such as driving or operation hazardous machinery till you know how the medication affects you. The is essential to tell her doctor around all other medications you use, consisting of vitamins and also herbs. Perform not protect against using any medication without very first talking to your doctor.


The following uses to the ingredients:Cyclobenzaprine (found in Flexeril)

Alcohol deserve to increase the nervous mechanism side impacts of cyclobenzaprine such together dizziness, drowsiness, and difficulty concentrating. Some world may likewise experience special needs in thinking and also judgment. You must avoid or limit the use of alcohol while being treated through cyclobenzaprine. Carry out not use much more than the recommended sheep of cyclobenzaprine, and also avoid tasks requiring mental alertness such as driving or operating hazardous machinery until you know just how the medicine affects you. Talk to your physician or pharmacist if friend have any kind of questions or concerns.


The following applies to the ingredients:Hydrocodone (found in Norco)

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Benefit must outweigh risk

US FDA pregnant category: no assigned

Risk Summary: Based on animal data, may reason fetal harm; an extensive maternal use of opioids during pregnancy may reason neonatal opioid withdrawal syndrome.

Comments:-Women need to be advised of the risk of neonatal abstinence syndrome and also ensure that proper treatment will certainly be available.-Long-acting opioids need to not be offered during and immediately prior to labor, when brief acting analgesics or various other analgesic techniques are much more appropriate.

Rats administered this drug during gestation and lactation showed boosts in stillborn pups and also decreases in pup survive at doses indistinguishable to the person dose the 100 mg/day. Lessened nursing behavior and decreased human body weights to be observed at 2 times the person dose. Diminished fetal weights were observed in rabbits provided this drug during the period of organogenesis in ~ doses identical to 5 times the human being dose of 100 mg/day. Additionally, increases in the number of umbilical hernias, irregularly shame bones, and delays in fetal skeletal maturation were observed in the research at sheep 15 time the human being dose of 100 mg/day. No fetal malformations were observed in rats and also rabbits at doses around 2 (rats) and also 10 (rabbits) time a human dose that 100 mg/day. Prolonged use of opioid analgesics throughout pregnancy for medical or nonmedical functions may cause neonatal opioid withdrawal syndrome. There are no controlled data in person pregnancy.

Chronic opioid usage may cause reduced fertility in males and females; the is unknown even if it is these effects on fertility are reversible.

US FDA pregnancy category Not Assigned: The us FDA has actually amended the pregnancy labeling dominance for prescription drug assets to require labeling that consists of a review of risk, a conversation of the data supporting that summary, and also relevant information to assist health care providers make prescribing decisions and counsel women about the use of drugs throughout pregnancy. Pregnancy categories A, B, C, D, and X room being phased out.


References


"Product Information. Zohydro ER (HYDROcodone)."Zogenix, Inc, mountain Diego, CA. "Product Information. Hysingla ER (HYDROcodone)."Purdue Pharma LP, Stamford, CT.
The following uses to the ingredients:Acetaminophen-Hydrocodone (found in Norco)

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Benefit should outweigh risk us FDA pregnancy category: C Comments:-Prolonged use of opioids throughout pregnancy can an outcome in physical dependence in the neonate; women must be advised of the risk of neonatal abstinence syndrome and also ensure that appropriate treatment will certainly be available.-Monitor neonates exposed come opioid analgesics for indicators of excess sedation and also respiratory depression.

Opioid analgesics cross the placenta. Hydro codon use throughout labor may reason respiratory depression in the newborn infant. Prolonged use the opioids during pregnancy can an outcome in physical dependency in the neonate and neonatal opioid tap the money syndrome quickly after birth. The onset, duration, and also severity the the problem will vary based upon maternal usage (duration the use, timing, and amount of critical use) and also rate of elimination in the newborn. Acetaminophen has not been linked with major congenital malformations, although pet studies have figured out adverse impacts at clinically relevant doses. Epidemiologic data carry out not clearly report an combination with oral acetaminophen and major birth defects, miscarriage, or disadvantage maternal or fetal outcomes when this medicine is used during pregnancy, but due come methodological constraints cannot definitively create the lack of any kind of risk. In pregnant rats receiving dental drug in ~ doses approximately 0.88 time maximum human daily dose (MHDD) during organogenesis, fetotoxicity (reduced fetal weight and length) and dose-related rises in bone sport (reduced ossification and rudimentary rib changes) were observed. Locations of necrosis in both the liver and also kidney the pregnant rats and fetuses to be observed as soon as pregnant rats were offered oral drug throughout gestation at sheep 1.2 time the preferably human daily dose. There room no managed data in human being pregnancy.

Chronic usage of opioids may reason reduced fertility; the is unknown even if it is these impacts are reversible.

FDA pregnancy category C: animal reproduction studies have displayed an adverse result on the fetus and there are no adequate and well-controlled research studies in humans, yet potential benefits may warrant use of the medicine in pregnant women despite potential risks.


"Product Information. Acetaminophen-Hydrocodone Bitartrate (acetaminophen-hydrocodone)."Mikart Inc, Atlanta, GA. "Product Information. Norco (acetaminophen-hydrocodone)."Allergan Inc, Irvine, CA. "Product Information. Lortab (acetaminophen-hydrocodone)."Akorn Inc, Buffalo Grove, IL.
The following uses to the ingredients:Acetaminophen (found in Norco)

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Benefit must outweigh risk AU TGA pregnant category: AUS FDA pregnancy category: not Assigned

Risk Summary: A clear association of medicine use and birth defects, miscarriage, or disadvantage maternal or fetal outcomes has actually not been shown with human being use; animal studies have actually demonstrated adverse occasions at clinically relevant doses.

In pregnant rats receiving dental drug in ~ doses up to 0.85 time maximum human everyday dose (MHDD) throughout organogenesis, fetotoxicity and dose-related increases in bone sports (reduced ossification and also rudimentary rib changes) to be observed. Locations of necrosis in both the liver and kidney that pregnant rats and fetuses to be observed when pregnant rats were offered oral drug throughout gestation at doses 1.2 time the best human daily dose. Pet studies using the IV formulation have actually not been performed. In humans, this drug and its metabolites overcome the placental barrier. Huge cohort studies have actually not found an association between maternal usage in the an initial trimester and also either adverse pregnant outcomes or congenital malformations. Some evidence of enhanced risk of neurodevelopmental disorders (e.g., attention deficit hyperactivity disorder ), respiratory condition (e.g., asthma) and also reproductive toxicity (e.g., androgen disruption) has actually been suggested in epidemiologic studies. However, extrapolating causation native pharmaco-epidemiological studies to humans is tricky considering assorted confounders and biases natural in the research design. Associations checked out in clinical cohort studies need clarification v randomized clinical trials (RCTs), which would certainly be challenging to carry out ethically in pregnant populations. The mechanism whereby this medicine or that metabolites affect neurological development, asthma, or endocrine/reproductive toxicity is poorly understood. That is crucial to factor in the threat of untreated febrile condition in mother and also child when assessing risks and also benefits of making use of this drug. There room no managed data in human being pregnancy.

Epidemiologic data, consisting of a populace based case-control study from the national Birth Defects prevention Study (n= 11,610) and also data from 26,424 live singleton births have displayed no raised risk of major birth defects in children with very first trimester prenatal exposure. In 2015, the us Food and also Drug administration released outcomes of their testimonial on published research researches looking in ~ mothers who took this medicine as either an end the counter or prescription product at any type of time during their pregnancy and also the danger of fist deficit hyperactivity (ADHD) in their babies. They uncovered all researches reviewed had potential restrictions in your designs the prevented illustration reliable conclusions. In a prospective birth cohort examine (Avon Longitudinal research or Parents and also Children ) maternal drug exposure was assessed through questionnaire at 18 and also 32 weeks, kids were assessed in ~ 61 months. Mothers were questioned around behavioral difficulties in their kids at 7 year old; children"s behavioral problems to be assessed making use of the Strengths and Difficulties Questionnaire (SDQ). A variety of confounders were evaluated return a limitation the the study was absence of information for drug use. The authors imply there might be one association between drug use during pregnancy and also behavioral difficulties in childhood that may be as result of an intrauterine mechanism. Additional studies are necessary to test choices to a causal explanation.

According to published pet studies, this medicine may cause reduced fertility in both males and females described as lessened testicular weights, lessened spermatogenesis, diminished fertility; and reduced implantation sites, respectively.

AU TGA pregnancy classification A: drugs which have been take away by a huge number that pregnant women and women the childbearing period without any type of proven rise in the frequency the malformations or other direct or indirect harmful results on the fetus having actually been observed.

US FDA pregnancy category Not Assigned: The us FDA has amended the pregnancy labeling ascendancy for prescription drug commodities to call for labeling that contains a summary of risk, a discussion of the data supporting that summary, and relevant info to aid health treatment providers make prescribing decisions and also counsel women around the use of drugs throughout pregnancy. Pregnant categories A, B, C, D, and also X space being phased out.


The following uses to the ingredients:Cyclobenzaprine (found in Flexeril)

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This drug should be used throughout pregnancy only if clearly needed. us FDA pregnancy category: B

Embryofetal advance in rats and rabbits given around 3 and also 15 times, respectively, the preferably recommended person dose (MRHD) was no adversely effected. Dams receiving this drug at sheep 3 time or an ext the MRHD throughout pregnancy and also lactation, had pups with decreased body weight and survival. There room no adequate and controlled research studies in pregnant women.

US FDA pregnancy classification B: animal reproduction studies have failed to demonstrate a threat to the fetus and there room no adequate and well-controlled researches in pregnant women.adversely


"Product Information. Flexeril (cyclobenzaprine)."Merck & Co, Inc, West Point, PA. "Product Information. Amrix (cyclobenzaprine)."A-S medication Solutions, Chicago, IL.
The following uses to the ingredients:Hydrocodone (found in Norco)

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Use is no recommended and also a decision have to be made to discontinue breastfeeding or discontinue the drug, taking right into account the importance of the drug to the mother.

Excreted into human milk: Yes

Comments: babies exposed come this drug with breast milk should be very closely monitored because that excess sedation and also respiratory depression; withdrawal symptom can occur when maternal administration of hydro-codon is quit or breastfeeding is stopped.

Maternal use of oral narcotics during breastfeeding can reason infant drowsiness, main nervous device depression, and even death. Newborns are specifically sensitive. As soon as a mother"s milk comes in, it is best to administer pain manage with a nonnarcotic analgesic. There space no studies describing medicine levels that extended-release hydrocodone or the metabolites in breast milk. Hydrocodone is metabolized come 6 active metabolites consisting of hydromorphone.


"Product Information. Zohydro ER (HYDROcodone)."Zogenix, Inc, san Diego, CA. Joined States national Library that gaianation.net"Toxnet. Toxicology Data Network. Obtainable from: URL: http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT." (): "Product Information. Hysingla ER (HYDROcodone)."Purdue Pharma LP, Stamford, CT.
The following uses to the ingredients:Acetaminophen-Hydrocodone (found in Norco)

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A decision need to be made come discontinue breast-feeding or discontinue this drug, considering the importance of the medicine to the mother

Excreted into human being milk: correct (acetaminophen) correct (hydrocodone) Comments: -Breastfed babies should it is in monitored because that excess sedation and also respiratory depression; instant medical attention have to be seek if infant creates breathing difficulties or limpness. -Withdrawal symptoms can take place in breastfed infants when maternal drug use or breastfeeding are stopped.

Breastfed babies of mother who obtain opioids, especially newborns, have the right to experience drowsiness and CNS depression, even death. A examine in 30 breastfeeding women discovered mean and median hydro codon infant everyday doses that 3.9 and also 2.1 mcg/kg, respectively, i beg your pardon calculates to 2.4% and 1.6% that weight-adjusted maternal doses. Hydro-codon is metabolized come 6 active metabolites including hydromorphone. Mean and median hydromorphone everyday doses that 2.1 and 0.3 mcg/kg, respectively, were found. Of interest was that 2 ladies excreted much more hydromorphone 보다 others which could represent ultrarapid CYP450 2D6 metabolizers.


"Product Information. Acetaminophen-Hydrocodone Bitartrate (acetaminophen-hydrocodone)."Mikart Inc, Atlanta, GA. "Product Information. Lortab (acetaminophen-hydrocodone)."Akorn Inc, Buffalo Grove, IL. "Product Information. Norco (acetaminophen-hydrocodone)."Allergan Inc, Irvine, CA. Unified States nationwide Library that gaianation.net"Toxnet. Toxicology Data Network. Accessible from: URL: http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT." ():
The following applies to the ingredients:Acetaminophen (found in Norco)

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Caution is recommended. Excreted into human milk: yes Comments; -This drug has actually been used without noticeable harmful effects.-This medicine is thought about compatible v breastfeeding by the American Academy of Pediatrics.

This drug is excreted right into breast milk in very little amounts. Released reports reveal optimal levels occur 1 come 2 hours after dosing and also are undetectable after 12 hours. Reports have also shown infants ingesting 90 mL of chest milk every 3 hrs would receive an typical of 0.14% (range 0.04% come 0.23%) of the mother"s dose; calculated to be a best maternal weight-adjusted dose of around 2%. Other studies have shown comparable calculated maximal maternal weight readjusted doses (1.1% come 3.6%); these doses are about 0.5% the the shortest recommended infant dose that this drug. A solitary case of a maculopapular rash has actually been reported in a 2-month old education infant; the rashes recurred ~ above rechallenge.


Cerner Multum, Inc."Australian Product Information."O 0United States national Library of gaianation.net"Toxnet. Toxicology Data Network. Obtainable from: URL: http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT." (): Committee top top Drugs, 1992 come 1993"The move of drugs and other chemicals into human milk."Pediatrics 93 (1994): 137-50"Product Information. Ofirmev (acetaminophen)."Cadence Pharmaceuticals Inc, san Diego, CA.
The following applies to the ingredients:Cyclobenzaprine (found in Flexeril)

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Caution is recommended.

Excreted into person milk: UnknownExcreted into pet milk: Yes

The impacts in the parenting infant are unknown.

This drug has been presented to it is in excreted in rat milk and attain concentrations in the milk which room 50% of those in the rat maternal plasma. As this medicine is carefully related to the tricyclic antidepressants, few of which are recognized to be excreted in human being milk, usage caution particularly when other drugs that reason sedation are supplied simultaneously.


"Product Information. Amrix (cyclobenzaprine)."A-S medicine Solutions, Chicago, IL. Hucker HB, Stauffer SC, Balletto AJ, White SD, Zacchei AG, Arison BH"Physiological disposition and also metabolism that cyclobenzaprine in the rat, dog, rhesus monkey, and also man."Drug Metab Dispos 6 (1978): 659-72"Product Information. Flexeril (cyclobenzaprine)."Merck & Co, Inc, West Point, PA.

Therapeutic Duplication Warnings

No warnings were discovered for your selected drugs.
Therapeutic duplication warnings are only returned as soon as drugs in ~ the same team exceed the recommended therapeutic duplication maximum.

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Drug communication Classification

These share are just a guideline. The relationship of a specific drug communication to a particular individual is daunting to determine. Constantly consult your health care provider before starting or stopping any medication.

MajorHighly clinically significant. Stop combinations; the risk of the interaction outweighs the benefit.
ModerateModerately clinically significant. Usually prevent combinations; usage it just under unique circumstances.
MinorMinimally clinically significant. Minimization risk; evaluate risk and also consider an alternate drug, take actions to circumvent the interaction risk and/or institute a security plan.
UnknownNo interaction information available.

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