Over the Counter Better than a Prescription?

What is Vicodin?

Vicodin is the most prescribed medication by far over the past decade.  In California alone, 1 billion dosage units of hydrocodone combination products were dispensed in 2013.  Vicodin is a combination of acetaminophen (Tylenol) and hydrocodone (narcotic opioid).  In 2014 the FDA placed Vicodin in a more restrictive drug schedule to limit the abuse and misuse of opioid products.

  • Vicodin addiction costs Americans $484 billion annually.
  • Vicodin abuse has quadrupled in the past 10 years.
  • Two million people across the United States suffer from Vicodin addiction.
  • Nearly one in 10 teenagers had used the prescription painkiller by their senior year in high school.

How can I relieve my dental pain without Vicodin?

Most dental pain is caused by inflammation.  Vicodin does NOTHING to help relieve the inflammation which is causing most dental pain.  Vicodin is only masking the pain.  Instead, taking a NSAID in combination with acetaminophen can help manage your pain.

What over the counter (OTC) medication combination can I use for immediate pain relief?

  • A combination of ibuprofen and acetaminophen, alternating every 2 hours, is as effective as Vicodin.
  • Immediately take 400-600 mg of ibuprofen (depending on body size and severity of pain).
  • Hour two ➔ 500 mg of acetaminophen.
  • Hour four ➔ 400-600 mg of ibuprofen.
  • Hour six ➔ 500 mg of acetaminophen.
  • Continue this alternating once every two hours, with the same drug being taken four hours apart, for 24-48 hours after the dental pain episode.

Tell me a little more about how this works?

  • The combination of ibuprofen and acetaminophen increases the magnitude of analgesia (pain relief), speeds up the onset of analgesia and has more of a consistent drug effect compared to either medication alone.
  • Acetaminophen shows good absorption and ibuprofen blocks prostaglandin synthesis in the tooth and the brain.

Are there any side effects I should be concerned about?

  • Ibuprofen can have serious gastrointestinal adverse effects, including bleeding, ulceration and perforation of the stomach or intestines, which can be fatal.  These events can occur at any time during use with and without warning symptoms. Elderly patients are at a greater risk for serious gastrointestinal events.
  • While taking acetaminophen, you should not be drinking alcohol.
  • These medications are not meant to be taken as a combination on a chronic basis, rather they are meant for short term use (24-48 hour period).

*Please read the complete insert with the medication prior to taking medication.*

What are the sources for this information?

  • Peter L. Jacobsen, PhD, DDS
    Professor at U.O.P., Arthur A. Dugoni School of Dentistry & author of The Little Dental Drug Booklet, used by dentists for 20 years
  • Kenneth M. Hargraves, PhD, DDS
    Chair of the Department of Endodontics at the University of Texas, San Antonio & published 150 papers and edited 2 textbooks