IP 109

This article was reviewed and approved by Dr. Drew Sutton MD

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IP 109 are capsule-shaped, white pills imprinted with this alphanumeric code. They are a generic, prescription, pain-relieving medication in the narcoticanalgesic drug type. The two drugs are combined because they increase the effects of each other.

Since this is a pain-relieving medication, they lower physical discomfort. Therefore, doctors will recommend this medication to relieve moderate to severe pain, but only if a patient is not taking over-the-counter or other prescription medications that interact with them.

According to Medlineplus.gov, “Taking certain medications with a hydrocodone combination product may increase the risk of serious or life-threatening breathing problems, sedation, or coma.”

Each pill contains the following ingredients:

Hydrocodone Bitartrate

Hydrocodone bitartrate is an opioid used to treat mild to severe pain. It is also a cough suppressant.

It is a central nervous system depressant that targets opioid receptors in the brain. In addition, Hydrocodone stimulates the addiction pathway in the brain’s limbic system. Bitartrate is a salt that determines how Hydrocodone is absorbed and metabolized by the body. In 2007, the FDA established guidelines for Hydrocodone that mandated the inclusion of bitartrate in all hydrocodone products.

Acetaminophen

Acetaminophen is an analgesic that reduces mild to moderate pain by preventing enzymes from sending nerve pain signals to the brain.

When taken in therapeutic ranges, acetaminophen is a safe and effective over-the-counter medication used by millions of people every day for alleviating headaches, joint pain, general body pain, and fever.

High doses of acetaminophen may cause:

  • Acute liver failure.
  • Allergic reactions: signs of hypersensitivity to acetaminophen include facial and throat swelling, rash/hives, breathing difficulties, and vomiting.
  • Low blood sugar leads to shock and unconsciousness.
  • Interfere with normal blood clotting

Recent research suggests that acetaminophen may interact with cannabinoid receptors to analgesic effects.

Side Effects

The most common side effects include:

  • Nausea
  • Vomiting
  • Fatigue
  • Dizziness

Some people may also experience;

  • brain fog
  • trouble focusing
  • anxiety
  • mood changes
  • constipation
  • difficulty urinating
  • skin rash or itching

Addiction

Anyone who takes prescription opioids can become addicted, sometimes in just a matter of days.

Hydrocodone is a Schedule II Controlled Substance because of its high potential for abuse and addiction.

According to the NIH, “Hydrocodone can be habit-forming, causing physical and psychological dependence. Its abuse liability is similar to morphine and less than oxycodone. Hydrocodone is a primary driver of opioid-related abuse and misuse with its easy availability and abuse patterns. Patients consuming alcohol, other opioids, antihistamines, antipsychotics, anti-anxiety agents, or other central nervous systems (CNS) depressants along with Hydrocodone may exhibit an additive CNS depression.”

  • The CDC states that other central nervous systems addiction treatment for opioid abuse. However, once addicted to a prescription opioid, it can be challenging to stop using it.

Because it is a narcotic, there is a substantial risk of addiction associated with taking this medication. For this reason, anyone who has a history of substance use disorders should not take this medication. In addition, it should be used with extreme caution and only as advised by a doctor.

  • It is a prescribed narcotic, so you should seek guidance from your doctor each step of the way.

Decreasing the dose too quickly may result in opioid withdrawal symptoms. Emotional and physical withdrawal symptoms may include:

  • muscle aches
  • restlessness
  • anxiety
  • increased heart rate
  • tremors
  • abdominal cramping
  • insomnia

Overdose

Call 911 at the first sign of a possible overdose.

When someone abuses this drug and consistently exceeds recommended dosage guidelines, they are at high risk for overdose and suffering medical problems dangerous to their health.

Overdose victims must get treatment as soon as possible, limiting further absorption by the body of drugs containing Hydrocodone and acetaminophen.

Signs of a hydrocodone bitartrate and acetaminophen overdose include:

  • Decreased breathing and heart rate
  • Low blood pressure
  • Inability to stay awake or remain conscious
  • Disorientation
  • Slurring speech
  • Skin is cold and clammy
  • Bluish tinge to the lips (lack of oxygen)

Since your body will have become acclimated to the medication, taking a more significant dose than is recommended can lead to an overdose, which may cause the following symptoms:

  • Loss of appetite
  • Extreme fatigue
  • Sweating
  • Stomach pain
  • Nausea
  • Vomiting
  • Dark urine

Without emergency treatment, the person may slip into cardiac arrest as the respiratory system stops providing the heart with oxygenated blood. Emergency rooms keep counteractive medications like naloxone for and activated charcoal hydrocodone overdose.

  • The U.S. CDC reports that Hydrocodone, oxycodone, and methadone are the most common medications involved in opioid overdose deaths.

Alcohol

As with most pain medications, consuming alcohol while taking any drug can be dangerous. It can cause a severe reaction that drastically impairs a person’s level of consciousness and even their ability to breathe. So, drinking alcohol is an extreme risk.

However, if someone were to combine this medicine with other sedatives such as alcohol, they are at risk of severe side effects such as slowed breathing, decreased alertness, decreased heart rate, and even death.

Label

Alphanumeric markings

The initials IP stands for Intellectual Property, often placed on medications to assist in tracking. It serves to protect the manufacturer who developed the medicine and promotes the creation of other life-saving drugs. The number 109 refers to this drug’s specific NDC code; see below.

NDC codes

The number 109 is on this medication refers to the FDA’s National Drug Code (NDC) found on the outer packaging of all drugs. The NDC is a good reference for identifying a medication since they are unique and specific.

There are the three NDC codes assigned to IP109 as follows:

NDC NumberPills Per Bottle
53746-109-01100
3746-109-05500
53746-109-101000

Treatment for dependency

The FDA developed the Risk Evaluation and Mitigation Strategy (REMS) to ensure pharmaceutical companies aren’t marketing opioid analgesics with a high addiction risk that outweighs the drug’s benefits. Drugmakers seeking FDA-approved opioid analgesics must facilitate REMS educational programs to doctors, nurses, and other healthcare providers under REMS requirements. In addition, any healthcare professional licensed to prescribe opioid analgesics must complete at least one program and counsel patients on using opioids safely.

Dispensing rates of prescription opioid analgesics have declined recently in the U.S. In 2020, the CDC reported dispensing rates fell to their lowest in 15 years, with about 43 opioid analgesic prescriptions written per 100 adult U.S. citizens. However, certain country regions still have alarmingly high dispensing rates, particularly in the south and Midwest. For example, nearly four percent of U.S. counties were issued enough opioid analgesic prescriptions by physicians to give each resident at least one medication.

More about this class of drugs see IP115

  • image courtesy of CVS.com