Hydrocodone bitartrate

FRIDAY, Nov. 7, 2025 — Getting your wisdom teeth pulled? You don’t need opioids to deal with the pain of the extraction, a new study says. A combination of ibuprofen and acetaminophen provided better pain relief than hydrocodone with acetaminophen for the first two days after wisdom tooth surgery, researchers reported Nov. 6 in JAMA Network Open . Both men and women also had greater satisfaction post-op when using over-the-counter pain medications compared to opioids, researchers said. The sex-specific results are important because women consistently report higher pain levels after surgery, researchers said. "We wanted to determine whether the pain medication’s effects were consistent in males and females separately," said lead researcher Dr. Janine Fredericks-Younger , an associate professor at Rutgers School of Dental Medicine in Newark, New Jersey. "And what we found is that in both subgroups (males and females), the non-opioid was superior for that first day and night, and then no worse than the opioid for the rest of the post-op period,” Fredericks-Younger said in a news release. For the clinical trial, researchers recruited more than 1,800 men and women slated to undergo wisdom tooth extraction, a painful procedure that requires cutting into gums and sometimes removing bone. Such dental procedures are how many Americans are introduced to opioids, researchers said in background notes. Dentists wrote more than 8.9 million opioid prescriptions in 2022. "There are studies out there to show that when young people get introduced to opioids, as many have via wisdom tooth extraction, there's an increased likelihood that they'll eventually use them again, and then it can lead to addiction," Fredericks-Younger said. Roughly half of the trial participants received 400 milligrams of ibuprofen ( Advil , Motrin) and 500 milligrams of acetaminophen ( Tylenol ) for their pain, the study says, The other half got 5 milligrams of hydrocodone with 300 milligrams of acetaminophen. Patients tracked their pain twice a day for nine days using electronic diaries, noting not just their pain but also their sleep quality, ability to perform daily activities, and overall satisfaction. On every measure, the over-the-counter meds matched or beat the opioid, including better sleep and less interference with daily activities, the study found. Those prescribed opioids also were twice as likely to call back requesting additional pain meds, researchers found. "The results actually came in even stronger than we thought they would," senior researcher Dr. Cecile Feldman said in a news release. She’s dean of the Rutgers School of Dental Medicine. "We expected to find the non-opioid to be non-inferior, so that at least it was no worse than opioids,” she said. “We were surprised to see that it was actually superior." These results should limit the common dental practice of writing “just in case” opioid prescriptions for patients who are told to start with over-the-counter meds, researchers said. The American Dental Association already recommends against opioids as a first-line pain treatment, researchers noted. "How can we now, with the evidence and the knowledge that we have, eliminate these prescriptions from being written?" Fredericks-Younger said. Even though this study focused on wisdom tooth extractions, Feldman said the findings could apply to other dental procedures. "We feel pretty confident in saying that opioids should not be prescribed routinely for dental procedures," she said. "Our non-opioid combination really should be the analgesic choice." However, future studies are needed to see if the same holds true for other types of surgeries, particularly those to treat orthopedic injuries, Feldman added. Sources Rutgers University, news release, Nov. 6, 2025 JAMA Network Open, Nov. 6, 2025

THURSDAY, Oct. 9, 2025 -- Older adults in nursing homes (NHs) with concomitant use of tramadol and antidepressants have an increased risk for seizures , according to a study published online Oct. 8 in Neurology . Yu-Jung Jenny Wei, Ph.D., from The Ohio State University in Columbus, and colleagues conducted a population-based cohort study using a 100 percent Medicare NH sample from January 2010 to December 2021. Long-term residents aged 65 years or older who initiated antidepressants on existing tramadol use (tramadol-antidepressant users) or initiated tramadol on existing antidepressant use (antidepressant-tramadol users) were included in the study and followed until the end of one year, NH discharge, death, or study end. A total of 11,162 concomitant tramadol-antidepressant users and 58,994 concomitant antidepressant-tramadol users were identified. The researchers found that for the tramadol-antidepressant and antidepressant-tramadol groups, the incidence rate of seizures was 16.10 and 20.17 per 100 patient-years, respectively. The adjusted incidence rate ratios for seizures were higher with co-use of tramadol with CYP2D6-inhibiting (versus CYP2D6-neutral) antidepressants for both subgroups (1.09 and 1.06, respectively). The findings were corroborated by a negative control exposure analysis, with no risk for seizures seen in association with hydrocodone with CYP2D6-inhibiting (versus CYP2D6-neutral) antidepressants. "These findings underscore the need for careful prescribing practices, especially for older adults with complex health conditions," Wei said in a statement. "Doctors should be aware of potential seizure risks when prescribing tramadol with antidepressants, particularly CYP2D6 inhibitors. Given how commonly both are prescribed to older adults, these interactions may be more important than previously thought." Abstract/Full Text (subscription or payment may be required)