What is Lortab? Hydrocodone and acetaminophen explained

Medically reviewed by [Reviewer name, credentials] · Last updated October 17, 2026

Your doctor said “I’ll send in some Lortab for the pain.” Then you get to the pharmacy counter, the bag is stapled shut, and the label says something else entirely: hydrocodone bitartrate and acetaminophen. So what is Lortab, and did you get the right medicine? Almost certainly, yes. The name on the bottle is the generic name for the same two ingredients that made up the Lortab brand.

This guide walks you through what is in the tablet, why the brand name has nearly vanished, who it is meant for, and the habits that keep it safe. No jargon, no scare tactics, just the facts you need before you take the first dose.

Two ingredients, two jobs

To understand what is Lortab doing in your body, think of it as a two-person crew. One member handles how your brain reads pain signals. The other works on the pain process itself in a different way. Together they can relieve pain with a smaller opioid amount than the opioid would need alone, which is the whole reason the combination exists.

Hydrocodone: the opioid half

Hydrocodone is an opioid. It attaches to opioid receptors in the brain and spinal cord, mostly the mu receptor. When those receptors are switched on, pain messages get turned down and your emotional reaction to pain softens too. That is why people often describe opioid relief as “the pain is still there, but it bothers me less.”

The same receptors also control breathing, alertness, and gut movement. That explains the classic opioid side effects: drowsiness, constipation, nausea, and, at high levels, dangerously slow breathing. Your liver breaks hydrocodone down mainly through two enzymes, called CYP3A4 and CYP2D6. The CYP2D6 route turns a small portion into hydromorphone, a stronger opioid. This detail matters later when we talk about interactions. The half-life of hydrocodone is about 4 hours, which means your body clears about half of a dose in that time.

So, is Lortab an opioid? Yes. Because one of its two ingredients is an opioid, the whole product is treated as one by doctors, pharmacists, and the law.

Acetaminophen: the familiar half

Acetaminophen is the same medicine sold over the counter as Tylenol and in hundreds of store brands. Scientists still debate exactly how it works, but it seems to act mainly in the central nervous system to reduce pain and fever. It does not calm inflammation the way ibuprofen or naproxen do.

Paired with hydrocodone, acetaminophen adds pain relief through a separate pathway. The catch is the liver. In large amounts, acetaminophen can cause serious liver injury, and that risk is the reason every current tablet holds a fixed 325 mg. We cover the full math in our guide to the Lortab acetaminophen limit, but the core rule is simple: adults should not go over 4,000 mg of acetaminophen a day from all sources combined, and your prescriber may set a lower limit for you.

From Lortab to generic: a short history

If you have taken Lortab before, you may remember tablets that looked different or had a different second number. That is because the product changed several times. Here is how the brand you remember turned into the generic you were just handed.

The 500 mg era

For years, many hydrocodone combination tablets, including older Lortab versions, carried 500 mg of acetaminophen per tablet. You might have seen strengths such as 5/500, 7.5/500, or 10/500. The Norco brand, by contrast, used 325 mg. With several tablets a day, plus any over-the-counter cold or headache products, people could reach dangerous acetaminophen totals without noticing.

The FDA steps in: 2011 and 2014

In January 2011, the FDA asked drug makers to limit acetaminophen in prescription combination products to 325 mg per tablet or capsule. The deadline was January 14, 2014. On that date, the agency also asked prescribers and pharmacists to stop prescribing and dispensing combination products with more than 325 mg per unit.

The reasoning was straightforward. The FDA found no evidence that more than 325 mg per dose added enough pain relief to justify the extra liver risk. Most liver injury cases involved people taking more than 4,000 mg a day, often from more than one acetaminophen product at once. The agency noted that unintentional overdoses involving prescription combination products accounted for about half of acetaminophen-related liver failure cases in the U.S.

October 2014: Schedule III becomes Schedule II

Before 2014, hydrocodone combination products sat in Schedule III, which allowed refills on a single prescription. The Drug Enforcement Administration moved all of them to Schedule II in a final rule published August 22, 2014, effective October 6, 2014. Schedule II is the tightest category for drugs that have an accepted medical use.

For you, the practical effect is this: Lortab and its generics cannot be refilled. Every fill needs a new prescription. That is why your pharmacist may tell you “there are no refills on this one,” even if your old bottles from years ago listed several.

Is Lortab discontinued?

The brand is. Drugs.com lists the Lortab brand name as discontinued in the United States. The medicine itself has not been banned or pulled for safety reasons. Generic hydrocodone and acetaminophen tablets, plus brands such as Norco, contain the same ingredients in the same strengths and fill the gap. Many people and even some clinicians still say “Lortab” out of habit, the way people say “Kleenex” for any tissue.

If you want to see how the old brand stacks up against its best-known cousin, read Lortab vs Norco. For the Vicodin comparison, see Lortab vs Vicodin.

Year	What changed	What it means for you
Before 2011	Many tablets held 500 mg acetaminophen	Old bottles may show 5/500, 7.5/500, or 10/500
2011	FDA asks makers to cap acetaminophen at 325 mg per unit	Manufacturers start reformulating
January 2014	FDA asks prescribers and pharmacies to stop using products above 325 mg	The 500 mg versions leave the shelves
October 2014	DEA moves hydrocodone combinations to Schedule II	No refills; a new prescription every time
Today	Lortab brand discontinued in the U.S.	You will usually receive a generic labelled hydrocodone bitartrate and acetaminophen

What is Lortab used for, and when do doctors avoid it?

Older labels described the use as “moderate to moderately severe pain.” Current class labeling for opioids is stricter. It says these products are for pain severe enough to need an opioid, and only when other options, such as non-opioid medicines, have not worked well enough or are not a good fit for you.

In everyday practice, that usually means short courses for sudden, intense pain. Typical examples include:

• Pain in the first few days after surgery
• Broken bones, bad sprains, or other acute injuries
• Dental surgery, such as removing impacted wisdom teeth (see our guide on hydrocodone after tooth extraction)
• Selected cases of severe pain where other medicines are not enough

The CDC’s 2022 opioid prescribing guideline encourages doctors to try non-opioid treatments first when they make sense, to use the lowest effective dose, and to prescribe no more than the expected duration of severe pain. For many acute injuries, that is just a few days. Longer-term use for ongoing pain is a separate decision with its own risks and benefits.

When a doctor will likely choose something else

The hydrocodone and acetaminophen prescribing information lists situations where the medicine should not be used, plus others that call for extra caution. Your doctor will usually avoid it or proceed very carefully if you have:

• An allergy to hydrocodone or acetaminophen, or a past serious reaction to either
• Significant breathing problems, including acute or severe asthma when you cannot be monitored, or already slowed breathing
• A known or suspected blockage in the stomach or bowel, including a condition called paralytic ileus
• Recent use of an MAO inhibitor (a class of antidepressants and some other drugs), currently or within the last 14 days
• Serious liver disease, which affects both ingredients
• Sleep apnea, COPD, or other conditions that already reduce breathing reserve
• A head injury or increased pressure in the skull, since opioids can hide changes in alertness
• A personal or family history of substance use disorder, which raises the risk of hydrocodone addiction
• Pregnancy, since long-term use can cause withdrawal symptoms in the newborn

Older adults can also be more sensitive to drowsiness, confusion, and falls. Kidney problems may change how a doctor doses the medicine. None of these points automatically rule it out, but they explain why your prescriber asks so many questions before writing the script.

How to take Lortab medication safely

Knowing what is Lortab made of is only half the job. The other half is building a few habits around it. Most opioid harm happens not from a single bad decision but from small slips that stack up: an extra tablet here, a glass of wine there, a cold medicine at bedtime.

Whatever strength is on your label, here are the habits pharmacists most often wish every patient followed:

• Take it exactly as labelled. Your bottle states how many tablets and how often. Label maximums vary by strength and by manufacturer, so the bottle and your prescriber decide, not a website. Our hydrocodone dosage guide explains how those limits are set.
• Do not double up if a dose seems weak. Relief usually begins within an hour (more on that in how long hydrocodone takes to kick in). Call your prescriber if pain is not controlled.
• Count your acetaminophen. Check every over-the-counter product for “acetaminophen,” “APAP,” or “acetam.” before you take it.
• Skip alcohol completely while you are taking it. Alcohol adds to both the breathing risk and the liver risk.
• Do not drive or use machinery until you know how it affects you.
• Plan for constipation from day one: fluids, fiber, movement, and a stool softener or laxative if your pharmacist suggests one.
• Store it locked up, out of reach of children, teens, guests, and pets. A single tablet can be deadly to a child.
• Keep naloxone at home. Naloxone nasal spray is sold over the counter and can reverse an opioid overdose.
• Dispose of leftovers promptly through a drug take-back program or pharmacy kiosk.
• Never share your tablets. Giving away a Schedule II drug is illegal and can be fatal for someone who is not used to opioids.

Five questions to ask before you leave the pharmacy

Pharmacists offer counseling on new prescriptions, and a two-minute chat can prevent most common mistakes. If the line is long, call back later. These questions cover the essentials:

1. What is the most I can take in one day with this strength, and what should I do if that is not enough?
2. Do any of my other medicines, vitamins, or supplements interact with this one?
3. Which of my over-the-counter products already contain acetaminophen?
4. How should I handle constipation, and when should I call about it?
5. Where is the nearest take-back site for leftover tablets?

It also helps to write down the time of each dose on a scrap of paper or a phone note. When pain is bad or sleep is broken, it is easy to forget whether you took the last tablet two hours ago or five. A simple log stops accidental double doses and gives your doctor useful information at your follow-up visit. Bring the log, and the bottle, to any appointment where your pain plan will be discussed.

If you are caring for someone else, such as an older parent recovering from surgery, the same log works even better. Keep the tablets with you rather than on the nightstand, and watch for confusion, unusual sleepiness, or falls, which are more common in older adults on opioids.

Side effects deserve their own deep dive. Our guide to Lortab side effects sorts them into what is normal, what needs a phone call, and what is an emergency.

Interactions: a quick overview

The hydrocodone and acetaminophen label carries several boxed warnings, the FDA’s most serious type. Several of them involve other substances. The table below gives you a plain-language map by drug class. It is not a complete list, so always show your pharmacist everything you take, including supplements.

Drug or substance class	Examples	Why it matters
Benzodiazepines and other sedatives	Alprazolam, diazepam, lorazepam, sleep medicines	Combined sedation can cause severe drowsiness, slowed breathing, coma, and death
Alcohol	Beer, wine, spirits, some liquid medicines	Deepens sedation and breathing risk; adds to acetaminophen liver strain
Gabapentinoids	Gabapentin, pregabalin	Can add to breathing suppression, especially in older adults (see hydrocodone and gabapentin)
CYP3A4 inhibitors	Clarithromycin, some azole antifungals, some HIV medicines, grapefruit	Slow hydrocodone breakdown, so levels rise and breathing can slow
CYP3A4 inducers (and stopping them)	Rifampin, carbamazepine, phenytoin	Can lower hydrocodone levels and weaken relief; stopping the inducer can make levels jump
Other opioids	Tramadol, oxycodone, codeine cough syrups	Stacked opioid effects raise overdose risk
Serotonergic drugs	Some antidepressants, triptans, tramadol	Rare risk of serotonin syndrome
MAO inhibitors	Phenelzine, selegiline, linezolid	Can cause serious reactions; avoid within 14 days
Other acetaminophen products	Tylenol, many cold, flu, and sleep products	Easy to exceed the daily acetaminophen limit

Food is less of a concern, although grapefruit is worth avoiding because of the CYP3A4 effect. Our article on foods to avoid while taking hydrocodone covers the details.

Myths vs facts: what is Lortab really?

Because the brand name stuck around long after the product changed, plenty of half-truths still float around. Here are the ones pharmacists hear most.

Myth	Fact
“Lortab was banned.”	The brand was discontinued. The same ingredients are still prescribed as generic hydrocodone and acetaminophen.
“The generic is weaker than real Lortab.”	Generics must meet FDA standards for the same active ingredients, strength, and how the body absorbs them.
“It’s mostly Tylenol, so it’s mild.”	It contains a full opioid. It can cause dependence, addiction, and fatal breathing problems.
“Old 500 mg Lortab was stronger for pain.”	The extra acetaminophen added liver risk without enough proven benefit, which is why the FDA capped it at 325 mg.
“I can get a refill like before.”	Since October 2014 it is Schedule II. Each fill needs a new prescription.
“One drink with it is fine.”	Even small amounts of alcohol add to sedation and liver strain. The safest choice is none.
“If it’s prescribed, I can’t get addicted.”	Addiction can develop with prescribed use. Risk grows with higher doses and longer courses.
“Lortab contains codeine.”	No. Hydrocodone is a different opioid, although the two are chemically related.

Dependence, tolerance, and stopping

If you take hydrocodone for a few days after surgery, you can usually just stop when the pain fades. After weeks of regular use, though, your body adapts. You may need more for the same effect (tolerance), and you may feel withdrawal if you stop suddenly (physical dependence). Neither one means you are addicted, but both deserve respect.

The FDA has warned that stopping opioids abruptly in people who are physically dependent can cause serious withdrawal, uncontrolled pain, and psychological distress. A 2025 FDA labeling update for opioid pain medicines again stresses avoiding sudden discontinuation and making sure patients have access to naloxone. If you have been taking it daily for more than a short while, ask your prescriber how to step down.

Signs that use is drifting into a problem include taking more than prescribed, running out early, using it for stress or sleep rather than pain, or feeling strong cravings. If any of that sounds familiar, help is available and effective, and asking for it early makes recovery easier. The SAMHSA helpline listed at the end of this article is a good first step.

Frequently asked questions

What is Lortab in simple terms?

Lortab is a brand name for a prescription pain pill that combines hydrocodone, an opioid, with acetaminophen, the active ingredient in Tylenol. It is used for short-term severe pain when other medicines are not enough. The brand is discontinued in the U.S., but the same combination is dispensed as a generic.

What is the Lortab generic name?

The generic name is hydrocodone bitartrate and acetaminophen. Your bottle may also say “hydrocodone/APAP,” since APAP is a common abbreviation for acetaminophen. Other brand names for the same combination include Norco.

Is Lortab an opioid?

Yes. Hydrocodone, one of its two ingredients, is an opioid that acts on the same receptors as oxycodone and morphine. That means Lortab carries opioid risks, including dependence, addiction, and dangerously slowed breathing at high doses or with other sedating substances.

Is Lortab a Schedule II drug?

Yes. The DEA moved all hydrocodone combination products, including Lortab and its generics, from Schedule III to Schedule II on October 6, 2014. Schedule II drugs cannot be refilled, so you need a new prescription each time.

Why can’t I find brand-name Lortab anymore?

The Lortab brand has been discontinued in the United States. It was not banned for safety reasons. Generic hydrocodone and acetaminophen tablets with the same ingredients and strengths are widely available, and pharmacies routinely dispense those instead.

What strengths does Lortab come in?

Current tablet strengths are 5/325, 7.5/325, and 10/325, meaning milligrams of hydrocodone over milligrams of acetaminophen. Liquid versions also exist. Older 500 mg acetaminophen versions were phased out after the FDA’s 325 mg limit took full effect in 2014.

How long does Lortab last?

Pain relief from an immediate-release dose typically lasts about 4 to 6 hours, which is why labels describe dosing every 4 to 6 hours as needed. Hydrocodone’s half-life is about 4 hours. It can show up on drug tests for longer than you feel it; see how long hydrocodone stays in your system.

Can I take Tylenol with Lortab?

Only if your prescriber or pharmacist says it is safe and helps you count the total. Every Lortab tablet already contains 325 mg of acetaminophen, and adults should not exceed 4,000 mg a day from all sources. Many people are told to aim lower, especially if they drink or have liver problems.

The takeaway: what is Lortab, in a nutshell

So, what is Lortab? It is a brand name for hydrocodone plus acetaminophen, a strong two-ingredient pain reliever meant for short stretches of severe pain. The brand is gone from U.S. shelves, but the generic in your bag is the same medicine. Treat it with respect: take only what the label says, count your acetaminophen, avoid alcohol and other sedatives, store it locked up, and keep naloxone nearby. If anything about your dose or your pain feels off, your pharmacist is a free, fast first call.

This article is for education only and is not medical advice. Do not start, stop, or change any medicine without talking to your prescriber. Hydrocodone and acetaminophen is a controlled substance that should only be used with a valid prescription from a licensed clinician. If you suspect an overdose, call 911 right away. For questions about taking too much acetaminophen, call Poison Control at 1-800-222-1222 or visit poison.org. If you or someone you love is struggling with substance use, the SAMHSA National Helpline is free, confidential, and open 24/7 at 1-800-662-4357.

Sources

• Drugs.com: Lortab (brand discontinued note)
• Drugs.com: Lortab dosage
• DailyMed: Hydrocodone bitartrate and acetaminophen tablets prescribing information
• Federal Register: Rescheduling of hydrocodone combination products to Schedule II (2014)
• CDC Clinical Practice Guideline for Prescribing Opioids for Pain (2022)
• FDA: Opioid analgesic labeling safety communication (July 2025)
• SAMHSA National Helpline