Watson 349 is a combination of two important analgesics namely Acetaminophen and hydrocodone bitartarate. It contains 500 milligrams of acetaminophen and 5 milligram of hydrocodone bitartarate. Mechanism of action of both medications is different. Acetaminophen controls pain by inhibiting nitric oxide pathway mediated by a number of neurotransmitters mainly substance P and N-methyl-D-aspartate. Hydrocodone on the other hand, is an opioid analgesic that acts by activating opioid receptors present in the brain and spinal cord; activation of these receptors is a natural pain relief method also used by our body. Due to two different mechanism of pain relief, Watson 349 is more potent painkiller than either of the two drugs present in a single pill.
Watson 349 is commonly available in most of the countries of the world. Most common brand of Watson 349 is Vicodin manufactured by Watson Pharmaceuticals, United States of America. It is also marketed by other brand names for example Lortab and Narco. Combination of acetaminophen and hydrocodone are also available in strengths that are different from Watson 349. Other preparations with different strength are Watson 3202 (acetaminophen 325 milligrams and hydrocodone 5 milligrams) and Watson 503(acetaminophen 650 milligram and hydrocodone 10 milligrams.
Watson 349 is an effective analgesic that can be used in a variety of medical conditions that need pain relief. The beauty of this drug is hidden behind the facts that on one hand it is moderately strong oral preparation of analgesics while on the other hand it is devoid of erosive effect on the stomach (a common problem with the use of non steroidal anti-inflammatory drugs). Despite of the long-term use it causes gastric inflammation or ulceration less commonly than non steroidal anti-inflammatory drugs. It relieves pain effectively but it should be ensured that patient don’t overdose Watson 349, that may lead to serious consequences.
What is this medicine for?
Watson 349 is a unique analgesic because of two different medications combined in a single pill. It is used to control moderate to moderately severe pain in a number of diseases. The main advantage of using Watson 349 is that as against non-steroidal anti-inflammatory drugs, it does not cause symptoms of gastric erosion and dyspepsia. So Watson 39 can be used for long time and on as needed basis without many of the side effects of NSAIDs. Some of the common conditions in which Watson 349 is useful are,
- Osteoarthritis of back, knee joints, shoulder joints, wrist joint, ankle joints and other joints. Osteoarthritis is a chronic condition and patient suffering from osteoarthritis does not get cure of this diseases. He or she needs painkillers off and on and sometimes on daily basis. Watson 349 is an ideal choice for such a disease due to lesser side effects.
- Rheumatoid arthritis: again it is a chronic condition which often starts in young to middle aged women and continues throughout life. Watson 349 can be used in rheumatoid arthritis to control pain in mild to moderate disease.
- Joint pains in systemic lupus arthritis, sacro-iliitis and other musculoskeletal disorders
- Watson 349 is also useful in acute back pain/ chronic back pain and neuropathic pains
- Migraine or tension headaches may be relieved by taking Watson 349
- Watson 349 is also very useful in cancer palliative therapy to control pains of malignancies or cancer. Cancer patients who have advanced stage disease and cure of the disease is not possible, controlling pain becomes difficult. In such situation Watson 349 is effective with few side effects of the medication.
Above mentioned are some of the conditions where Watson 349 can provide effective pain relief. In addition, the doctors also prescribe it in a number of other conditions.
Side effects on Watson 349
Almost every medicine used to treat any disease has some side effects and the patient should know these side effects before using this drug. Watson 349 has two medicines in a single pill so side effects of each of the component are different. The most severe side effect of Watson 349 is severe liver injury leading to liver failure that occurs if over dose of this medicine is taken. Acetaminophen is the culprit in causing severe liver damage. Some of the common side effects of using Watson 349 are,
- Blurred vision
- Constipation that is mainly due to hydrocodone component of Watson 349
- Difficulty in breathing and respiratory depression are the side effects of hydrocodone component that particularly appear on over dosage of Watson 349
- Dizziness: patient feels dizziness initially on starting Watson 349 but this side effect disappears with the continuous use of the medicine
- Drowsiness and increased sleepiness is again a side effect of opioid component of Watson 349 that gradually disappear when this medicine is used for extended period of time
- Flushing of face is a common experience among patients using Watson 349
- Lightheadedness is also a symptoms that particularly appears in first few days of using Watson 349
- Mental/mood changes are also associated with Watson 349. Patient may feel depressed
- Nausea and vomiting are common side effects of opioid analgesics, which reduce, with use of this medicine. If nausea and vomiting are severe then anti-emetics may need to be taken along with Watson 349 pill. This symptom again improves over time.
- Liver damage that may be mild or severe
Side effects of prolonged use of Watson 349
Some of the common side effects, which appear on prolonged use of this medicine, are following.
- Dependence: when a person uses Watson 349 over long period, he or she develops dependence on this drug that means he or she develop a craving for taking this medication continuously often at high doses and got addiction to this medicine.
- Kidney disease especially analgesic abuse nephropathy may occur when patient uses Watson 349 at high doses for prolonged period of time for years. This may result into renal failure.
- Another side effect of Watson 349 is withdrawal symptoms. When someone is using this medication for some time and suddenly stops it withdrawal symptoms appear which anxiety; diarrhea; fever, runny nose, or sneezing; goose bumps and abnormal skin sensations; nausea; vomiting; pain; rigid muscles; rapid heartbeat; seeing, hearing, or feeling things that are not there; shivering or tremors; sweating; and trouble sleeping.
Precautions on Watson 349
Some medications and medical conditions may interact with Watson 349 resulting in unfavorable effects. So before starting Watson 349 it is necessary to inform your doctor if you have any of the following conditions,
- Brain tumor
- Head injury, hydrocephalus or other central nervous system disorders
- Kidney disease
- Drug abuse or drug addiction
- Inflammatory bowel disease (IBD): ulcerative colitis or Crohn’s disease
- Drinking alcohol more than three drinks in a day
- Heart disease or other cardiovascular problems
- Liver disease including acute and chronic hepatitis or cirrhosis of liver
- Lung disease, bronchial asthma, obstructive sleep apnea or other breathing disorders
- Know allergy to acetaminophen or hydrocodone bitartarate or narcotic analgesics or other medication or foods
- If you are a lactating mother (breast-feeding the baby)
- If you are planning to conceive or you are pregnant
- If you already are taking some drugs both prescribed and unperceived, dietary supplement as well as herbal remedies.
- If you have previously made suicidal attempt or have suicidal thinking
- If you have intestinal or gastric problems, intestinal obstruction, recent abdominal surgery, chronic inflammation or ulceration of the gut, problems of adrenal gland; prostate gland enlargement
Also inform your doctor before starting Watson 349, if you are taking any of the following medications,
- Barbiturate anesthetics (e.g., thiopental),
- Monoamine oxidase inhibitors for example phenelzine
- tricyclic antidepressants or TCAs e.g., amitriptyline
- Alcohol or medicines that contain alcohol
- Medicines for depression, anxiety, schizophrenia or other mental disorders
- Medicines for pain management like buprenorphine, butorphanol, pentazocine, tramadol, propoxyphene and nalbuphine.
- Sleeping pills
- Muscle relaxants
Conditions that are not suitable for Watson 349 use
- Patient who have allergy to acetaminophen or opioid should not use Watson 349
- Patients who use alcohol or certain other medicines that increases dizziness and drowsiness should not use Watson 349 otherwise these symptoms may get worsened. For the same reason patients who are drivers or perform high risk tasks at some factory, should also avoid Watson 349
- Concomitant use of sleeping pills or muscle relaxants with Watson 349 should be avoided. Before starting Watson 349, if patient is taking such medication he or she should tell the pharmacist or doctor.
- Use of Watson 349 in elderly patients is not suitable because of the potential side effects like drowsiness, light-headedness and dizziness. This may lead to increased chances of falling and fractures in elderly
- Patients with liver disease should avoid use of Watson 349 because it may aggravate liver damage and push the patient to hepatic encephalopathy.
- Use of Watson 349 in small children is not safe and may result in harmful side effects so, it should not be used in children
- People with lung disease and breathing problems should not use Watson 349 especially patient who have chronic obstructive pulmonary disease, bronchial asthma, obstructive sleep apnea and respiratory failure
- Patient with kidney disease, renal failure and analgesic abuse nephropathy should avoid Watson 349 otherwise serious outcomes may result. Such patient with organ failure becomes drowsy and even unconscious which may remain for days.
- This medication is contraindicated in acute liver failure
- Pregnancy and breast-feeding are the conditions in which Watson 349 is relatively contra-indicated and should be avoided. If someone is on Watson 349 treatment and gets pregnancy, she should immediately contact her doctor. Breast-feeding mothers should not use Watson 349 or avoid breast-feeding during its use.
Allergy symptoms of Watson 349
As we know that allergy or hypersensitivity to any drug can happen so is with Watson 349. Sometimes mild allergic symptoms appear which disappear on discontinuing the drug. Severe allergic symptoms warrant immediate contact with emergency medical service and urgent treatment of hypersensitivity.
Mild symptoms of allergy to Watson 349
If a patient taking Watson 349 develops itching, hives and redness of the skin and no problem with breathing occurs, these are symptoms of mild hypersensitivity which will settle on withdrawing the medication and sometime use of anti-histamine drugs. Even the mild allergy symptoms indicate that this drug no more should be used. Doctor should be informed about these symptoms.
Severe allergy symptoms of Watson 349
Severe allergic reactions to Watson 349 may appear within seconds to minutes after taking this medication in-patient who are allergic to either of the two components of Watson 349. Patient with severe allergy develop following symptoms
- Skin rash
- Hives and urticaria
- Symptoms of angioedema, which include swelling of lips throat and chest tightness, which cause difficulty in breathing and in severe cases no breathing at all.
- Changes or loss of hearing
- Severe anxiety along with mental and mood changes
- Decreased urine output
These hypersensitivity symptoms need urgent treatment in medical emergency otherwise patient may die. Important measures to overcome this dangerous situation are use of anti-histamine drugs, steroids, adrenaline injection and maintaining the airway with passing endotracheal tube or performing emergency tracheotomy (in cases where swelling of the larynx does not allow endotracheal intubation). Patient needs admission in intensive care unit for extensive monitoring till his or her condition is out of danger.
Dosage of Watson 349
Watson 349 should be used in the dosage prescribed by the doctor or pharmacist for the specific duration told. Dosage may vary according to severity of the problem for which this medicine is used. Usual dosage for Watson 349 is one tablet every four to six hours for the prescribed period as advised by the doctor. Total daily dosage should not five tablets. Patient can take Watson 349 empty stomach or with meals. Patients, who feel more nausea and vomiting, should take this medicine with meals to avoid these side effects.
If a dose of Watson 349 is missed
In case a dose of Watson 349 is missed, it should be taken as early as remembered but if time for the next dose has reached, only take the usual dose. Two doses of Watson 349 should not be taken at one time.
Over dosage of Watson 349
Over dosage of Watson 349 may result in a number of symptoms depending upon how much quantity or tablets have been taken. In case, a single extra tablet or two are taken usually don’t cause any symptoms. If patient has ingested more tablets either incidentally or as a suicidal attempt, local poisoning control service should be called and patient should get immediate management for over dosage.
Symptoms of over dosage include bluish discoloration of the skin, cold and clammy skin difficult drowsiness that may lead to coma, difficulty in breathing or slow breathing, excessive perspiration (sweating) disturbed functions of cardiovascular system, nausea or vomiting, convulsion (seizures) pain abdomen and bilateral constricted pupils (pin point pupils)
Management of over dosage should be done at medical emergency or intensive care setting. Management includes gastric lavage and decontamination with activated charcoal, anti-dote for acetaminophen and hydrocodone where signs of toxicity appear and supportive measures to breathing and cardiovascular dysfunction