{
 "query": "acetaminophen / hydrocodone",
 "ingredient": "acetaminophen / hydrocodone",
 "slug": "acetaminophen-hydrocodone",
 "rxcui": "214182",
 "brands": [
  "Hycet",
  "Norco",
  "Verdrocet"
 ],
 "names": [
  "acetaminophen / hydrocodone"
 ],
 "components": [
  {
   "ingredient": "acetaminophen",
   "slug": "acetaminophen",
   "grade": "C",
   "total": 69,
   "scores": {
    "safety": "D",
    "evidence": "B",
    "regulatory": "C",
    "conflict": "D",
    "options": "A"
   },
   "boxed": false,
   "controlled": false,
   "first_approval_fmt": "11/07/1968",
   "first_approval": "19681107"
  },
  {
   "ingredient": "hydrocodone",
   "slug": "hydrocodone",
   "grade": "D",
   "total": 62,
   "scores": {
    "safety": "F",
    "evidence": "F",
    "regulatory": "B",
    "conflict": "A",
    "options": "A"
   },
   "boxed": true,
   "controlled": true,
   "first_approval_fmt": "10/25/2013",
   "first_approval": "20131025"
  }
 ],
 "classes": [],
 "alternatives": [],
 "label": {},
 "faers": null,
 "faers_base": {
  "total": 20692304,
  "serious_share": 0.5742697381596559,
  "death_share": 0.09102355155810585
 },
 "recalls": [],
 "recall_total": 0,
 "drugsfda": {
  "first_approval": "19681107",
  "first_approval_fmt": "",
  "anda": 2,
  "nda": 0,
  "rems": true,
  "labeling_recent": 0
 },
 "trials": null,
 "pubmed": null,
 "payments": {
  "year": "2024",
  "usd": 0.0,
  "records": 0,
  "by_name": [],
  "names_checked": [
   "acetaminophen / hydrocodone",
   "Hycet",
   "Norco",
   "Verdrocet"
  ],
  "source": "bulk-index"
 },
 "partd": {
  "year": "2024",
  "claims": 20107206,
  "beneficiaries": 5266914,
  "spend": 386982896.58,
  "by_brand": [
   {
    "brand": "Hydrocodone-Acetaminophen",
    "claims": 20107206,
    "per_claim": 19.245980599,
    "is_generic": false
   }
  ],
  "per_claim": 19.245980599194137
 },
 "mdl": [],
 "dsc": [],
 "settlements": [],
 "prescrire": null,
 "eml": null,
 "exposure": null,
 "scores": {
  "safety": {
   "score": 38,
   "letter": "F",
   "why": [
    "Graded by its riskiest ingredient, hydrocodone (38)",
    "Carries an FDA boxed warning, the strongest warning the FDA issues (-30)",
    "Subject to a REMS safety program: FDA requires special controls to use it (-10)",
    "Federally controlled substance: dependence and misuse risk (-10)",
    "Death appears in 3.8x the share of reports seen across all of FAERS (-12)"
   ],
   "weight": 0.35
  },
  "evidence": {
   "score": 43,
   "letter": "F",
   "why": [
    "Graded by its riskiest ingredient, hydrocodone (43)",
    "79 randomized trials and 1 systematic reviews/meta-analyses indexed in PubMed",
    "No Cochrane review found (-5)"
   ],
   "weight": 0.25
  },
  "regulatory": {
   "score": 70,
   "letter": "C",
   "why": [
    "Graded by its riskiest ingredient, acetaminophen (70)",
    "Recalls since 2016: 3 Class I, 25 Class II, 0 Class III across 12 generic makers (-30)"
   ],
   "weight": 0.15
  },
  "conflict": {
   "score": 60,
   "letter": "D",
   "why": [
    "Graded by its riskiest ingredient, acetaminophen (60)",
    "Pharma paid doctors $0 tied to this drug last year: negligible",
    "Named in 1 active federal multidistrict litigation(s) (-40)"
   ],
   "weight": 0.15
  },
  "options": {
   "score": 90,
   "letter": "A",
   "why": [
    "Graded by its riskiest ingredient, acetaminophen (90)",
    "Generic versions approved (12 applications)",
    "1 same-class alternative(s) (-10)"
   ],
   "weight": 0.1
  }
 },
 "total": 53,
 "grade": "D",
 "questions": [
  "This is a fixed combination of acetaminophen and hydrocodone. Why both together, instead of only the one I need?",
  "In 2013 the FDA issued a safety communication about this drug (FDA warns of rare but serious skin reactions with the pain reliever/fever reducer acetaminophen). Does that risk apply to me?",
  "The most-reported problems in FDA's adverse event data are fatigue, nausea. How would we recognize and handle those?",
  "Off-label use is among the most-reported items for this drug. Is my use on-label, and if not, what evidence supports it?",
  "Why this one over phenacetin? What would make you pick one of those instead?",
  "This drug is in active federal litigation. What is the claim, and does it affect my risk?",
  "What result are we expecting, by when, and what is the plan if it does not happen?",
  "If 100 people like me took this drug, how many would actually get better because of it, and how many would be harmed by it? (Doctors call these the number needed to treat and the number needed to harm.)",
  "This drug carries a boxed warning. Which specific risk does it cover, and does it apply to me?",
  "This is a controlled substance. What is the plan for how long I take it and how I stop?",
  "This drug has a REMS safety program. What monitoring does that require from us?",
  "The most-reported problems in FDA's adverse event data are drug dependence, death, overdose, toxicity to various agents. How would we recognize and handle those?",
  "Why this one over codeine, dextromethorphan, ethylmorphine? What would make you pick one of those instead?"
 ]
}