Lortab is a prescription drug that is classified as a Schedule 2 controlled substance by the Drug Enforcement Administration. The primary ingredient in Lortab is hydrocodone, which is the opioid component. Lortab also contains acetaminophen, a non-opioid painkiller. Brand name Lortab is only available in a liquid elixir formulation.

Lortab elixir, which is a syrup-like liquid, also contains seven percent alcohol. Other brand name forms of Lortab were discontinued, although other forms of hydrocodone/acetaminophen are still available as generic or brand-name tablets or liquids.

Lortab is meant for the treatment of moderate to severe pain which cannot be adequately controlled by a non-opioid medication.

How Does Lortab Elixir Work?

As with other opioid medications, there is the potential for misuse and addiction with Lortab use, which is why it’s available only with a prescription.

The main reason Lortab use may lead to addiction is because of its opioid component. When someone takes an opioid such as hydrocodone (one of the active ingredients in Lortab), it passes the blood-brain barrier and binds to the opioid receptors in the brain and central nervous system. When the binding occurs, it triggers the release of a large amount of dopamine into the brain and body.

Dopamine is a feel-good brain chemical that releases naturally, but the amount released after consuming an opioid, like Lortab, is much higher than what is normally released. When taking Lortab, a person feels a rush of euphoria, an increased sense of well-being and an overall feeling of relaxation. As these effects occur, the neural pathways in the brain start paving the way wanting more of the drug and craving the initial high. This process is how addiction develops.

Hydrocodone treats pain by altering the way the person perceives pain. Opioids stop the brain from recognizing pain signals sent by the body.

With Lortab, both hydrocodone and acetaminophen stop pain signals from being transmitted from the brain to the body, but they do so through different mechanisms. Hydrocodone stops pain signals from transmitting, while acetaminophen blocks the formation of chemicals in the body that increases pain. This combination effect is why Lortab and other opioid combination drugs are very effective for pain control.

While there are medical applications for Lortab elixir, people frequently misuse it recreationally to relax, experience euphoria, help them sleep or to numb their emotions.

Lortab Elixir Doses

The dosage of Lortab Elixir is based on the patient’s individual factors including the severity of pain a person experiences and the response of the individual patient to the medicine. Doctors are warned that tolerance can develop when using medications containing hydrocodone.

For an adult, the usual dosage of liquid Lortab is 11.25 milliliters (less than one tablespoon) every four to six hours as needed, with a maximum daily dose of 67.5 milliliters. One tablespoon of Lortab Elixir (about 15 milliliters) contains 10 milligrams of hydrocodone and 300 milligrams of acetaminophen.

A measuring device calibrated for precise measurement of the dose is necessary to administer Lortab safely. Such devices are usually provided by a pharmacy that dispenses Lortab when a patient picks up their prescription.

Lortab Elixir Side Effects

Adverse reactions and side effects can develop with Lortab use, including addiction and opioid overdose.

Lortab elixir should be taken exactly as instructed by a physician because of the opioid component and potential for overdose and addiction, and also because of the risks related to the acetaminophen and alcohol contained in the medication. Acetaminophen toxicity can lead to acute liver damage and failure. It is recommended not to take more than 4000 milligrams of acetaminophen, the amount contained in about 13 tablespoons of Lortab elixir,  over a 24-hour period.

Since Lortab elixir also contains alcohol, which is also toxic to the liver, adverse effects on the liver can be even more likely.

Other side effects of using Lortab elixir include common opioid-related effects, such as:

  • Drowsiness
  • Dizziness
  • Decreased respiratory rate
  • Decreased heart rate
  • Constipation
  • Nausea/vomiting
  • Mood changes
  • Low blood pressure

Differences Between Lortab Elixir and Lortab Pills

The main difference between Lortab elixir and Lortab pills is that Lortab pills are no longer available. Lortab elixir is still available with a prescription but should be used cautiously, just like other opioids.

Key Points: Lortab Elixir

Some key facts to remember when discussing Lortab elixir:

  • Lortab elixir contains hydrocodone, acetaminophen, and alcohol
  • Lortab elixir should only be used for pain that cannot be controlled with non-opioid painkillers
  • Lortab elixir can become addictive, especially with long-term use
  • Lortab elixir is associated with many side effects, including drowsiness, dizziness, constipation and decreased respiratory rate
  • Lortab elixir needs to be measured precisely to avoid overdose
  • The acetaminophen component of Lortab elixir can be toxic to the liver with high doses
  • Lortab pills are no longer manufactured, but generic pills with the same ingredients are still available

If you or a loved one live with addiction, help is available. Contact The Recovery Village today to speak to a representative about how professional treatment can address addiction and any co-occurring mental health disorders. Begin your healthier future today.

Dailymed. “Lortab (syrup).” November 2018. Accessed April 10, 2019.

Dailymed. “Tylenol Extra Strength Prescribing Information.” October 2018. Accessed April 10, 2019.