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Dr. Andrew Rynne

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Can taking Methocarbamol and Hydrocodone-Acetaminophen together lead to alcohol-like symptoms?

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Dr. Matt Wachsman

Addiction Medicine Specialist

Practicing since :1985

Answered : 3252 Questions

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Posted on Mon, 16 Oct 2017 in Pain Management
Question: I would like to speak with Dr. Wachsman. can the combination of methocarbamol 500mg and hydrocodone-acetaminophen 5-325 produce alcohol like symtems ie: drowsiness, slurred speech, mood chances, hallucinations, irrational behavior
doctor
Answered by Dr. Matt Wachsman 1 hour later
Brief Answer:
no,

Detailed Answer:
each individual one of the drugs HAS drowsiness, slurred speech AS THEIR MAIN SIDE EFFECT. so, it wouldn't be a combination...not necessarily....simply because methocarbamol OR hydrocodone just by itself does a lot of these symptoms ALL BY ITSELF. Might be more common if they add up.

Then
depends a bit on the mood changes and irrational behavior, if it is psychosis, maybe...not to common and not very likely... if it is crabbiness because you're drowsy, yeah really common and really likely.

The hallucinations depend on the type. There's a type called "hypnogogic hallucinations" which occur when you are sort of asleep and are going in and out of dreams. These are really common on these particular drugs. Going into a manic episode with delusions and hallucinations for days after you take them I would be doubtful about and I'd have to look up if that's ever been reported.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Matt Wachsman 1 hour later
I had fallen several feet from a ladder...hurt really bad... took 3 0f each pill within 15 minutes. apparently I called my counselor and left a number of questionable messages...I remember being upset about another personal matter and very tired almost as if I had sleep deprivation. counselor interpreted this to alcohol and called p.o . would the drugs explain this behavior I was not drinkink

see previous question....falling off ladder
doctor
Answered by Dr. Matt Wachsman 3 hours later
Brief Answer:
I think there are several possibilities.

Detailed Answer:
First, that is a bit more than the recommended dose especially of the robaxin. oxycodone 15 and tylenol 750 are doses that are frequently prescribed. extra strength tylenol is 1000 mg and over the counter.
Robaxin is generally give up to 1000 mg and this is about double the usual maximal dose.

But, that is not the most likely cause of sleepiness, confusion, and angry outbursts. Indeed, I testified in a similar case for court 5 years ago.

Concussion USUALLY causes changes in behavior and confusion with drowsiness.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Matt Wachsman 11 hours later
the real question is... could the drugs (in all likelihood) be the root cause of this abnormal behavior...calling people ....leaving messages... slurred speech....vague memory etc. did not think of possible concussion symtoms...do not remember if hit head...it was only a short fall and extreme pain was in hip

the real question is......? waiting for reply
doctor
Answered by Dr. Matt Wachsman 8 hours later
Brief Answer:
so, what changed.

Detailed Answer:
If the person always behaves that way, then no. If the drugs were always there and weren't changing then it is a bit of a stretch to say why they were a problem at one point and no other time. If the drugs were just present at one Time and then the person acted weird, these drugs certainly commonly do have psychological effects most notably sedation.

But it's a concussion.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Matt Wachsman 1 hour later
Thank you

by the way..drugs were used sparingle and sporatically....only when pain became acute....every couple weeks and maybe only one dose each for one day...this was first time took large dose to to acute pain...it was not a normal dily or even weekly occurrence does that make a difference...really do not remember head injury because of such pain in hip
doctor
Answered by Dr. Matt Wachsman 10 hours later
Brief Answer:
ohhhh... drugs or concussion

Detailed Answer:
while only the robaxin was outside the normal dose range, a TRIPLING of the dose that normally is ok is a whole new roll of the dice.

I had this happen with just percocet on a pleasant 80 year old. She was using the percocet sparingly. And also the oxycodone sparingly. And also the roxicet sparingly. She didn't know they were all the same drug. And, basically had serious sedation and change in mentation for a few hours.

That's a telling feature. Oxycodone is about a 4 hr window. If the change in mentation occurred for 8 hrs or a bit more it was mostly the robaxin. If it was about 4 hrs or less then the oxycodone played a major role.

But concussion still seems more likely.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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