In my limited knowledge hydrocodone itself has no real bad effect on the liver. It is often marketed in pill form for pain relief with acetaminophen (tylenol). The tylenol too is not especially harmful to the liver except when used after drinking alcohol. drinking activates an enzyme CYP2E1 in the liver. This enzyme may transform elements in the tylenol into chemicals that are harmful to the liver.
The National Institute of Alcohol Abuse and Alcoholism notes that liver damage may occur with as little as 2.6 grams of acetaminophen (four to five "extra-strength" pills) taken over the course of the day in persons consuming varying amounts of alcohol (NIAAA, Seeff). The damage caused by alcohol-acetaminophen interaction is more likely to occur when acetaminophen is taken after, rather than before, the alcohol has been metabolized.
This liver damage is so serious it leads to the need for liver transplants. Since 1998, the Food and Drug Administration in the United States has required a specific warning on labels about acetaminophen. That warning reads:
• Acetaminophen: "Alcohol Warning: If you consume 3 or more alcoholic drinks every day, ask your doctor whether you should take acetaminophen or other pain relievers/fever reducers. Acetaminophen may cause liver damage."
I take Codeine 60-90 mg daily for neuropathy and all the other "stuff." I've been taking it for about six months now and the main difference is I can now walk okay again and get around almost like a normal person. However, if I take Ibuprofen 400-600 mg daily, I get the red palms and smelly urine and disoriented feelings, but it does help a lot with inflammation. I have cirrhosis and my liver is still compensated.
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