Chronic Pain and You
Step 2 of the analgesic ladder is the mild to moderate narcotic combinations, such as Vicodin, Vicoprofen, Tylenol with Codeine, Percocet, and Percodan to name a few. These products contain the non-narcotics from Step 1 that is aspirin, Tylenol or Motrin along with low dose of a narcotic like codeine, oxycodone or hydrocodone. Since these products are combinations, they have a maximum dose effect. A maximum dose effect means you can take only a certain amount of these drugs a day due to the toxicity of the non-narcotic ingredient. Tylenol toxicity can occur if you take more than the recommended dose, which is for example eight regular strength Vicodin, or five extra strength Vicodin tablets per day. That number of tablets contains a maximum daily-recommended dose of Tylenol. The use of these products for breakthrough pain, that is pain that occurs while you're taking narcotics on a regular schedule, increases the likelihood of reaching the maximum daily-recommended dose. If pain is still not controlled we move to step 3 of the ladder.