How to Taper Off Vicodin

The Vicodin brand of medication is part of a drug class known as opioids and contains the opioid hydrocodone and the over-the-counter drug acetaminophen. Due to its potency, the hydrocodone of Vicodin helps treat many levels of pain and discomfort. However, you can become physically dependent on the drug over time if you take it regularly. This means you can get uncomfortable withdrawal symptoms if you quit cold turkey: instead, doctors recommend a taper, a method of gently weaning off Vicodin.

What Is Vicodin Tapering or Weaning Off Vicodin?

Weaning off Vicodin means slowly and consistently decreasing your dose until you are off the drug. When an individual decides to quit Vicodin cold turkey instead, they will experience the full impact of opioid withdrawal. In contrast, Vicodin tapers can avoid withdrawal outright. Not to mention, the headway that is made gradually reprograms the body to live without Vicodin. It heals itself progressively rather than forcing it into a sink-or-swim ultimatum, like going cold turkey.

A physician-approved Vicodin taper schedule prevents or alleviates the following withdrawal symptoms:

Flu-like symptoms

• Sweating
• Watery eyes
• A runny nose
• Headaches
• Fever

Psychological symptoms

• Sweating
• Cravings
• Panic attacks
• Anxiety
• Depression

Plus, other common side effects such as:

• Nausea
• Vomiting
• Muscle aches
• Diarrhea
• Constipation
• Insomnia
• Cramping
• Spasms

How to Taper off Vicodin

Medical tapers conducted in a rehabilitation facility are the best option for people seeking treatment. A Vicodin taper should not be attempted without the supervision of a medical professional to avoid complications. Vicodin reduction rates will fluctuate depending on each patient’s individual needs, and these needs can change week by week. Physicians recommend a taper to start slow: a monthly reduction of 10% of Vicodin pills, for instance. Faster tapers can call for reductions as high as 25% every few days or so. Regardless of the type of taper, do not attempt to taper off Vicodin without the guidance of a medical professional.

Types of Vicodin Tapering Methods

Several Vicodin tapering methods exist, including direct tapering, substitute tapering and titration tapering. However, experts recommend only direct tapering or substitute tapering. Titration tapering is not recommended and can be dangerous.

Direct Tapering

Your doctor may recommend a direct taper for your Vicodin. In a direct taper, you slowly decrease your Vicodin dose until you can completely stop it without withdrawal symptoms.

Substitute Tapering

Sometimes, doctors recommend a substitute taper for Vicodin. In a substitute taper, Vicodin is changed for an alternate opioid that can be more easily tapered and has less overdose risk. Examples of such opioids include buprenorphine and methadone. Experts recommend medication-assisted treatment (MAT) with methadone or buprenorphine for substitute tapering.

Titration Tapering

Titration tapering is not recommended. In a titration taper, you dissolve Vicodin in water. Then, you drink progressively smaller amounts of the concoction daily to taper yourself off the drug. However, this is dangerous because Vicodin does not completely dissolve in water. This means it is impossible to predict the Vicodin dose you might be taking every day in a taper, putting you at an overdose risk and defeating the point of the taper.

Why Consider Tapering vs. Stop Vicodin Cold Turkey?

Stopping Vicodin cold turkey is not recommended. Withdrawal symptoms can be severe when you quit cold turkey, leading to dangerous complications. For example, dehydration from vomiting and diarrhea can have fatal consequences if left untreated.

A taper is a gradual method to ease yourself off Vicodin. You can avoid withdrawal by allowing your body to adjust to progressively lower Vicodin doses.

Common Vicodin Withdrawal Symptoms

Withdrawal symptoms are common when you stop Vicodin without medical support or a taper. While not everyone will experience all symptoms, any withdrawal symptoms can be overwhelming. Symptoms can include:

• Muscle aches
• Trouble sleeping
• Runny eyes and nose
• Sweating
• Yawning
• Enlarged pupils 
• Abdominal cramps
• Diarrhea
• Goosebumps
• Nausea and vomiting
• Agitation
• Anxiety

Side Effects of Tapering off Vicodin

When a taper is properly conducted, side effects should be minimal to nonexistent. The point of a taper is to ease your body off Vicodin so it can gently acclimate to being without the drug. Therefore, experiencing withdrawal effects during the taper means your taper may need to be stopped or slowed to allow your body to catch up to the new, lower dose.

Vicodin Withdrawal Timeline

Vicodin is a short-acting opioid whose withdrawal timeline reflects that of other short-acting opioids. Although withdrawal symptoms can vary based on the person, they follow a general timeframe as regards when they begin versus when they end:

• Withdrawal symptoms begin: within 12 hours of the last Vicodin dose
• Withdrawal symptoms peak: within 24–48 hours of the last Vicodin dose
• Withdrawal symptoms taper off: within three to five days of the last Vicodin dose

Occasionally, a person may experience lingering withdrawal symptoms like anxiety, depression and insomnia for several weeks or months after the last Vicodin dose. These symptoms will resolve over time with continued abstinence.

Medications Used When Tapering off Vicodin

Many different medications can be used when tapering off Vicodin. This includes the medication-assisted treatment (MAT) agents buprenorphine and methadone. Although the opioid blocker naltrexone is not prescribed during a taper as it can cause withdrawal symptoms, your doctor may prescribe it to help you stay off Vicodin over the long term. Your doctor can help you decide on the best MAT regimen for you. 

Methadone

Methadone is a first-line MAT drug to prevent Vicodin withdrawal symptoms. The drug comes strictly in an oral dosage form and, when prescribed for MAT, must be obtained at specialty methadone clinics which often require a daily visit. Because it can be difficult to attend a methadone clinic every day, many doctors instead prescribe buprenorphine products.

Buprenorphine (Sublocade, Suboxone)

Buprenorphine is an alternative to methadone and a first-line MAT medication. The drug comes in multiple formulations, including an oral (Suboxone) and an injectable (Sublocade) form. Either oral or injectable buprenorphine can help ease you off Vicodin; however, some doctors prefer the injectable form as it is given only once monthly in a doctor’s office, which means you don’t need to remember to take a pill every day. 

Naltrexone (Vivitrol)

Naltrexone is a second-choice drug if someone cannot take methadone or buprenorphine. The drug is an opioid blocker and comes as an oral tablet and a long-acting injectable drug. Doctors avoid naltrexone during a taper as the drug can cause withdrawal symptoms due to its opioid-blocking effects. However, once you are off Vicodin and have achieved sobriety, your doctor may prescribe naltrexone to help keep you off Vicodin over the long term.

Naloxone (Narcan)

When sold on its own under the brand name Narcan, naloxone is an emergency opioid-reversal agent that can save someone’s life during an overdose. An opioid blocker like naltrexone is avoided during tapering as it can cause immediate withdrawal symptoms. 

That said, naloxone is an ingredient in some opioid reversal drugs like Suboxone. This is because naloxone is only active when injected, not taken by mouth. Adding it to Suboxone deters people from dissolving the drug and trying to inject it instead of taking it by mouth as prescribed.

Can Tapering Your Vicodin Intake Reduce Withdrawal Symptoms?

Tapering your Vicodin can reduce or eliminate withdrawal symptoms. A Vicodin taper is meant to ease you off the drug and avoid withdrawal. As such, an appropriate Vicodin taper can help you avoid withdrawal entirely as your body gets used to lower and lower doses of the drug until it is stopped.

How The Recovery Village Uses Vicodin Tapering

The Recovery Village strongly supports you every step of the way in your brave choice to quit Vicodin. We offer Vicodin tapering through MAT options like buprenorphine as medically appropriate. We offer a full continuum of care, from tapering in our medical detox center to rehab in our inpatient and outpatient centers. Don’t wait: contact us today to see how we can help.

Editor – Theresa Valenzky

Theresa Valenzky graduated from the University of Akron with a Bachelor of Arts in News/Mass Media Communication and a certificate in psychology. She is passionate about providing genuine information to encourage and guide healing in all aspects of life. Read more

Medically Reviewed By – Dr. Jessica Pyhtila, PharmD

Dr. Jessica Pyhtila is a Clinical Pharmacy Specialist based in Baltimore, Maryland with practice sites in inpatient palliative care and outpatient primary care at the Department of Veteran Affairs. Read more