Comments on: Dr. House and Vicodin addiction http://www.kevinmd.com/blog/2008/09/dr-house-and-vicodin-addiction.html medical blog Sun, 22 Nov 2009 14:15:05 -0500 http://wordpress.org/?v=2.8.4 hourly 1 By: Doctor Rocktor http://www.kevinmd.com/blog/2008/09/dr-house-and-vicodin-addiction.html/comment-page-1#comment-108159 Doctor Rocktor Sun, 19 Jul 2009 04:29:18 +0000 http://clients.emmense.com/kevinmd/2008/09/dr-house-and-vicodin-addiction.html#comment-108159 Dr House - I thought that I might ask you here (as you appear to be a reader of some of the posts of KevinMD at times - and the comment section of the ABC News Health article is a dense miasma of chatter as it stands already). In your ABC News Health article you make the statement that, "Vicodin is ototoxic", and refer to patients under your care who consumed, "15 to 75 tablets per day". At 500mg of acetaminophen (minimum, I believe) per (5mg) hydrocodone tablet, such intake represents a truly astronomical amount of acetaminophen (7.5g to 37.5g in a 24-hour time period), not to mention 75mg to 375mg of hydrocodone bitartrate. I assume that you would likely not make the assertion that hydrocodone (itself) or circulating metabolite of hydrocodone (themselves) have been definitively shown to be neurotoxic in the human hearing system - were it not for a specifically identified mechanism having been identified at some point by someone. From a *small* bit of research, I was only able to find papers that noted such phenomena in persons consuming hydrocodone/aetaminophen combinations (where the measured mass of acetaminophen equals 100 times that of the hydrocodone bitartrate present in each individual dosage. Ho, Vrabec, and Burton, Baylor College of Medicine (in Pain Physician, May 2007, (also) only studied patients consuming similar hydrocodone/acetaminophen combination medications. However, they refer to such measurable hearing loss at (hydrocodone) dosing ranges as low (at least in one or more cases) as "10" ... "mg per day". Is your assertion that "Vicodin is ototoxic" based upon *direct* findings establishing that hydrocodone (or it's circulating metabolites) are definitively the culprit in these episodes - or is it your speculation by (secondary) *deduction* (based on a dearth of such reports where comparable quantities of acetaminophen consumed have been reported to cause such phenomena in the human hearing system?) . Dr House -

I thought that I might ask you here (as you appear to be a reader of some of the posts of KevinMD at times – and the comment section of the ABC News Health article is a dense miasma of chatter as it stands already).

In your ABC News Health article you make the statement that, “Vicodin is ototoxic”, and refer to patients under your care who consumed, “15 to 75 tablets per day”.

At 500mg of acetaminophen (minimum, I believe) per (5mg) hydrocodone tablet, such intake represents a truly astronomical amount of acetaminophen (7.5g to 37.5g in a 24-hour time period), not to mention 75mg to 375mg of hydrocodone bitartrate.

I assume that you would likely not make the assertion that hydrocodone (itself) or circulating metabolite of hydrocodone (themselves) have been definitively shown to be neurotoxic in the human hearing system – were it not for a specifically identified mechanism having been identified at some point by someone.

From a *small* bit of research, I was only able to find papers that noted such phenomena in persons consuming hydrocodone/aetaminophen combinations (where the measured mass of acetaminophen equals 100 times that of the hydrocodone bitartrate present in each individual dosage.

Ho, Vrabec, and Burton, Baylor College of Medicine (in Pain Physician, May 2007, (also) only studied patients consuming similar hydrocodone/acetaminophen combination medications. However, they refer to such measurable hearing loss at (hydrocodone) dosing ranges as low (at least in one or more cases) as “10″ … “mg per day”.

Is your assertion that “Vicodin is ototoxic” based upon *direct* findings establishing that hydrocodone (or it’s circulating metabolites) are definitively the culprit in these episodes – or is it your speculation by (secondary) *deduction* (based on a dearth of such reports where comparable quantities of acetaminophen consumed have been reported to cause such phenomena in the human hearing system?)
.

]]> By: Anonymous http://www.kevinmd.com/blog/2008/09/dr-house-and-vicodin-addiction.html/comment-page-1#comment-87385 Anonymous Tue, 23 Sep 2008 00:26:00 +0000 http://clients.emmense.com/kevinmd/2008/09/dr-house-and-vicodin-addiction.html#comment-87385 I've never found any real literature suggesting that Vicodin causes hearing loss.<br/><br/>It was associated with Rush's hearing loss, but I doubt Vicodin caused the deafness. I suspect it was autoimmune. I’ve never found any real literature suggesting that Vicodin causes hearing loss.

It was associated with Rush’s hearing loss, but I doubt Vicodin caused the deafness. I suspect it was autoimmune.

]]> By: Anonymous http://www.kevinmd.com/blog/2008/09/dr-house-and-vicodin-addiction.html/comment-page-1#comment-87379 Anonymous Mon, 22 Sep 2008 20:30:00 +0000 http://clients.emmense.com/kevinmd/2008/09/dr-house-and-vicodin-addiction.html#comment-87379 Is that what caused Rush's hearing loss? Is that what caused Rush’s hearing loss?

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