Contains hydrocodone and ibuprofenStrong evidence

Is Hydrocodone and Ibuprofen (Vicoprofen) affected by genetics?

Yes. All 2 active ingredients have pharmacogenetic evidence.

Genes CYP2D6 CYP2C9

Hydrocodone and ibuprofen is affected by pharmacogenetics through the CYP2D6 and CYP2C9 genes. Your genotype for these genes can change how well Hydrocodone and ibuprofen works for you or how well you tolerate it. The strongest evidence level on this page is Strong, from the published guidelines shown below.

Also sold as Vicoprofen, Ibudone, Reprexain.

Pharmacogenetic guidelines are written for one ingredient at a time, so the guidance below is for each ingredient on its own. What your genes mean for a combination product is less clear, because the dose and the other ingredients can change things. If you take Hydrocodone and ibuprofen, it's worth talking over with your prescriber or pharmacist. How we handle combination products.

What's in Hydrocodone and ibuprofen

Hydrocodone Affected by CYP2D6

Affected by CYP2D6. Guidance from CPIC, strong evidence.

Read the full hydrocodone genetics guide

Ibuprofen Affected by CYP2C9

Affected by CYP2C9. Guidance from CPIC, strong evidence.

Read the full ibuprofen genetics guide

Hydrocodone phenotype recommendations

Published guidance from CPIC on how hydrocodone should be dosed or substituted based on your CYP2D6 phenotype.

Phenotype	What it means	Recommendation	Evidence
Ultrarapid MetabolizerCYP2D6	There isn't enough evidence to say whether your result changes how hydrocodone works for you, so the guideline makes no recommendation.	CPIC No recommendation for hydrocodone therapy because of minimal evidence regarding adverse events or analgesia.	Not rated
Normal MetabolizerCYP2D6	Your body processes hydrocodone normally, so the usual dose is expected to work.	CPIC Use hydrocodone label recommended age- or weight-specific dosing.	Strong
Intermediate MetabolizerCYP2D6	The usual dose is recommended. If it doesn't relieve your pain, a different pain medicine may be considered.	CPIC Use hydrocodone label recommended age- or weight-specific dosing. If no response and opioid use is warranted, consider non-codeine or non-tramadol opioid.	Optional
Poor MetabolizerCYP2D6	Your body makes less of hydrocodone's stronger active form. It's not clear this changes pain relief, so the usual dose is recommended, with a different pain medicine to consider if it doesn't work.	CPIC Use hydrocodone label recommended age- or weight-specific dosing. If no response and opioid use is warranted, consider non-codeine and non-tramadol opioid.	Optional
IndeterminateCYP2D6	The impact of your genotype on response to this drug is unknown.	CPIC Initiate therapy with recommended starting dose.	Not rated
Not availableCYP2D6	The impact of your genotype on response to this drug is unknown.	CPIC Initiate therapy with recommended starting dose.	Not rated

Source: CPIC

Ibuprofen phenotype recommendations

Published guidance from CPIC on how ibuprofen should be dosed or substituted based on your CYP2C9 phenotype.

Phenotype	What it means	Recommendation	Evidence
Normal MetabolizerCYP2C9	Your body processes this drug normally, so the usual starting dose applies.	CPIC Initiate therapy with recommended starting dose. In accordance with the prescribing information, use the lowest effective dosage for the shortest duration consistent with individual patient treatment goals.	Strong
Intermediate MetabolizerCYP2C9	Your body slows the drug down slightly, but usually the normal starting dose is fine.	CPIC Initiate therapy with recommended starting dose. In accordance with the prescribing information, use the lowest effective dosage for the shortest duration consistent with individual patient treatment goals. CPIC Initiate therapy with lowest recommended starting dose. Titrate dose upward to clinical effect or maximum recommended dose with caution. In accordance with the prescribing information, use the lowest effective dosage for the shortest duration consistent with individual patient treatment goals. Carefully monitor adverse events, such as blood pressure and kidney function, during course of therapy.	Moderate
Poor MetabolizerCYP2C9	Your body clears this drug very slowly, so it can build up. A much lower starting dose, or a different drug, is suggested.	CPIC + CPIC Initiate therapy with 25 to 50% of the lowest recommended starting dose. Titrate dose upward to clinical effect or 25 to 50% of the maximum recommended dose with caution. In accordance with the prescribing information, use the lowest effective dosage for the shortest duration consistent with individual patient treatment goals. Upward dose titration should not occur until after steady-state is reached (at least 8 days for celecoxib and 5 days for ibuprofen, flurbiprofen, and lornoxicam after first dose in PMs). Carefully monitor adverse events such as blood pressure and kidney function during course of therapy. Alternatively, consider an alternate therapy not metabolized by CYP2C9 or not significantly impacted by CYP2C9 genetic variants in vivo.	Moderate
IndeterminateCYP2C9	The impact of your genotype on response to this drug is unknown.	CPIC Initiate therapy with recommended starting dose.	Not rated
Not availableCYP2C9	The impact of your genotype on response to this drug is unknown.	CPIC Initiate therapy with recommended starting dose.	Not rated

Source: CPIC

The genes behind the guidance

CYP2D6 Cytochrome P450 2D6

CYP2D6 is the most clinically important pharmacogene. It metabolizes around a quarter of all prescription drugs, including many antidepressants, opioids, and stimulants. The gene is unusually variable: roughly 7 percent of people are poor metabolizers (they barely activate CYP2D6), and another 1 to 3 percent are ultrarapid metabolizers (their enzyme is overactive).

The v4 report preserves the activity score used in its interpretation. Some medicines use a combined CYP2D6/CYP2C19 recommendation. CYP2D6 inhibitors can change functional metabolism; a genotype alone does not capture that effect.

See all drugs affected by CYP2D6

CYP2C9 Cytochrome P450 2C9

CYP2C9 metabolizes warfarin, phenytoin, celecoxib, and some NSAIDs. Variants that reduce its activity are most consequential for warfarin, where even small changes in drug clearance translate into very different doses (and a real bleeding risk if missed).

Poor metabolizers need substantially lower warfarin doses to hit the same INR target.

See all drugs affected by CYP2C9

Browse the full drug class: Pain medications.

Related medications

Find out how your genetics affect Hydrocodone and ibuprofen

This page describes the general pharmacogenetics. A Gene2Rx report analyzes your own DNA to tell you which metabolizer group you fall into, across every medication.

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Informational only, not medical advice. Pharmacogenetic guidance describes population-level patterns; your individual response depends on many factors. Never start, stop, or change a medication without talking to your prescribing clinician.