M365 is a white, capsule-shaped pill with “M365” indexed on one side. This drug is a mixture of acetaminophen (325mg) and hydrocodone bitartrate (5mg) and belongs to the drug class narcotic analgesics. Both drugs last for a similar length of time in the body which makes them appropriate to be given together. This is a prescribed medicine and both are pain relievers used to treat any pain, back pain, joint pains, arthritis, cough, and many other conditions.

Hydrocodone is an opioid, while acetaminophen is an analgesic. Opioids (narcotics) are very strong pain relievers while analgesics are less potent pain reliever that enhances the effects of hydrocodone and at the same time a fever reducer. Together, they are effective at relieving moderate-to-moderately severe pain.


  • Available in tablet and oral solution.
  • They cost less in generic versions.
  • Dosage is based on weight (children), medical condition, and response to treatment.
  • They work best at the first sign of pain.
  • Not available for use in children 6 years old and below.

Side Effects of Acetaminophen/Hydrocodone

Common side effects

  • Anxiety, drowsiness, and dizziness
  • Some nausea
  • Vomiting
  • Upset stomach
  • Constipation
  • Headache
  • Change in mood
  • Blurry vision
  • Ringing in the ears
  • Dry mouth

Serious side effects that need immediate medical attention

  • Trouble breathing
  • Hives
  • Face, lip, tongue or throat swelling
  • Slow breathing or heartbeat
  • Fainting
  • Confusion
  • Feeling afraid
  • Unwanted thoughts or behavior
  • Seizures
  • Trouble urinating
  • Pain in the upper stomach
  • Itching
  • Not eating
  • Dark urine
  • Clay stools
  • Jaundice of the skin or eyes

Some may people not experience these side effects and some of the common symptoms tend to go away once the body has adjusted to treatment. There are other signs and symptoms not listed above. If they become bothersome or unusual or if the symptoms persist, immediately report to your doctor.

Important Information

Before taking this medicine, inform your treating physician:

  • If you have allergies to acetaminophen or hydrocodone or similar medicines.
  • Tell the doctor if you have allergies to other medicines and other substances.
  • If you have a recent head injury, breathing disorders, liver or kidney disease, low blood pressure, stomach disorders, adrenal gland disorders, mental illness, drug or substance abuse, and curvature of the spine.
  • If you feel you are pregnant, pregnant, or planning to get pregnant.
  • If you are breastfeeding.

How to take this medicine:

  • Take exactly as prescribed. Do not increase or decrease your dosage or use for a longer period without your doctor’s advice.
  • Call emergency help in case of overdose. Symptoms include extreme drowsiness, sweating, pinpoint pupils, nausea, vomiting, dark urine, yellowing of the skin or eyes, confusion, cold and clammy skin, muscle weakness, fainting, weak pulse, slow heart rate, coma, blue lips, shallow breathing, or no breathing.
  • Do not double dose in case of a missed dose. If you are taking the medicine on a regular schedule, take the medicine as soon as you remember and skip the schedule if it is almost time for the next dose.
  • Properly measure liquid form of this medicine provided by the pharmacist. Do not use a regular table spoon.
  • This medicine causes constipation. Exercise, increase fiber in diet and water intake. Do not use laxatives or stool softeners without your doctor’s knowledge.
  • Inform the doctor or the dentist before undergoing other treatment, surgery, or dental extraction that you are taking this medicine.


  • Keep out of the reach of children and pets.
  • Store in a safe place away from others. Misuse of this medicine can cause addiction, overdose, toxic side effects, and death.
  • Store acetaminophen and hydrocodone at room temperature away from moisture and heat.
  • Discard properly unused or expired medicines.



This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment.

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