Reviewed by Dr. Diana Rangaves, PharmD, RPh
The T259 pill, also known as the T259 white pill, is a prescription medication containing 10 mg of hydrocodone bitartrate and 325 mg of acetaminophen. Hydrocodone is an opioid pain medicine, while acetaminophen is a non-opioid pain reliever. Together, these ingredients are used to manage pain severe enough to require an opioid when other treatment options do not provide enough relief.
Because this medication contains hydrocodone, it is classified as a Schedule II controlled substance in the United States. Although hydrocodone has an accepted medical use, it also carries serious risks, including misuse, addiction, physical dependence, respiratory depression, and overdose. Therefore, this prescription medicine should only be taken as directed by a healthcare professional.
How to Identify the T259 Pill
| Feature | T259 White Pill |
|---|---|
| Imprint | T 259 |
| Active ingredients | Hydrocodone bitartrate and acetaminophen |
| Strength | 10 mg hydrocodone / 325 mg acetaminophen |
| Color | White or off-white |
| Shape | Capsule-shaped / oblong |
| Size | About 13 mm |
| Drug type | Opioid analgesic combination |
| Availability | Prescription only |
| Drug schedule | Schedule II |
| Manufacturer | Ascent Pharmaceuticals |
| Manufactured for | Camber Pharmaceuticals |
These details describe the expected appearance and product information for the white T259 tablet.
Why Are Some T259 Pills White or Yellow?
One point that can cause confusion is pill color. Separate white and yellow T259 product records exist. The white/off-white T259 tablet discussed in this article contains hydrocodone 10 mg and acetaminophen 325 mg. A separate yellow T259 record also lists the same 10 mg/325 mg strength.
Therefore, a difference in color does not automatically mean that a T259 tablet is counterfeit. However, appearance alone cannot confirm that an unknown pill is genuine. If prescription medication looks different from what a person normally receives, the safest approach is to compare the pharmacy label and ask a pharmacist to verify it.
Hydrocodone Overview
Hydrocodone is a strong prescription opioid analgesic used to manage significant pain. Because it can affect breathing, alertness, and the central nervous system, it must be used carefully. Hydrocodone also carries risks of physical dependence, misuse and addiction, and overdose, which is why medications containing it are tightly controlled.
Hydrocodone can cause:
- Physical dependence
- Misuse
- Addiction
- Withdrawal symptoms
- Respiratory depression
- Overdose
For these reasons, hydrocodone should only be used by the person for whom it was prescribed. The dose should not be increased, shared with another person, or changed without medical guidance. Long-term opioid use can also lead to physical dependence, and suddenly stopping treatment may cause withdrawal symptoms.
Hydrocodone Forms and Strengths
Hydrocodone is available in different prescription products, strengths, and formulations. Some medicines contain hydrocodone alone, while others combine it with another pain reliever such as acetaminophen. Therefore, two hydrocodone products may not contain the same dose even if they look similar.
The T259 pill specifically contains 10 mg of hydrocodone and 325 mg of acetaminophen. Other hydrocodone/acetaminophen products can contain different amounts of hydrocodone, even when the amount of acetaminophen is the same. Therefore, the strength shown on a prescription label should always be checked carefully.
Different hydrocodone strengths may be prescribed depending on a person’s medical condition, previous treatment, pain level, and other health factors. For this reason, patients should follow the strength and directions on their own prescription label rather than comparing their medicine only with pictures online.
For comparison, the G037 pill is another hydrocodone/acetaminophen tablet with a different imprint, making it useful for readers comparing hydrocodone pill markings.
How Hydrocodone and Acetaminophen Work
Hydrocodone mainly works by activating mu-opioid receptors in the central nervous system. These receptors are found in areas of the brain and spinal cord involved in pain and other body functions. When hydrocodone activates them, the brain processes pain signals differently, which can reduce the feeling of pain.
Acetaminophen also helps relieve pain, although it does not work through opioid receptors. Its exact pain-relieving mechanism is not fully established, but its effects are thought to involve actions within the central nervous system. Together, hydrocodone and acetaminophen can provide pain relief when non-opioid treatments are not adequate.
Possible effects of hydrocodone include:
- Drowsiness
- Sedation
- Slower reaction time
- Dizziness
- Respiratory depression
These effects can become stronger when hydrocodone is combined with alcohol, benzodiazepines, sleeping medicines, muscle relaxants, other opioids, or other drugs that slow the central nervous system.
What Is the T259 Pill Used For?
Hydrocodone and acetaminophen combinations are used to manage pain severe enough to require an opioid when other treatments do not provide adequate relief or cannot be tolerated. Because opioids carry serious risks, they are generally reserved for situations in which alternative pain treatments are not enough.
The T259 pill is a hydrocodone/acetaminophen 10 mg/325 mg tablet. Although people may sometimes use brand names such as Norco when discussing this drug combination, T259 is more accurately identified by its active ingredients, strength, and imprint.
Risks and Warnings for the T259 White Pill
This hydrocodone/acetaminophen tablet can cause serious health problems, especially when it is taken in larger amounts than prescribed or combined with substances that slow the brain and nervous system. One of the most serious risks is respiratory depression, which means breathing can become dangerously slow or shallow. This risk may be greater when treatment begins, after a dose increase, or during an overdose.
Hydrocodone also carries a risk of addiction, misuse, and physical dependence. Physical dependence means the body has adapted to regular opioid use and may develop withdrawal symptoms if the medicine is stopped suddenly. Dependence and addiction are not the same condition, although both are important opioid safety concerns.
The T259 white pill contains 325 mg of acetaminophen, which adds to its pain-relieving effect. However, taking too much acetaminophen can cause serious liver injury. This can happen accidentally when a person takes this medication along with other pain, cold, flu, headache, or fever medicines that also contain acetaminophen. Therefore, patients should check the active ingredients of other medicines before combining them.
Who Should Not Take T259?
Hydrocodone/acetaminophen should not be used by people with significant respiratory depression, acute or severe asthma in an unmonitored setting, a known or suspected bowel blockage, or a known allergy to hydrocodone, acetaminophen, or another ingredient in the tablet.
Before using the medication, a healthcare professional should also know about a history of head injury, seizures, liver or kidney problems, thyroid problems, difficulty urinating, or conditions involving the pancreas or gallbladder. A history of alcohol or drug misuse, opioid overdose, or certain mental health problems should also be discussed because these factors can affect treatment safety.
Pregnancy and Breastfeeding
People who are pregnant, planning a pregnancy, or breastfeeding should discuss hydrocodone/acetaminophen with a healthcare professional. Prolonged opioid use during pregnancy can cause neonatal opioid withdrawal syndrome, which can become serious if it is not recognized and treated after birth.
Hydrocodone and acetaminophen can pass into breast milk and may affect a nursing baby. In particular, unusual sleepiness, breathing difficulty, or limpness in the infant requires immediate medical attention. Therefore, the possible benefits and risks should be discussed with a healthcare professional before breastfeeding while taking this medicine.
Alcohol creates another major concern because it can increase the sedating and breathing-suppressing effects of hydrocodone. Combining opioids with alcohol, benzodiazepines, or other central nervous system depressants can lead to severe drowsiness, respiratory depression, coma, or death.
Side Effects of the T259 Pill
Like other opioid medicines, the white T259 tablet can cause side effects even when it is taken as prescribed. Some effects may be mild, while others may require urgent medical attention. Frequently reported reactions to hydrocodone/acetaminophen include light-headedness, dizziness, sedation, nausea, and vomiting. Constipation and drowsiness can also occur.
Common side effects may include:
- Dizziness
- Drowsiness
- Nausea
- Vomiting
- Constipation
- Light-headedness
- Itching
- Sedation
Constipation is common with opioid medicines because hydrocodone reduces movement through the digestive system. Drowsiness and dizziness can also affect driving, operating machinery, or other activities that require full alertness. A related guide on hydrocodone/acetaminophen side effects covers similar effects associated with the same medication combination.
Seek urgent medical help if someone develops:
- Very slow or difficult breathing
- Extreme sleepiness
- Trouble waking up
- Loss of consciousness
- Severe confusion
- Blue or gray lips
- Swelling of the face, tongue, or throat
- A severe or spreading skin rash
- Blistering or peeling skin
Serious allergic reactions, including anaphylaxis, have been reported with hydrocodone/acetaminophen. Serious skin reactions, including Stevens-Johnson syndrome and toxic epidermal necrolysis, have also been reported.
Breathing problems are especially important because opioid-related respiratory depression can become life-threatening. If a person is difficult to wake, is breathing very slowly, or has stopped breathing, emergency medical help is needed immediately.
T259 Drug Interactions
This medication can interact with prescription medicines, over-the-counter products, alcohol, and other substances. Some combinations can increase sedation and respiratory depression, while others may change how hydrocodone is processed by the body. Therefore, patients should give their healthcare provider or pharmacist a complete list of the medicines and products they use.
Important examples include:
- Benzodiazepines
- Other opioids
- Alcohol
- Sedatives
- Sleeping medicines
- Muscle relaxants
- Certain anxiety medicines
- Other central nervous system depressants
Combining hydrocodone with other central nervous system depressants can cause severe sleepiness and dangerously slow breathing. This risk is also covered in the site’s guide to hydrocodone interactions with alcohol and other CNS depressants. Therefore, these combinations may require special medical review and monitoring.
Hydrocodone is processed in part through an enzyme called CYP3A4. Some medicines can block or increase the activity of this enzyme, which may change the amount of hydrocodone in the body. Higher hydrocodone levels can increase sedation and respiratory depression. In addition, combining opioids with certain serotonergic medicines has been linked to serotonin syndrome, a potentially life-threatening reaction.
The T259 tablet already contains 325 mg of acetaminophen, so additional acetaminophen needs special attention. Tylenol and many pain, headache, cold, and flu medicines contain the same active ingredient. As a result, using several acetaminophen-containing products together can unintentionally increase total intake and raise the risk of liver injury.
How to Avoid Fake Hydrocodone Pills?
Counterfeit prescription pills can be dangerous because they may closely copy the shape, color, size, and imprint of legitimate medications. A fake tablet may look like a prescription opioid while containing a different drug or an unpredictable amount of an active ingredient. Prescription medicines should therefore be obtained through legitimate, licensed pharmacy channels.
Counterfeit pills may contain:
- Fentanyl
- Methamphetamine
- Incorrect amounts of medicine
- Different active ingredients
- No expected medication at all
Illicit counterfeit pills can contain fentanyl or methamphetamine and may be made to resemble legitimate prescription medicines. The site’s fentanyl guide explains fentanyl, overdose risk, and naloxone in greater detail.
Do not take a pill if:
- It came from an unknown seller
- It was bought from an unverified website
- It was given to you by someone else
- It is loose and its source is unknown
- The packaging appears unusual or damaged
If medication received from a licensed pharmacy looks different from previous prescriptions, that difference does not automatically mean the medicine is fake. Manufacturers and product appearance can differ. Instead, compare the pharmacy label and ask a pharmacist to verify the medication.
Overdose
A T259 overdose can involve toxicity from hydrocodone, acetaminophen, or both. Hydrocodone overdose mainly affects the brain and breathing system, while excessive acetaminophen can seriously damage the liver. Because both ingredients can cause life-threatening complications, suspected overdose requires immediate medical attention.
Possible signs of an opioid overdose include:
- Very slow breathing
- Stopped breathing
- Extreme sleepiness
- Trouble waking up
- Pinpoint pupils
- Cold or clammy skin
- Slow heartbeat
- Loss of consciousness
- Coma
Hydrocodone overdose can cause severe respiratory depression, extreme sleepiness that may progress to coma, airway problems, and other dangerous complications. Pinpoint pupils may occur, although they are not present in every opioid overdose.
Acetaminophen overdose can also be dangerous because severe liver injury may develop even when early symptoms do not appear serious.
Possible early symptoms include:
- Nausea
- Vomiting
- Sweating
- Stomach discomfort
- Feeling weak or unwell
If an opioid overdose is suspected, call 911 immediately. Naloxone is used for the emergency treatment of an opioid overdose. However, emergency care is still necessary because the opioid’s effects may last longer than the effects of the reversal medicine.
Safe Use and Storage of T259
Safe use of the T259 pill begins with following the prescription exactly. Taking more medication than prescribed or changing treatment without medical guidance can increase the risk of serious side effects, dependence, and overdose.
Several basic safety steps can reduce the risks linked with T259 and other hydrocodone products:
- Take the medicine exactly as prescribed.
- Do not increase the dose without medical advice.
- Avoid alcohol.
- Do not share opioid medication.
- Check other products for acetaminophen.
- Keep the medication away from children.
- Store it in a secure location.
- Tell your healthcare provider about other medicines you take.
- Ask about naloxone if you are prescribed an opioid.
- Dispose of unused opioid medication safely.
When T259 is expired or no longer needed, a drug take-back location or medication mail-back option is generally preferred. If these options are not readily available, patients should follow the current disposal instructions provided with the medication or current FDA guidance.
People who use hydrocodone regularly may develop physical dependence. Therefore, suddenly stopping treatment can cause withdrawal symptoms. People who may be physically dependent on opioids should speak with their healthcare professional before reducing or stopping treatment.
The white T259 product is manufactured by Ascent Pharmaceuticals, Inc. for Camber Pharmaceuticals, Inc. It should be stored at controlled room temperature of about 20°C to 25°C (68°F to 77°F) in a secure, child-resistant container.
Common package information includes:
- NDC 31722-997-01: 100-tablet bottle
- NDC 31722-997-05: 500-tablet bottle
- Manufacturer: Ascent Pharmaceuticals, Inc.
- Manufactured for: Camber Pharmaceuticals, Inc.
These package and manufacturer details apply to the white T259 10 mg/325 mg product described here.
Secure storage is especially important because accidental ingestion of an opioid can cause a life-threatening overdose, particularly in children.
Frequently Asked Questions
Is T259 the Same as Vicodin?
No. T259 should not be identified as a Vicodin-branded pill. Vicodin is a brand name associated with hydrocodone and acetaminophen, but product strengths, manufacturers, and tablet imprints can differ. The T259 pill discussed in this article is identified specifically by its T 259 imprint and hydrocodone 10 mg/acetaminophen 325 mg strength.
Further Information
The T259 pill discussed in this article is a prescription hydrocodone/acetaminophen medicine used for pain severe enough to require an opioid when alternative treatments are not adequate. Because it contains a strong opioid, it should only be used as prescribed and should be stored securely.
References
- DailyMed — Hydrocodone Bitartrate and Acetaminophen Tablets
- DailyMed — Yellow T259 Product Record
- FDA — Counterfeit Medicine
- FDA — Disposal of Unused Medicines
- DEA — One Pill Can Kill
- Drugs.com — T 259 Pill
Medical Disclaimer: This article is for educational and informational purposes only. It does not replace medical advice, diagnosis, or treatment from a qualified healthcare professional.