A white, oblong pill marked M367 is identified as hydrocodone bitartrate 10 mg and acetaminophen 325 mg. It is a prescription opioid pain medicine and a Schedule II controlled substance in the United States.
The imprint, color, shape, and size can help identify a regulated pharmacy product. A visual check cannot confirm what is inside a loose pill. Counterfeit tablets can copy the M367 imprint and may contain fentanyl or another harmful substance.
Possible overdose: Call 911 now if the person is hard to wake, has slow or stopped breathing, has blue or gray lips or skin, collapses, or has a seizure. Give naloxone if it is available, then stay with the person. Follow the naloxone directions. Another dose may be needed every 2 to 3 minutes if the person does not respond or overdose signs return. Emergency care is still needed if the person wakes up. For other suspected poisonings in the United States, call Poison Control at 1-800-222-1222.
What is the M367 pill?
M367 is an immediate-release tablet that combines an opioid with a non-opioid pain reliever. Each tablet contains:
- Hydrocodone bitartrate, 10 mg: an opioid that changes how the brain and nervous system respond to pain.
- Acetaminophen, 325 mg: the medicine found in Tylenol and many cold, flu, and sleep products. It reduces pain and fever.
The combination is prescribed when pain is severe enough to need an opioid and other treatments do not give enough relief. This medicine can cause addiction, slowed breathing, overdose, and liver injury.
M367 pill identification
| Detail | Identification |
|---|---|
| Imprint | M367 |
| Color | White |
| Shape | Capsule-shaped or oblong |
| Size | About 15 mm |
| Other side | Bisecting score line |
| Strength | Hydrocodone bitartrate 10 mg and acetaminophen 325 mg |
| Manufacturer | SpecGx LLC |
| Base NDC | 0406-0125; the package suffix varies |
| Route | Taken by mouth |
| Availability | Prescription only |
| U.S. controlled drug class | Schedule II |
SpecGx LLC makes the M367 tablet. Other companies may repackage or relabel it. Check the pharmacy bottle for the labeler, directions, and lot information.
Can appearance prove that an M367 pill is genuine?
No. Color, shape, and imprint support identification, but they cannot confirm the ingredients or strength. A pill from a friend, dealer, social media seller, or unlicensed website may be counterfeit even when it looks correct.
Use only medicine prescribed for you and dispensed by a licensed pharmacy. Ask a pharmacist to check any pill that differs from the tablets in your original bottle.
What is M367 used for?
M367 is used for pain severe enough to require an opioid when other pain treatments are inadequate. A clinician may prescribe hydrocodone and acetaminophen after an injury, operation, or dental procedure, or for another serious pain condition.
The reason for the prescription, dose, and length of treatment depend on the person. M367 should be taken only for the condition listed on the prescription. It should never be shared.
How does M367 relieve pain?
Hydrocodone attaches to opioid receptors in the brain and spinal cord. This lowers the experience of pain. It also slows activity in the central nervous system, which can cause sleepiness and dangerous breathing problems.
Acetaminophen also reduces pain and fever. Its exact pain-relief mechanism is not fully understood.
M367 dosage and safe use
The directions on your prescription bottle control your dose. For the 10 mg/325 mg strength, the labeled starting dose is 1 tablet every 4 to 6 hours as needed, with no more than 6 tablets per day. Your prescriber may give different directions based on your health, other medicines, and past opioid use.
Follow these rules:
- Take the exact amount prescribed at the stated times.
- Call the prescriber if the dose does not control your pain.
- M367 is usually taken as needed. If you miss a scheduled dose, take the next dose at the usual time. Never take a double dose.
- Take it by mouth. Never snort, dissolve, or inject it.
- Check every medicine label for acetaminophen, APAP, or paracetamol.
- Avoid alcohol.
- Wait to drive or use machinery until you know how the medicine affects you.
- Keep the tablets in their original labeled bottle.
- Never give a tablet to another person.
Call your prescriber if pain gets worse after a dose, you become more sensitive to pain, or new pain starts. Opioids can sometimes increase pain sensitivity. Taking an extra tablet can raise the overdose risk.
Can you split an M367 pill?
The tablet is scored into 2 pieces. Take half a tablet only if your prescription says to do so. Ask your pharmacist or prescriber before splitting it, and use a pill cutter if you are told to take half.
Side effects
Possible side effects include:
- Constipation
- Nausea or vomiting
- Sleepiness
- Dizziness
- Lightheadedness
- Tiredness
- Headache
- Stomach pain
Standing up slowly may reduce dizziness. Constipation is common with opioids and can become severe. Ask a clinician or pharmacist about a bowel plan if it develops. Call your clinician when a side effect is severe, continues, or interferes with eating, drinking, walking, or staying awake.
Serious side effects that need medical care
Call 911 for:
- Slow, shallow, difficult, or stopped breathing
- Extreme sleepiness or inability to wake
- Fainting, severe weakness, or confusion
- Swelling of the face, lips, tongue, or throat
- Chest pain or a very fast heartbeat
- Agitation, fever, stiff muscles, or trouble walking
Get medical care right away for yellow skin or eyes, dark urine, severe upper stomach pain, or a rash with blisters or peeling skin. These may be signs of liver injury or a serious skin reaction.
Breathing problems can happen at any time. The risk is greatest when treatment starts or after a dose increase. Alcohol and other medicines that cause sleepiness raise the risk. Older adults and people with lung disease also face greater danger.
M367 overdose symptoms and what to do
An M367 overdose can involve hydrocodone, acetaminophen, or both. The 2 ingredients cause different types of harm.
Signs of an opioid overdose
- Slow, shallow, irregular, or stopped breathing
- Inability to wake or respond
- Very small or enlarged pupils
- Slow heartbeat
- Cold or clammy skin
- Blue or gray lips, nails, or skin
- Limp body, choking sounds, or unusual snoring
Give naloxone right away if it is available, then call 911. Stay with the person and follow the package directions. Another dose may be needed every 2 to 3 minutes if the person does not respond or overdose signs return. Naloxone can wear off before the opioid does, so the person still needs emergency care.
Signs of too much acetaminophen
Early acetaminophen poisoning may cause nausea, vomiting, sweating, poor appetite, or stomach pain. Some people feel well at first. Liver injury can appear later, so waiting for symptoms is unsafe.
Call Poison Control at 1-800-222-1222 right away if someone may have taken too much acetaminophen or several products that contain it. Call 911 for collapse, seizure, breathing trouble, or inability to wake. Do not make the person vomit unless a medical professional tells you to do so.
Acetaminophen and liver safety
Each M367 tablet contains 325 mg of acetaminophen. Six tablets contain 1,950 mg. Acetaminophen from Tylenol, cold medicine, flu medicine, migraine products, and sleep aids must be added to that total.
Most reported cases of acetaminophen liver injury involved more than 4,000 mg in 24 hours, often after a person used several products containing it. Treat 4,000 mg as the upper label limit. People with liver disease or regular alcohol use face greater risk and should ask a clinician about their safe limit.
Your prescription limit still applies when the acetaminophen total is below 4,000 mg. Hydrocodone can cause a fatal overdose before the acetaminophen amount reaches that level.
Call Poison Control at 1-800-222-1222 right away after taking more than 4,000 mg in 24 hours, even if you feel well. A suspected overdose needs prompt care because treatment works best when started early.
M367 drug and substance interactions
Tell the prescriber and pharmacist about every prescription drug, nonprescription medicine, vitamin, and supplement you use. Important interactions include:
| Substance or medicine | Main concern |
|---|---|
| Alcohol | Severe sleepiness, slowed breathing, overdose, and added liver risk |
| Benzodiazepines, such as alprazolam, diazepam, or lorazepam | Profound sedation, coma, and fatal breathing problems |
| Other opioids, sleep medicines, muscle relaxants, antipsychotics, gabapentin, or pregabalin | Greater sedation and breathing risk |
| Products containing acetaminophen or APAP | Accidental acetaminophen overdose and liver injury |
| Some antibiotics, antifungals, and HIV medicines | Hydrocodone levels may rise and slow breathing |
| Rifampin, carbamazepine, or phenytoin | Hydrocodone levels and pain control may change |
| Some antidepressants, migraine medicines, linezolid, or MAO inhibitors | Serotonin syndrome or opioid toxicity; tell the prescriber about any MAO inhibitor taken within the past 14 days |
Do not start or stop an interacting medicine on your own. A change can raise or lower hydrocodone levels. A pharmacist can screen the full list and tell you what action is needed.
Who should not take M367?
M367 should not be used in these situations:
- Significant respiratory depression, meaning dangerously slow or weak breathing
- Acute or severe asthma in a setting without close medical monitoring or resuscitation equipment
- A known or suspected blockage in the stomach or intestines
- An allergy to hydrocodone, acetaminophen, or another tablet ingredient
Contact the prescriber before taking a dose if any item may apply to you.
Who needs extra medical advice before taking M367?
Give the prescriber your full medical and substance-use history. Extra care may be needed if you have:
- COPD, sleep apnea, or another chronic breathing condition
- Liver or kidney disease
- Severe constipation
- A head injury, brain tumor, or seizures
- Low blood pressure
- Thyroid, pancreas, gallbladder, or urinary problems
- A history of alcohol or drug misuse, overdose, depression, or another mental health condition
- Older age, frailty, or poor nutrition
Pregnancy and breastfeeding
Extended opioid use during pregnancy can cause withdrawal in a newborn. Tell the prescriber if you are pregnant, may be pregnant, or plan to become pregnant.
Hydrocodone can pass into breast milk. A nursing infant may become unusually sleepy, have trouble feeding, develop breathing problems, or become limp. Those signs require emergency care. A clinician should assess the risks before hydrocodone is used while breastfeeding.
Children
Safety and effectiveness have not been established in children. Never give M367 to a child unless it was prescribed and dispensed for that child. One accidental dose can be fatal.
Counterfeit M367 pills and fentanyl risk
Counterfeit pills may contain the wrong drug, the wrong amount, no active drug, or a harmful added substance. Fentanyl-laced counterfeit medicines have been linked to increased overdose deaths.
A pill’s appearance cannot confirm that it is genuine. A copied M367 imprint does not prove that a tablet contains hydrocodone 10 mg and acetaminophen 325 mg.
Use these safety steps:
- Fill prescriptions at a state-licensed pharmacy.
- Keep pills in the pharmacy bottle.
- Avoid loose tablets and medicine sold through social media or an unlicensed site.
- Contact the pharmacy if a refill has a new color, shape, imprint, or package.
- Keep naloxone available when a clinician or pharmacist recommends it, and make sure people around you know where it is.
Tolerance, physical dependence, addiction, and withdrawal
These terms describe different effects:
- Tolerance means a dose gives less effect after repeated use. A prescriber should assess rising pain or reduced relief. Increasing the dose without approval can cause an overdose.
- Physical dependence means the body has adjusted to the drug. A sudden stop can cause withdrawal.
- Opioid use disorder involves problems such as strong cravings, loss of control, repeated risky use, or continued use despite harm.
Withdrawal may cause restlessness, sweating, runny nose, watery eyes, yawning, muscle or joint pain, stomach cramps, vomiting, diarrhea, anxiety, fast breathing, or a fast heartbeat.
People who take M367 regularly should speak with their prescriber before stopping. A safe dose reduction is based on the dose, treatment length, symptoms, and health history. There is no single taper schedule that fits every patient.
Signs that M367 use needs medical help
Speak with a doctor or addiction specialist if you notice any of these signs:
- Taking more tablets or taking them more often than prescribed
- Running out early or seeking pills from several sources
- Strong cravings or repeated failed attempts to cut down
- Using M367 to relax, cope with emotions, or avoid withdrawal
- Hiding use or continuing despite health, work, or relationship problems
- Mixing M367 with alcohol, sedatives, or other opioids
Treatment can include medicine for opioid use disorder, counseling, and support based on the person’s needs. U.S. treatment services can be found through FindTreatment.gov.
M367 compared with similar pills
Similar-looking white tablets can contain different opioid doses. Read the full imprint and confirm it with a pharmacist or trusted pill identifier.
| Pill or product | Active ingredients | Main difference |
|---|---|---|
| M365 | Hydrocodone 5 mg and acetaminophen 325 mg | Lower hydrocodone strength than M367 |
| M366 | Hydrocodone 7.5 mg and acetaminophen 325 mg | Lower hydrocodone strength than M367 |
| M367 | Hydrocodone 10 mg and acetaminophen 325 mg | Highest hydrocodone strength in the M365 to M367 group |
| G 037 | Hydrocodone 10 mg and acetaminophen 325 mg | Same listed strength with a different imprint |
| T259 tablet details | Hydrocodone 10 mg and acetaminophen 325 mg | Same listed strength with a different imprint and manufacturer |
| Percocet | Oxycodone and acetaminophen | Contains oxycodone; strengths vary by product |
Hydrocodone and acetaminophen products have been sold under names such as Norco, Lortab, and Vicodin. The pharmacy label states the product dispensed. Brand names, labelers, and tablet markings can change, so compare the full imprint instead of relying on a familiar name.
How might M367 make you feel?
At a prescribed dose, M367 may reduce pain and cause sleepiness, dizziness, nausea, slower thinking, or a relaxed feeling. Hydrocodone can also cause euphoria, which raises its misuse risk.
Severe drowsiness, confusion, slurred speech, blue or gray skin, or slow breathing may signal an overdose. Call 911 and give naloxone if it is available.
How soon does M367 work, and how long does it stay in the body?
There is no exact start time or duration that applies to everyone. The prescribed dosing interval is usually every 4 to 6 hours as needed. Pain relief and side effects vary by person. Follow the timing on your bottle even if pain returns sooner.
In a study of 5 adult men who took a 10 mg oral dose, hydrocodone reached its average peak blood level in about 1.3 hours and had an average half-life of about 3.8 hours. Peak blood level is not the same as the exact time pain relief begins. Acetaminophen has a half-life of about 1.25 to 3 hours. Half-life means the time needed for the amount in the blood to fall by half.
Half-life does not show when it is safe to take an extra dose or how long a drug test will stay positive. Test results depend on the type of test, dose, frequency of use, metabolism, and health. A testing laboratory or clinician can explain a specific result.
Safe storage and disposal
Store M367 at 68°F to 77°F (20°C to 25°C), protected from light, in its original tightly closed bottle. Keep it away from excess heat and moisture, and do not store it in the bathroom. Keep it locked, out of sight, and out of reach of children, visitors, and pets. Accidental ingestion of 1 dose can be fatal to a child.
Use a pharmacy drop box, mail-back envelope, or drug take-back program for unused tablets. If no take-back option is readily available, flush unused hydrocodone and acetaminophen tablets. Remove or cover personal details on the empty bottle before discarding it.
Frequently asked questions
What should you do if you find a loose M367 pill?
Do not take or taste it. Keep it away from children and pets. A pharmacist can check the imprint, and a drug take-back location can dispose of it. If someone already swallowed it, call Poison Control at 1-800-222-1222. Call 911 for slow breathing, inability to wake, collapse, or seizure.
Is M367 a strong pain pill?
M367 contains 10 mg of hydrocodone, the highest hydrocodone amount among M365, M366, and M367 tablets. Strength alone does not predict a safe dose. Opioid tolerance, age, breathing health, liver function, other medicines, and alcohol use all change the risk.
Is M367 oxycodone?
M367 contains hydrocodone and acetaminophen. A T194 tablet containing oxycodone 10 mg is one example of an oxycodone and acetaminophen product. Percocet products can also contain oxycodone and acetaminophen. Both opioids can cause addiction, slowed breathing, and overdose.
Is M367 the same as Norco or Vicodin?
M367 identifies a generic tablet containing hydrocodone 10 mg and acetaminophen 325 mg. Norco and Vicodin are brand names that have been used for hydrocodone and acetaminophen products. Their strengths, manufacturers, and imprints can differ. Check the pharmacy label for the exact product and company that supplied it.
Can you take Tylenol with M367?
M367 already contains 325 mg of acetaminophen, the active ingredient in Tylenol. Taking more acetaminophen can raise the risk of liver damage. Ask a pharmacist or prescriber before combining them and count acetaminophen from every product.
Can you take ibuprofen with M367?
M367 does not contain ibuprofen. Some patients can use ibuprofen with hydrocodone and acetaminophen. It may be unsafe for people with kidney disease, stomach ulcers, bleeding risk, heart disease, or pregnancy. Check with a clinician or pharmacist who knows your health and medicines.
Can M367 make you high?
Hydrocodone can cause euphoria. Using M367 for that effect, taking extra tablets, or using it by a route other than prescribed can cause a fatal overdose. Large amounts of acetaminophen can cause fatal liver injury. Keep the medication locked and use it only as prescribed.
Final safety guidance
Use M367 only from your own prescription bottle and follow its directions. Check all medicines for acetaminophen, avoid alcohol, and ask a pharmacist before adding any drug or supplement. Keep naloxone available when advised. Call 911 for slowed breathing, inability to wake, collapse, or seizure.
This information is for education and does not replace advice from a physician, pharmacist, or poison specialist. A licensed clinician should make decisions about diagnosis, dosing, drug interactions, pregnancy, breastfeeding, and stopping an opioid.
Sources
- DailyMed: M367 hydrocodone bitartrate and acetaminophen prescribing information
- MedlinePlus: Hydrocodone combination products
- FDA: Counterfeit medicine
- DEA: One Pill Can Kill
- Poison Help: What to do in a poison emergency
- FDA: Where and how to dispose of unused medicines
- FindTreatment.gov: U.S. substance-use treatment locator