A white oblong tablet stamped M367 is hydrocodone 10 mg with acetaminophen 325 mg. The imprint one digit away is the same drug at half the opioid dose.
M365, M366 and M367 come from the same manufacturer and look nearly alike. Two of the three are the same shape and the same color.
What an M367 Pill Is
M367 is a generic hydrocodone and acetaminophen tablet, the combination sold for years under the brand names Vicodin and Lortab. Almost every prescription now filled is generic, which is why you are far more likely to see M367 stamped on a tablet than a brand name on a bottle.
Hydrocodone is an opioid and changes how the nervous system registers pain. Acetaminophen works separately and also lowers fever. The combination relieves pain better than either ingredient alone at the same dose, which is the reason the two are packaged together.
Because it contains hydrocodone, M367 is a Schedule II controlled substance, the same federal category as oxycodone and morphine.
Why M365, M366 and M367 Get Confused
This is the part that matters most on an identification page, and it is the reason to look at the last digit twice.
All three imprints belong to the same hydrocodone and acetaminophen family, and all three are white. M365 is 325 mg of acetaminophen with 5 mg of hydrocodone, capsule-shaped. M366 is 325 mg with 7.5 mg, oval. M367 is 325 mg with 10 mg, capsule-shaped.
M365 and M367 are the pair to watch. Same color, same oblong shape, same manufacturer style, and double the opioid between them. Nothing about the tablet announces the difference except one digit that wears with handling.
The acetaminophen amount is identical across all three at 325 mg, so the only thing changing between them is the hydrocodone.
How to Confirm Which One You Have
Read the imprint against good light and compare it to the strength printed on the prescription label. The label states the hydrocodone amount, so a bottle reading 5 mg with M367 tablets inside, or the reverse, is a reason to call the pharmacy before taking any of them.
Shape helps only with M366. If the tablet is oval it is the 7.5 mg. If it is oblong it is either the 5 mg or the 10 mg, and the digit is the only separator.
A tablet with no bottle and no label cannot be confirmed by looking at it. A pharmacist can identify it without an appointment.
M367 Dosage and Daily Limits
The usual adult dose for the 10 mg and 325 mg strength is one tablet by mouth every 4 to 6 hours as needed for pain. The maximum is 6 tablets in 24 hours.
Six tablets is a lower count than some other opioid combinations allow, and the reason is worth knowing.
Why the Opioid Sets the Ceiling Here
On many combination painkillers the daily tablet cap exists to keep acetaminophen under control. On M367 that is not what is happening.
Total acetaminophen should stay under 4 grams in 24 hours. Six M367 tablets deliver 1,950 mg, which is less than half that limit. The cap is set by the hydrocodone instead, at 10 mg per tablet.
That distinction changes what you watch for. On a 10 mg tablet the ceiling is about respiratory depression and opioid load, not liver injury. The acetaminophen still counts toward the daily total though, so cold and flu remedies, sleep aids and other pain relievers containing acetaminophen still need checking against the label.
Alcohol raises the risk of liver injury from acetaminophen and separately raises the risk of dangerously slowed breathing when combined with an opioid. Both reasons point the same direction.
Side Effects of the M367 Pill
Constipation tends to persist rather than fade, and it is worth raising with a prescriber early. Severe confusion, extreme drowsiness, slowed breathing or difficulty waking someone are overdose signs rather than side effects, and they need a 911 call.
When an M367 Pill Is Counterfeit
Counterfeit tablets are pressed to copy real imprints, M367 among them, using presses that produce convincing tablets with no quality control behind them.
Some contain illegally made fentanyl instead of hydrocodone. Because there is no manufacturing standard, the amount varies between tablets in the same batch, so one may contain none and the next a lethal amount.
Appearance cannot separate a counterfeit from the real thing, and neither can taste or breaking the tablet open. The only meaningful check is provenance. A tablet dispensed by a licensed pharmacy against a prescription in your own name is verified. Anything else is not, no matter how clean the imprint looks.
Signs of an Opioid Overdose
Call 911 first. Give naloxone if it is on hand while waiting. Naloxone reverses opioid overdose and does no harm if opioids turn out not to be involved, so there is no reason to hesitate over the decision.
Why People Search for Street Value
We do not publish street prices for prescription opioids, and the reason is practical rather than prim.
A tablet bought outside a pharmacy has unverified contents, which is exactly the counterfeit problem above. What someone paid for it says nothing about what is in it.
How Misuse Usually Starts
Most opioid misuse does not begin as a decision to misuse anything. It begins with taking an extra tablet on a bad day, or taking them a little closer together than the label says, or finishing someone else's leftover prescription.
Tolerance builds with continued use, meaning the same dose does less. Physical dependence follows, meaning stopping abruptly brings withdrawal. Neither of those is addiction on its own, and both can happen to someone following instructions.
The signs worth acting on are different: needing more for the same relief, thinking about the next dose beyond what the pain warrants, trying to cut back without managing it, or continuing despite the problems it is causing.
Crushing, snorting or injecting the tablets changes how fast the dose arrives and sharply raises overdose risk. So does combining hydrocodone with alcohol, benzodiazepines or anything else that slows breathing.
