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Neurochem Res 21: 10051012

Mixed Agonist/Antagonist and Partial Agonist Opioid Analgesics The concomitant use of opioids with other opioid analgesics, such as butorphanol, nalbuphine, pentazocine, may reduce the analgesic effect of hydrocodone bitartrate and acetaminophen tablets and/or precipitate withdrawal symptoms

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The majority of reports of nausea, vomiting, and/or diarrhea occurred during dose escalation

This distinction is why the combination therapy works so devastatingly well: Youre hitting the appetite suppression target from TWO completely different angles simultaneously