Norco (Hydrocodone and Acetaminophen) - Oral

Warning:

Taking Norco (hydrocodone and acetaminophen) may raise your risk of a dangerously low breathing rate, severe drowsiness or sleepiness, and coma. In addition, combining Norco with certain medications—like macrolide antibiotics (e.g., erythromycin) or benzodiazepines (e.g., diazepam)—can further increase the risk for these side effects. If you have questions about medication interactions for Norco, speak with your pharmacist or healthcare provider. Norco may also raise the likelihood of substance use disorder (SUD), accidental overdose, or liver failure. Get medical help right away if you're experiencing the following symptoms: extremely low breathing rate; excessive drowsiness or sleepiness; coma; changes in mood or behavior; relationship issues; trouble with home, school, or work environments; dark urine; upper right-sided stomach pain; and yellowing of skin or eyes. If you're taking Norco throughout your pregnancy, your healthcare provider may recommend slowly stopping this medication before your due date to prevent withdrawal side effects in your newborn baby.

What Is Norco?

Norco (hydrocodone and acetaminophen) is a combination analgesic (pain reliever) that contains two different medications: hydrocodone bitartrate and acetaminophen (APAP). While the brand name "Norco" is no longer available, its generic version is available as a tablet.

Hydrocodone bitartrate is an opioid analgesic that works by attaching to opioid receptors (binding sites). APAP, on the other hand, is a non-opioid pain reliever. It's thought to work by activating (waking up) a system in the body that blocks pain signals.

The hydrocodone and APAP combination pain-reliever is generally available in prescription tablet or liquid dosage forms.

Drug Facts

Generic Name: Acetaminophen; Hydrocodone bitartrate

Brand Name: Norco

Drug Availability: Prescription

Therapeutic Classification: Opioid

Available Generically: Yes

Controlled Substance: Schedule II

Administration Route: Oral (by mouth)

Active Ingredient: Acetaminophen; Hydrocodone bitartrate

Dosage Form: Tablet, solution

What Is Norco Used For?

Norco is used to treat severe pain. This medication, however, isn't a first-choice option. It's typically used after trying non-opioid pain relievers, which haven't produced good results.

The Centers for Disease Control and Prevention (CDC) estimates that 50 million adults have daily chronic (long-term) pain in the United States (U.S.)—with approximately 20 million adults living with high-impact chronic pain. High-impact chronic pain lasts for three months—with restrictions on at least one major activity, such as your ability to perform house chores, go to school, or work outside your home. People living with chronic pain might not be receiving adequate care.

However, based on a 2019 national survey, roughly 10 million people reported misusing opioid prescriptions, and more than 1.5 million people had opioid use disorder (OUD) within the previous year. Between July 2019 and June 2020, human-made opioids—other than methadone—were also linked to over 48,000 deaths.

There are conflicting crises in the U.S. On the one hand, people with chronic pain are being under-treated. Since 1999, on the other hand, there has been a high number of deaths from opioid overdoses.

How to Take Norco

Since Norco dosage and directions might vary per person, carefully take this medication according to your healthcare provider's recommendations.

However, Norco is typically taken by mouth every four to six hours as needed. The maximum daily number of tablets will usually depend on the hydrocodone bitartrate strength in each tablet.

Storage

Since Norco is a schedule II controlled medication, your healthcare provider will not authorize any refills for this prescription.

When you bring this medication home from the pharmacy, store it at room temperature between 68 degrees to 77 degrees Fahrenheit (F)—with protection from light. With Norco being a controlled prescription, also store this medication in a locked cabinet or a safe place.

If you're going to travel with Norco, know the regulations of your final destination. Have a copy of your Norco prescription and keep the medication in its original container from the pharmacy, with your name on it. Talk with your healthcare provider to request medical necessity documentation—with an official letterhead.

How Long Does Norco Take to Work?

Norco is considered a short-acting opioid. In fact, Norco will reach maximum blood levels in approximately one hour—with the medication's effects lasting for about four hours.

What Are the Side Effects of Norco?

Side effects are possible with Norco.

This is not a complete list of side effects, and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your pharmacist or a healthcare provider. You may report side effects to the Food and Drug Administration (FDA) at fda.gov/medwatch or 1-800-FDA-1088.

Common Side Effects

Common side effects with Norco include:

  • Dizziness
  • Lightheadedness
  • Nausea and vomiting
  • Sleepiness or drowsiness

Severe Side Effects

Get medical help right away if you're experiencing severe or life-threatening side effects.

In reference to Norco's black box warnings, the following are some potentially severe side effects:

  • Dangerously low breathing rate
  • Liver failure
  • Substance use disorder (SUD) risk
  • Withdrawal side effects in your newborn baby

Other serious side effects may include:

  • Adrenal insufficiency: Adrenal insufficiency is also known as Addison's disease. People with this condition don't make enough of certain hormones—like cortisol. If you have adrenal insufficiency, symptoms may include dizziness, weakness, nausea, vomiting, and appetite changes.
  • Severe allergic reaction or skin rash: If you're experiencing a serious allergic reaction to Norco, you may have symptoms of a severe skin rash, itchiness, and swelling.
  • Severely low blood pressure: If you have extremely low blood pressure, you might experience severe dizziness and fainting.

Long-Term Side Effects

Norco's long-term side effects include a higher risk for adrenal insufficiency and substance use disorder (SUD). During pregnancy, long-term Norco use also raises the likelihood of withdrawal side effects in your newborn baby.

After long-term use, however, suddenly stopping Norco can raise your chances of discontinuation (withdrawal) side effects.

Report Side Effects

Norco may cause other side effects. Call your healthcare provider if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your healthcare provider may send a report to the FDA's MedWatch Adverse Event Reporting Program or call the FDA by phone (800-332-1088).

Dosage: How Much Norco Should I Take?

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The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For moderate to severe pain:
    • For oral dosage form (capsules):
      • Adults—1 or 2 capsules every 4 to 6 hours as needed. Your doctor may increase your dose as needed. However, the dose is usually not more than 8 capsules per day.
      • Children—Use and dose must be determined by your doctor.
    • For oral dosage form (elixir):
      • Adults and children 14 years of age and older and weighing 46 kilograms (kg) and more—11.25 milliliters (mL) every 4 to 6 hours as needed. Your doctor may increase your dose as needed. However, the dose is usually not more than 67.5 mL per day.
      • Children 10 to 13 years of age and weighing 32 to 45 kg—7.5 mL every 4 to 6 hours as needed. Your doctor may increase your dose as needed. However, the dose is usually not more than 45 mL per day.
      • Children 7 to 9 years of age and weighing 23 to 31 kg—5.6 mL every 4 to 6 hours as needed. Your doctor may increase your dose as needed. However, the dose is usually not more than 33.6 mL per day.
      • Children 4 to 6 years of age and weighing 16 to 22 kg—3.75 mL every 4 to 6 hours as needed. Your doctor may increase your dose as needed. However, the dose is usually not more than 22.5 mL per day.
      • Children 2 to 3 years of age and weighing 12 to 15 kg—2.8 mL every 4 to 6 hours as needed. Your doctor may increase your dose as needed. However, the dose is usually not more than 16.8 mL per day.
      • Children younger than 2 years of age—Use and dose must be determined by your doctor.
    • For oral dosage form (7.5 milligrams [mg] per 325 mg per 15 mL solution):
      • Adults and children 14 years of age and older and weighing 46 kg and more—15 milliliters (mL) or 1 tablespoonful every 4 to 6 hours as needed. Your doctor may increase your dose as needed. However, the dose is usually not more than 90 mL (6 tablespoonfuls) per day.
      • Children 10 to 13 years of age and weighing 32 to 45 kg—10 mL (2 teaspoonfuls) every 4 to 6 hours as needed. Your doctor may increase your dose as needed. However, the dose is usually not more than 60 mL (12 teaspoonfuls) per day.
      • Children 7 to 9 years of age and weighing 23 to 31 kg—7.5 mL (1 and 1/2 teaspoonfuls) every 4 to 6 hours as needed. Your doctor may increase your dose as needed. However, the dose is usually not more than 45 mL (9 teaspoonfuls) per day.
      • Children 4 to 6 years of age and weighing 16 to 22 kg—5 mL (1 teaspoonful) every 4 to 6 hours as needed. Your doctor may increase your dose as needed. However, the dose is usually not more than 30 mL (6 teaspoonfuls) per day.
      • Children 2 to 3 years of age and weighing 12 to 15 kg—3.75 mL (3/4 teaspoonful) every 4 to 6 hours as needed. Your doctor may increase your dose as needed. However, the dose is usually not more than 22.5 mL (4 and 1/2 teaspoonfuls) per day.
      • Children younger than 2 years of age—Use and dose must be determined by your doctor.
    • For oral dosage form (10 milligrams [mg] per 325 mg per 15 mL solution):
      • Adults—15 milliliters (mL) or 1 tablespoonful every 4 to 6 hours as needed. Your doctor may increase your dose as needed. However, the dose is usually not more than 90 mL (6 tablespoonfuls) per day.
      • Children 14 years of age and older and weighing 46 kg and more—11.25 mL (2 and 1/4 teaspoonfuls) every 4 to 6 hours as needed. Your doctor may increase your dose as needed. However, the dose is usually not more than 67.5 mL (13 and 1/2 teaspoonfuls) per day.
      • Children 10 to 13 years of age and weighing 32 to 45 kg—7.5 mL (1 and 1/2 teaspoonfuls) every 4 to 6 hours as needed. Your doctor may increase your dose as needed. However, the dose is usually not more than 45 mL (9 teaspoonfuls) per day.
      • Children 7 to 9 years of age and weighing 23 to 31 kg—5.6 mL (1 teaspoonful) every 4 to 6 hours as needed. Your doctor may increase your dose as needed. However, the dose is usually not more than 33.6 mL (6 and 1/2 teaspoonfuls) per day.
      • Children 4 to 6 years of age and weighing 16 to 22 kg—3.75 mL (3/4 teaspoonful) every 4 to 6 hours as needed. Your doctor may increase your dose as needed. However, the dose is usually not more than 22.5 mL (4 and 1/2 teaspoonfuls) per day.
      • Children 2 to 3 years of age and weighing 12 to 15 kg—2.8 mL (1/2 teaspoonful) every 4 to 6 hours as needed. Your doctor may increase your dose as needed. However, the dose is usually not more than 16.8 mL (3 and 1/4 teaspoonfuls) per day.
      • Children younger than 2 years of age—Use and dose must be determined by your doctor.
    • For oral dosage form (5 milligrams [mg] per 325 mg tablets):
      • Adults—
        • Lortab®: 1 or 2 tablets every 4 to 6 hours as needed. Your doctor may increase your dose as needed. However, the dose is usually not more than 12 tablets per day.
        • Norco® 5/325: 1 or 2 tablets every 4 to 6 hours as needed. Your doctor may increase your dose as needed. However, the dose is usually not more than 8 tablets per day.
        • Generic: Dose depends on the strength of the tablet and must be determined by your doctor.
      • Children—Use and dose must be determined by your doctor.
    • For oral dosage form (7.5 mg per 325 mg tablets):
      • Adults—
        • Lortab®: 1 tablet every 4 to 6 hours as needed. Your doctor may increase your dose as needed. However, the dose is usually not more than 6 tablets per day.
        • Norco® 7.5/325: 1 tablet every 4 to 6 hours as needed. Your doctor may increase your dose as needed. However, the dose is usually not more than 6 tablets per day.
        • Generic: Dose depends on the strength of the tablet and must be determined by your doctor.
      • Children—Use and dose must be determined by your doctor.
    • For oral dosage form (10 mg per 325 mg tablets):
      • Adults—
        • Lortab®: 1 tablet every 4 to 6 hours as needed. Your doctor may increase your dose as needed. However, the dose is usually not more than 6 tablets per day.
        • Norco® 10/325: 1 tablet every 4 to 6 hours as needed. Your doctor may increase your dose as needed. However, the dose is usually not more than 6 tablets per day.
        • Generic: Dose depends on the strength of the tablet and must be determined by your doctor.
      • Children—Use and dose must be determined by your doctor.

Modifications

Your healthcare provider might slightly modify (change) your Norco treatment under the following situations:

People with kidney or liver problems: If you have kidney or liver impairment, you might have higher amounts of hydrocodone in your body. Therefore, your healthcare provider may want to start you on a lower Norco dose.

People with seizures: If you have a history of a seizure condition, you might experience more seizures with Norco. Therefore, your healthcare provider will closely monitor you for worsening seizure control.

Pregnant people: If you took Norco during your pregnancy, your newborn baby will have a higher risk of withdrawal side effects, such as irritability, tremors, diarrhea, and vomiting. Your newborn might also have trouble gaining weight. Your healthcare provider will want to slowly stop this medication before your delivery date to prevent these side effects.

Nursing parents: Hydrocodone can cause negative effects in nursing babies. Some side effects may include drowsiness, breathing difficulties, and limpness. Your child might also have trouble with breastfeeding. If you notice these side effects, contact your healthcare provider right away. If taking Norco is necessary while nursing, try not to take more than 30 milligrams (mg) daily for only a few days.

Older adults—people over 65—tend to have a higher risk of side effects with opioids, such as Norco. Therefore, a lower starting dose is usually recommended.

Missed Dose

Norco is usually taken as needed.

If your healthcare provider recommends that you regularly take Norco on a scheduled basis, however, then take your missed dose as soon as you remember. If it's already close to your next scheduled dose, then skip the missed dose and take the following dose at your next scheduled time.

Don't try to double up to make up for the missed dose, and make sure to wait at least four hours between doses.

If you're regularly taking Norco as a long-term scheduled medication, missing too many doses might lead to withdrawal symptoms.

Overdose: What Happens If I Take Too Much Norco?

If you accidentally took too much Norco, overdose symptoms may include:

  • Cold and clammy skin
  • Coma
  • Dangerously low breathing rate
  • Excessive sleepiness or drowsiness
  • Kidney or liver toxicity
  • Limp muscles
  • Low blood pressure
  • Nausea or vomiting
  • Pinpoint pupils
  • Slow heart rate
  • Sweating

If you're experiencing an overdose, use naloxone to reverse Norco's effects. Your loved ones might need to help you with this.

Then, call 911 as soon as possible. As you are waiting for emergency assistance, your symptoms might return. If necessary, naloxone can be used every two to three minutes. Since there are various naloxone products available, talk with your pharmacist or healthcare provider for detailed directions.

What Happens If I Overdose on Norco?

If you think you or someone else may have overdosed on Norco, call a healthcare provider or the Poison Control Center (800-222-1222).

If someone collapses or isn't breathing after taking Norco, call 911 immediately.

Precautions

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It is very important that your doctor check your or your child's progress while using this medicine, especially within the first 24 to 72 hours of treatment. This will allow your doctor to see if the medicine is working properly and to decide if you or your child should continue to take it. Blood and urine tests may be needed to check for unwanted effects.

Do not use this medicine if you are using or have used an MAO inhibitor (eg, isocarboxazid [Marplan®], linezolid [Zyvox®], phenelzine [Nardil®], selegiline [Eldepryl®], tranylcypromine [Parnate®]) within the past 14 days.

It is against the law and dangerous for anyone else to use your medicine. Keep your unused tablets in a safe and secure place. People who are addicted to drugs might want to steal this medicine.

This medicine will add to the effects of alcohol and other CNS depressants (medicines that can make you drowsy or less alert). Some examples of CNS depressants are antihistamines or medicine for allergies or colds, sedatives, tranquilizers, or sleeping medicine, other prescription pain medicine or narcotics, medicine for seizures or barbiturates, muscle relaxants, or anesthetics (numbing medicines), including some dental anesthetics. Also, there may be a greater risk of liver damage if you drink three or more alcoholic beverages while you are taking acetaminophen. Do not drink alcoholic beverages, and check with your doctor before taking any of these medicines while you are using this medicine.

This medicine may be habit-forming. If you feel that the medicine is not working as well, do not use more than your prescribed dose.

If you think you or someone else may have taken an overdose of this medicine, get emergency help at once. Your doctor may also give naloxone to treat an overdose. Signs of an overdose include: cold, clammy skin, coughing that sometimes produces a pink frothy sputum, dark urine, difficult or trouble breathing, irregular, fast or slow, or shallow breathing, nausea, vomiting, pain in the upper stomach, pale or blue lips, fingernails, or skin, pinpoint pupils of the eyes, or yellow eyes or skin.

This medicine may cause sleep-related breathing problems (eg, sleep apnea, sleep-related hypoxemia). Your doctor may decrease your dose if you have sleep apnea (stop breathing for short periods during sleep) while using this medicine.

This medicine may cause adrenal gland problems. Check with your doctor right away if you have darkening of the skin, diarrhea, dizziness, fainting, loss of appetite, mental depression, nausea, skin rash, unusual tiredness or weakness, or vomiting.

Check with your doctor right away if you have pain or tenderness in the upper stomach, pale stools, dark urine, loss of appetite, nausea, unusual tiredness or weakness, or yellow eyes or skin. These could be symptoms of a serious liver problem.

This medicine may cause serious skin reactions (eg, acute generalized exanthematous pustulosis, Stevens-Johnson syndrome, toxic epidermal necrolysis). Check with your doctor right away if you have blistering, peeling, or loosening of the skin, chills, cough, diarrhea, itching, joint or muscle pain, red irritated eyes, red skin lesions, often with a purple center, sore throat, sores, ulcers, or white spots in the mouth or on the lips, or unusual tiredness or weakness.

This medicine may cause a serious type of allergic reaction called anaphylaxis, which can be life-threatening and requires immediate medical attention. Call your doctor right away if you have a rash, itching, hoarseness, trouble breathing, trouble swallowing, or any swelling of your hands, face, or mouth while you are using this medicine.

Dizziness, lightheadedness, or fainting may occur when you get up suddenly from a lying or sitting position. Getting up slowly may help lessen this problem. Also, lying down for a while may relieve dizziness or lightheadedness.

This medicine may make you dizzy, drowsy, or lightheaded. Do not drive or do anything else that could be dangerous until you know how this medicine affects you.

Using narcotics for a long time can cause severe constipation. To prevent this, your doctor may direct you or your child to take laxatives, drink a lot of fluids, or increase the amount of fiber in your diet. Be sure to follow the directions carefully, because continuing constipation can lead to more serious problems.

Before you or your child have any medical tests, tell the medical doctor in charge that you are taking this medicine. The results of certain tests may be affected by this medicine.

Do not change your dose or suddenly stop using this medicine without first checking with your doctor. Your doctor may want you or your child to gradually reduce the amount you are using before stopping it completely. This may help prevent worsening of your condition and reduce the possibility of withdrawal symptoms, including stomach cramps, anxiety, fever, nausea, runny nose, sweating, tremors, or trouble with sleeping.

Using this medicine while you are pregnant may cause serious unwanted effects, including neonatal withdrawal syndrome in your newborn baby. Tell your doctor right away if your child has an abnormal sleep pattern, diarrhea, a high-pitched cry, irritability, shakiness or tremors, sneezing, weight loss, vomiting, yawning, or failure to gain weight. Check with your doctor right away if you think you are pregnant or if you plan to become pregnant while using this medicine.

Check with your doctor right away if you have anxiety, restlessness, a fast heartbeat, fever, sweating, muscle spasms, twitching, nausea, vomiting, diarrhea, or see or hear things that are not there. These may be symptoms of a serious condition called serotonin syndrome. Your risk may be higher if you also take certain other medicines that affect serotonin levels in your body.

Using too much of this medicine may cause infertility (unable to have children). Talk with your doctor before using this medicine if you plan to have children.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

What Are Reasons I Shouldn't Take Norco?

Before taking Norco, talk with your healthcare provider if the following applies to you:

  • Severe allergic reaction: If you have a severe allergic reaction to Norco or any of its components (ingredients), this medication isn't an ideal option for you.
  • Pregnant people: If you took Norco during pregnancy, your newborn baby might experience withdrawal side effects. Your healthcare provider can help you slowly stop the medication before your due date to prevent these side effects.
  • Nursing parents: While nursing, taking Norco is linked to negative effects for the nursing baby. To prevent side effects to your baby, your healthcare provider will limit the Norco dose and length of therapy. Your healthcare provider will also closely monitor your baby.
  • Children: There is limited safety and effectiveness information about Norco in children.
  • Older adults: Older adults tend to have a higher risk for side effects. Therefore, a lower starting Norco dose is typically recommended.
  • People with brain-related injury or conditions: Norco can further increase pressure in the brain for people with brain tumors or high brain pressure. Therefore, your healthcare provider will closely monitor for side effects. In people with a head injury or coma, on the other hand, opioids can cause side effects that are similar to the symptoms of these medical conditions. As a result, Norco isn't recommended for people with a head injury or coma.
  • People with digestive system problems: Norco isn't recommended if you have a blockage or narrowing of your stomach or intestines.
  • People with severe asthma: If you're experiencing severe asthma or an asthma attack, Norco isn't recommended without direct supervision from your healthcare provider.
  • Severely low breathing rate: Avoid Norco if you have a dangerously low breathing rate.

What Other Medications Interact With Norco?

Use caution when taking Norco with the following medications:

Medications that slow down movement in the digestive system: Medications—like Benadryl (diphenhydramine) for allergies or Ditropan XL (oxybutynin ER) for overactive bladder—can slow down movement in your digestive system. These medications raise the risk of side effects, such as constipation that can lead to blocking or narrowing of your stomach or intestines.

Central nervous system (CNS) depressants: The CNS includes your brain and spinal cord. Medications—like Ativan (lorazepam)—suppress (slow down) the CNS. Combining these medications with Norco raises the risk of side effects, such as low blood pressure, dangerously slow breathing rate, and coma.

CYP3A4 and CYP2D6 inhibitors: CYP3A4 and CYP2D6 are proteins in the liver that are responsible for breaking down and clearing out certain medications—like Norco. Some medications—like the erythromycin antibiotic—also block these proteins from working. As a result, there is a higher amount of Norco in the body that can raise your risk of side effects.

CYP3A4 inducers: Medications—like rifampin for tuberculosis or Dilantin (phenytoin) for seizures—can encourage CYP3A4 to quickly break down Norco. With less Norco in the body, Norco will be less effective at relieving pain. CYP3A4-inducing medications may also increase the risk of withdrawal symptoms.

Mixed agonist/antagonist and partial agonist opioids: Mixed agonist/antagonist and partial agonist opioids don't work exactly the same way as full agonist opioids, such as Norco. In fact, mixed agonist/antagonist and partial agonist opioids can slightly work against full opioid agonists. Therefore, combining mixed agonist/antagonist and partial agonist opioids—like buprenorphine—with Norco can cause withdrawal symptoms.

Serotonergic medications: Serotonergic medications raise the amount of a naturally occurring chemical called serotonin. Selective serotonin reuptake inhibitors (SSRIs)—like Zoloft (sertraline)—are examples of serotonergic medications. Combining these medications with Norco increases the likelihood of serotonin syndrome, which is a rare but life-threatening condition. Symptoms of serotonin syndrome may include seizures, tremors, sweating, and extremely slow breathing.

Monoamine oxidase inhibitors (MAOIs): Combining Norco with MAOIs—like selegiline for depression or Parkinson's disease—can raise your risk for serotonin syndrome.

Diuretics (water pills): Opioids—like Norco—can lower the effectiveness of water pills, which are usually used for hypertension (high blood pressure). If you are taking Norco and a water pill, your healthcare provider will closely monitor your blood pressure adjust the water pill dose as necessary.

This isn't a complete list of medication interactions with Norco. For more detailed information about drug interactions with Norco, talk with your pharmacist or healthcare provider.

What Medications Are Similar?

There are several opioids used to relieve pain. Norco is a scheduled II controlled prescription that contains an opioid and acetaminophen. Therefore, the following medications are most similar to Norco.

  • Apadaz (benzhydrocodone and acetaminophen)
  • Percocet (oxycodone and acetaminophen)

Apadaz contains benzhydrocodone, which is a prodrug. A prodrug isn't active until you take it. Once benzhydrocodone is taken by mouth, the body will convert it to hydrocodone. Although some people might consider Apadaz safer than Norco, this medication still has a risk for abuse. While the FDA did approve Apadaz to treat severe pain for 14 days, the FDA didn't classify it as an abuse-deterrent medication.

As for oxycodone, like hydrocodone, CYP3A4 and CYP2D6 are also responsible for breaking down this opioid. Both of these opioids are the most commonly prescribed pain relievers. These two medications are also linked to many opioid overdose deaths.

Some people might report better pain relief and fewer side effects with specific opioids. In general, however, there are no significant differences between the various opioids—in terms of effectiveness and side effects. Interestingly, people with cancer might notice differences in pain relief with various opioids. There is also growing evidence about interactions between deoxyribonucleic acid (DNA) and medications, which might help with guiding opioid therapy in people with cancer pain.

Since all of these combination pain relievers contain an opioid, they're also central nervous system (CNS) depressants that suppress (slow down) the CNS. Combining multiple CNS depressants can raise your risk of serious side effects.

While healthcare providers can prescribe more than one opioid for your symptoms, many will try to limit combining multiple opioids. If you have questions or concerns, reach out to your healthcare provider.

Frequently Asked Questions

  • Where is Norco available?

    Most local retail pharmacies carry the generic version of Norco. It's available as a prescription from your healthcare provider. Some states, however, may require that your healthcare provider use special paper for your Norco prescription.

  • Can I drink alcohol with Norco?

    Both alcohol and Norco are central nervous system (CNS) depressants that supress (slow down) the CNS. Mixing alcohol and Norco should be avoided due to a higher risk of severe side effects.

  • Can I develop an addiction to Norco?

    Norco does carry a risk of developing substance use disorder (SUD). Talk with your healthcare provider or get medical help right away if you notice changes in your appetite, behavior, mood, or vision.

How Can I Stay Healthy While Taking Norco?

Living with pain can be difficult. Work with your healthcare provider to establish goals that are reasonable and achievable. In addition to Norco or other pain relievers, your healthcare provider may suggest other potentially helpful strategies. The following are some possible recommendations:

Medical Disclaimer

Verywell Health's drug information is meant for educational purposes only and is not intended as a replacement for medical advice, diagnosis, or treatment from a healthcare provider. Consult your healthcare provider before taking any new medication(s). IBM Watson Micromedex provides some of the drug content, as indicated on the page.

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