Norco
® (
hydrocodone/APAP) is a prescription pain medication. It is a narcotic and is classified as a controlled substance, which means that special laws and regulations control its sale and use. It is approved to treat moderate to moderately severe pain.
Compared to most
hydrocodone/APAP pain relievers, Norco contains less
acetaminophen, making it useful for people who need to take more hydrocodone without more acetaminophen. Although it may seem counterintuitive, because the tablets contain less acetaminophen, they are "stronger" than most other hydrocodone/APAP products. The maximum daily dose of such products is limited by the acetaminophen content, and having less acetaminophen per tablet allows for a higher daily dosage of hydrocodone without exceeding the maximum
acetaminophen dosage.
Norco is made by Watson Pharmaceuticals, Inc.
Hydrocodone, the narcotic component of Norco, is a commonly abused drug. Norco is readily available and relatively inexpensive, especially in generic form, and may be especially desirable as a drug of abuse (due to its low acetaminophen content).
It is important to distinguish between actual abuse of the drug and a physical dependence on the drug. Healthcare providers can have difficulty distinguishing behaviors associated with inadequate pain control from drug-seeking behaviors associated with abuse. Because Norco is a highly desired drug of abuse, people often obtain it through illegal means, such as from foreign countries or online sources that do not require a prescription. People who abuse Norco and suddenly stop using it are likely to experience withdrawal symptoms.
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Norco contains two different medications:
hydrocodone bitartrate and
acetaminophen.
Hydrocodone is a semi-synthetic narcotic, opioid pain reliever. It acts similarly to codeine. Hydrocodone is effective at decreasing pain and relieving coughing, but also causes drowsiness, mood changes, and mental "clouding." In the United States, hydrocodone is only available in combination with other medications; it is not available alone.
Acetaminophen ("APAP") is a pain reliever and fever reducer commonly found in non-prescription medications such as
Tylenol®. "APAP" is an acronym for one of the chemical names for acetaminophen. Combining hydrocodone with acetaminophen helps improve Norco's effectiveness at relieving pain and may limit the abuse potential of hydrocodone, as the maximum dose of Norco is usually limited by the acetaminophen content.
When and How to Take Norco
General considerations for when and how to take Norco include the following:
- The medication comes in tablet form. It is taken by mouth, usually every four to six hours as needed for pain.
- Be careful not to exceed the maximum recommended daily dose, as this could lead to overdose symptoms or to poisoning from the acetaminophen component, which can cause liver failure.
- Norco is either taken "as needed" or on a scheduled basis. "As needed" means you will only take a dose if you are experiencing pain (if you are not in pain, you will skip the dose), while "scheduled use" means you should take it on schedule, even if you are not in pain. Most healthcare providers prescribe it on an "as needed" basis, rather than a scheduled basis.
- It is best to take it with food, as this may help reduce stomach upset.
- For the medication to work properly, it must be taken as prescribed. Do not increase your dose without your healthcare provider's approval. Do not suddenly stop taking it, especially if you have taken it regularly for more than several weeks (see Norco Withdrawal).
The dose that your healthcare provider recommends will vary, depending on a number of factors, including:
- How you respond to Norco
- Whether you are accustomed to taking narcotic pain relievers
- Other medications you are taking
- Other medical conditions you may have.
As is always the case, do not adjust your dose unless your healthcare provider specifically instructs you to do so.
As with any medicine, Norco can cause side effects. However, not everyone who takes the drug will experience side effects. Most people tolerate it quite well. If side effects do occur, in most cases, they are minor and either require no treatment or can easily be treated by you or your healthcare provider. Serious side effects are less common.
Common side effects include, but are not limited to:
(Click Norco Side Effects to learn more, including potentially serious side effects that you should report immediately to your healthcare provider.)
Drug Interactions With Norco
What Should I Tell My Healthcare Provider?
You should talk with your healthcare provider prior to taking Norco if you have:
- Liver disease, such as cirrhosis, liver failure, or hepatitis
- Kidney disease, such as kidney failure (renal failure)
- A head injury or high intracranial pressure
- Severe abdominal (stomach) pain
- Hypothyroidism
- Addison's disease
- An enlarged prostate (benign prostatic hypertrophy or BPH)
- Lung disease of any sort
- A history of drug or alcohol dependence
- Any allergies, including allergies to foods, dyes, or preservatives.
Also, let your healthcare provider know if you are:
Make sure to tell your healthcare provider about any other medications you are taking, including prescription and non-prescription medicines, vitamins, and herbal supplements.
What If I Take an Overdose?
People who take too much Norco may have overdose symptoms that could include:
- Difficulty breathing
- Extreme drowsiness, leading to coma
- Cold, clammy skin
- A slow heart rate (bradycardia)
- Low blood pressure (hypotension)
- Cardiac arrest
- Nausea and vomiting
- Sweating
- Liver failure
- Death.
If you happen to overdose on Norco, seek immediate medical attention.
Norco tablets should be stored at room temperature, away from moisture and heat. Keep Norco and all other medications out of the reach of children. Because Norco is a highly desired drug of abuse, make sure to keep it in a safe place.
What Should I Do If I Miss a Dose?
Norco is often prescribed "as needed," which means you do not need to take a dose if you do not feel pain. If you forget to take a dose of Norco and notice significant pain, take your missed dose right away. However, make sure to wait the recommended time before the next dose.
Norco tablets are available in the following strengths:
Several different generic versions of Norco are available
(see Generic Norco).
