Norco (Acetaminophen/Hydrocodone)

What Is Norco (Acetaminophen/Hydrocodone)?

Norco is a brand name for the combination prescription drug acetaminophen/hydrocodone. It’s used to treat moderate to severe pain.
Vicodin, Lorcet, and Lortab are other brand names for this combination, which is also available as a generic.
Hydrocodone is a narcotic, while acetaminophen is a mild painkiller. Combined, they belong to a class of drugs called opioid analgesics, which work by blocking certain nerve cell receptors in the brain.
Manufactured by Watson Pharmaceuticals, now Actavis Inc., Norco was first approved by the Food and Drug Administration in 1997.
Doctors have prescribed acetaminophen/hydrocodone "off label" for coughs and insomnia.

Norco Warnings

As with all prescription drugs that contain acetaminophen, the FDA requires that the labels carry a "black box" warning highlighting the potential for severe liver damage, and another warning about the potential for allergic reactions.
Before taking Norcol, it's important to tell your doctor about any allergies you have, not only to hydrocodone and acetaminophen, but to other narcotics, such as morphine or codeine, and whether you have liver or kidney disease.
Since hydrocodone can slow or stop your breathing, your doctor also needs to know about any brain disorders or head injuries, asthma, chronic disruptive pulmonary disease, sleep apnea, or seizures. Like any narcotic painkiller, hydrocodone can become addictive.
You should be candid with your doctor if you've had a personal history of drug or alcohol abuse.

Pregnancy and Norco

Norco is in FDA Pregnancy Category C, meaning that it’s unknown if Norco can harm a developing fetus because no adequate and well-controlled studies have been carried out in pregnant women.
However, it could cause shallow breathing and symptoms of physical dependency and withdrawal in a newborn, and is therefore not recommended during pregnancy.
Since acetaminophen and hydrocodone are excreted in breast milk, it's best not to breastfeed while taking Norco.

The 'Norco High' and Abuse

Hydrocodone, the narcotic component of Norco, makes it ripe for abuse, especially since it's easily available as a generic and is not an expensive drug. The drug can give users a feeling of euphoria that lasts several hours.
Abuse of any narcotic drug, including Norco, can result in addiction, overdose, or death, especially in a child or other person using the drug without a prescription.

Norco Withdrawal

Going cold turkey, or stopping the drug abruptly after developing a dependency on it, will likely bring on withdrawal symptoms. These usually include sweating, a runny nose, watery eyes, goose bumps, nausea, vomiting, diarrhea, restlessness, and agitation.

Norco (Acetaminophen/Hydrocodone) Side Effects

Common Side Effects of Norco:

  • Drowsiness
  • Dizziness
  • Nausea, vomiting
  • Constipation
Lying down can lessen the side effects of Norco. Tell your doctor if they continue or get worse.

Serious Side Effects

  • Difficulty breathing, hives, swelling of the face, lips, tongue or throat (these are signs of an allergic reaction)
  • Decreased breathing, slow heartbeat
  • Lightheadedness
  • Confusion, unusual thoughts
  • Convulsions
  • Feeling anxious, fearful, or depressed; mood swings
  • Difficulty urinating
  • Upper abdominal pain, itching, little appetite, dark urine, clay-colored stools, jaundice
  • Skin redness or rash that causes blistering and peeling (a rare but potentially fatal reaction to the acetaminophen in Norco)
Get medical help at once if you experience any of these serious side effects.

Norco (Acetaminophen/Hydrocodone) Interactions

Always tell you doctor about all other drugs you are taking whether they're prescription or non-prescription, legal, illegal, or recreational — including herbal remedies and nutritional or dietary supplements — as they might interact with acetaminophen/hydrocodone.

Norco and Alcohol

Avoid drinking alcohol when taking Norco, as adding alcohol to acetaminophen can increase the risk of liver damage.
Alcohol can also intensify the dizziness and drowsiness that can accompany the drug.
You should not drive or operate heavy machinery while taking acetaminophen/hydrocodone.

Norco and Drug Interactions

Taking Norco with other narcotic painkillers, or other drugs that make you drowsy and slow down breathing, can be dangerous, even life-threatening.
Don't take antihistamines, muscle relaxers, anti-anxiety, anti-seizure medications, or antidepressants while taking Norco without first checking with your doctor — the dose of one or both drugs might need to be reduced.
Norco can interact dangerously with the following:
  • Monoamine oxidase inhibitors (MAOIs), including isocarboxazid, linezolid, phenelzine, rasagiline, selegine, tranylcypromine, or tricyclic antidepressants
  • Pentazocine, nalbuphine, butorphanol
  • Ketoconazole, narcotic antagonists, such as naltrexone
Remember that acetaminophen is a common ingredient in other over-the-counter painkillers. It's important to read the labels to make sure you're not taking another drug that contains acetaminophen (often written as APAP), which could be dangerous.

Norco and Food

Norco can be taken with or without food, but taking it with food might deter nausea.

Norco (Acetaminophen/Hydrocodone) Dosage

Acetaminophen/hydrocodone is sold as tablets and is available in three strengths:
  • 5 milligrams of hydrocodone, 325 mg of acetaminophen
  • 7.5 mg of hydrocodone, 325 mg of acetaminophen
  • 10 mg of hydrocodone, 325 acetaminophen
Under the brand name Norco, acetaminophen/hydrocodone comes in two strengths:
  • 7.5 mg hydrocodone, 325 mg acetaminophen
  • 10 mg hydrocodone, 325 mg acetaminophen
The dosage for acetaminophen/hydrocodone, regardless of the strength, is usually one tablet at four- to six-hour intervals, or as needed for pain. You should not take more than six tablets in one day.
If the drug doesn't seem to be working or has stopped working, talk to your doctor. Do not increase the dosage.
Norco should be prescribed cautiously to older people, as it is more likely to cause breathing problems in that population. Older people are also more apt to develop liver and kidney problems as a result of taking acetaminophen/hydrocodone.
There have been no studies on how Norco might affect children. It is usually prescribed only for adults.

Norco Overdose

An overdose of acetaminophen/hydrocodone can be fatal. If you think you’ve taken too much, seek medical attention or call a poison control center immediately.
Slow breathing, extreme sleepiness that progresses to stupor or coma, muscle flaccidity, cold or damp skin, slow heart rate, and extremely low blood pressure signal an overdose of hydrocodone.
Loss of appetite, nausea, vomiting, stomach pain, dark urine, and jaundice signal an acetaminophen overdose.

Missed Dose of Norco

If you are taking this drug on a regular schedule, take the forgotten dose as soon as you remember, but skip it if it is close to the time of your next dose. Never double up on doses.
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Norco Pictures

Acetaminophen-Hydrocodone 325 mg-10 mg-QUA, yellow, oval,
Hydrocodone-APAP 5mg-325mg-MAL, white, oblong,
Acetaminophen-Hydrocodone 325 mg-10 mg-WAT, yellow, oblong,
Acetaminophen-Hydrocodone 325 mg-5 mg-WAT, white/orange specks, oblong,

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