Vicodin vs. Norco: What's the Difference?

Medically reviewed by David Snyder, PharmD, BCPP

Norco and Vicodin are prescription medications composed of hydrocodone and acetaminophen, a nonopioid pain reliever, in different dosage forms. Although commonly known by their brand names, they are now only prescribed as generic versions.

Hydrocodone-acetaminophen is effective in managing moderate to severe pain. This medication comes in different dosage forms and strengths.

This article will explain the similarities and differences between the available dosage formulations of hydrocodone and acetaminophen, previously marketed under Vicodin or Norco.

What Are Vicodin and Norco?

Norco and Vicodin are prescription medications containing hydrocodone, an opioid analgesic, and acetaminophen, a nonopioid pain reliever. Vicodin and Norco were initially marketed as brand-name drugs but are now primarily prescribed as their generic versions (hydrocodone-acetaminophen) in varying dosage forms and strengths.

All formulations of hydrocodone and acetaminophen are used to manage moderate to severe pain, such as those caused by injuries, surgeries, or chronic conditions.

Vicodin vs. Norco: How Are They Different?

Hydrocodone-acetaminophen is a commonly prescribed pain medication. Dosage forms for this medication vary.

The generic version of Vicodin is typically available in tablet form, while Norco's generic is in both tablet and liquid forms.

Also, the hydrocodone-to-acetaminophen ratio differs between these formulations. Vicodin's formulation contains 5 milligrams (mg), 7.5 mg, or 10 mg of hydrocodone combined with 300 mg of acetaminophen.

Norco's formulation contains 5 mg, 7.5 mg, or 10 mg of hydrocodone combined with 325 mg of acetaminophen.

These formulations are prescribed based on certain factors and individual needs.

Side Effects

Hydrocodone-acetaminophen may cause the following side effects:

• Constipation

• Dizziness

• Nausea and vomiting

• Mood changes

• Anxiety

• Light-headedness

• Drowsiness

Safety Risks

Hydrocodone-acetaminophen carries boxed warnings for several safety risks. Boxed warnings are the strongest warnings issued by the Food and Drug Administration (FDA) for a prescription drug label.

This medication contains hydrocodone, an opioid analgesic considered habit-forming, and it may lead to addiction. It is important to let your healthcare provider know if you feel you are becoming dependent on the medication.

This risk is significant when this medication is misused or used without the supervision of a healthcare provider.

Additionally, because it contains an opioid, combining it with alcohol or sedatives may lead to overdosing. You should also not take it with any other opioid-containing medications.

Acetaminophen, the other active ingredient, can harm the liver if taken in high amounts. It is generally advised not to take more than 4,000 mg of acetaminophen daily. Be mindful of this when taking other acetaminophen products.

Drug Interactions

Hydrocodone-acetaminophen can interact with other medications, such as the following, which may lead to adverse effects or reduced effectiveness.

Central nervous system (CNS) depressants include:

• Sedatives, such as benzodiazepines

• Other opioids, such as oxycodone

• Alcohol

Monoamine oxidase inhibitors (MAOIs) include:

• Nardil (phenelzine)

• Parnate (tranylcypromine)

• Marplan (isocarboxazid)

• Emsam (selegiline) transdermal patch

Cytochrome P450 3A4 (CYP3A4) inhibitors include:

• Antifungal medications

• Human immunodeficiency virus (HIV) protease inhibitors, including Norvir (ritonavir)

• Certain antibiotics, such as erythromycin

Serotonergic drugs (drugs that increase the amount of serotonin in the body) include:

• Selective serotonin reuptake inhibitors (SSRIs), such as Prozac (fluoxetine), Lexapro (escitalopram), and Zoloft (sertraline)

• Serotonin-norepinephrine reuptake inhibitors (SNRIs), such as Cymbalta (duloxetine), Effexor (venlafaxine), and Pristiq (desvenlafaxine)
  

Warning

Excessive doses of hydrocodone-acetaminophen can increase the risk of heart attack or death. If you've taken too much hydrocodone-acetaminophen, immediately contact 911 and seek emergency medical help.

Summary

Vicodin and Norco are two brand-name medications that combine hydrocodone and acetaminophen for pain relief. Both medications have the same active ingredients but different dosage forms and strengths. Although often recognized by their brand names, Vicodin and Norco are now only available in their generic versions.

Vicodin and Norco carry potential side effects, interaction with other drugs, and risk of misuse. Talk to your healthcare provider about the specific dosage and administration guidelines for the formulation you've been prescribed.

Frequently Asked Questions

Can I use Norco or Vicodin while pregnant?

No. It is not recommended to take Norco or Vicodin during pregnancy. Opioid use can harm the fetus and lead to neonatal withdrawal symptoms.

Can I drink alcohol with Norco or Vicodin?

No. Taking Norco or Vicodin while drinking alcohol is not recommended, as it can cause severe side effects. Liver damage and respiratory depression are possible.

Can Vicodin or Norco have the risk of addiction?

Yes. Both medications have a high risk of addiction because they contain hydrocodone, an opioid that can be misused over a long period.

What is the recommended dosage for Vicodin and Norco?

The recommended dosage for Vicodin and Norco depends on factors such as the patient's pain score and response. It is recommended to seek advice from your healthcare provider.

Can I take Vicodin or Norco with other pain medications?

Maybe. Consult your healthcare provider to evaluate your situation before taking Vicodin or Norco with other pain medications. Certain combinations of pain medications can increase the risk of side effects such as respiratory depression and lead to severe interactions.

The author would like to recognize and thank Leen Alyaseen for contributing to this article.