Norco

( Hydrocodone-Acetaminophen )

Medically Reviewed by Harshi Dhingra, M.D.

Last Reviewed: Jun 27, 2022

Warnings

What are the risks of taking Norco (hydrocodone and acetaminophen)?

Norco can cause serious health problems, especially in certain high-risk patients. Some of the risks include:

Constipation: Norco can slow bowel movements and cause constipation. The risk is higher in people over age 65 and those taking other drugs that can cause constipation. You can reduce the risk of constipation by drinking plenty of water and eating a high-fiber diet. If the symptom persists, talk to your doctor or pharmacist about using a laxative like senna or docusate.
Drowsiness, dizziness, and confusion: Taking Norco can make you drowsy, dizzy, or confused. Do not drive or do anything that requires focus and attention until you know how this medication affects you. The risk of these side effects is higher in older people (age 65+). In addition, drinking alcohol can make drowsiness worse.
Liver failure: Norco contains acetaminophen, which can cause severe liver damage. The maximum daily dose of acetaminophen is 4 grams (4,000 mg). Norco preparations contain 325 mg of acetaminophen in each tablet. Acetaminophen is found in many over-the-counter pain relievers. Ensure you are not exceeding the total daily dose from all your combined medicines. The risk of liver damage is higher in people with existing liver disease and those who drink alcohol regularly.
Slowed breathing: High doses of Norco can lead to a slowing or even stopping of breathing, which can be fatal. The risk is higher in people over the age of 65, those on other drugs that affect breathing, and those on high doses of Norco.
Severe allergic reactions: You should stop taking Norco and call your doctor or get medical care immediately if you have signs and symptoms of an allergic reaction, including swelling of the throat or face, hives, itching, and vomiting.
Risks to newborn babies: Long-term use of Norco during pregnancy can cause serious and potentially life-threatening withdrawal symptoms in newborn babies. Tell your healthcare providers if you took Norco while pregnant. Your baby may need special medical care after birth.
Withdrawal symptoms: If you have taken Norco for several weeks or longer, especially at higher doses, you may experience withdrawal symptoms if you stop taking the medication suddenly. Your doctor will reduce the dose gradually.
Tolerance and dependence: Norco contains hydrocodone which is an opioid drug. It carries a high risk of tolerance (needing higher doses to get the same amount of pain relief) and dependence (addiction) even when used at prescribed doses. The risk is higher after long-term use of Norco and in people with a history of drug abuse. Talk to your healthcare provider or the pharmacist at your local pharmacy about the safe use of Norco.

If you are at a high risk of complications from Norco use, your doctor can help you find other pain medications.

What should I tell my doctor before starting Norco (hydrocodone and acetaminophen)?

Tell your healthcare provider if you are allergic to hydrocodone; acetaminophen; other opiate medications like oxycodone, morphine, codeine; any active or inactive ingredients in Norco preparations; or any other medication. Your local pharmacy can give you a list of ingredients.

Tell your doctor about all your medical conditions. Norco may not be suitable for people with certain medical conditions, such as liver disease and lung disease. Your doctor should know if you or anyone in your family has had a problem with alcohol abuse, recreational drug abuse, or misuse or abuse of prescription medications.

Give your doctor a complete list of your medications, including prescription drugs, over-the-counter medications, vitamins, dietary supplements, and natural products, especially St. John’s Wort and tryptophan. This can help avoid serious drug interactions.

Tell your doctor if you are pregnant, could be pregnant, plan to get pregnant, or are breastfeeding.

What precautions should I take while on Norco (hydrocodone and acetaminophen)?

Keep all appointments with your doctor while on Norco. Your doctor may want to see you often, especially at the start of treatment, to evaluate your response to the medication and adjust your dosage.

Norco can make you drowsy and/or dizzy. Do not drive, operate heavy machinery, or do anything that requires your complete attention before you know how this medicine affects you.

Drinking alcohol or using recreational drugs during treatment with hydrocodone products like Norco increases the risk of serious and potentially life-threatening side effects. Do not use recreational drugs or drink alcohol while on Norco treatment.

Tell your doctor if you become pregnant while on Norco. This medicine can cause serious problems in newborn babies if used during pregnancy.

Norco is a prescription drug intended for your use only. Do not allow anyone else to take your medicine. Hydrocodone can cause death in people who take this medication without a doctor’s supervision. This risk is especially high in children.

What are Norco (hydrocodone and acetaminophen) interactions?

Taking Norco with some other medications can affect how it works. Drug interactions can also increase the risk of serious adverse effects. Your physician may choose a different pain medication for you, change the dose or frequency of one or both medicines, and/or closely monitor you for side effects if there are known interactions between Norco and your other medications.

Tell your doctor if you are taking monoamine oxidase (MAO) inhibitors or have taken them within the past 2 weeks.

There can be interactions between Norco and medicines, such as:

Antidepressants
Antihistamines
Antipsychotics used to treat mental illness
Dextromethorphan (found in many cough medications)
Ipratropium (Atrovent) asthma medication
Cyclobenzaprine (Amrix)
Lithium (Lithobid)
Medications used to treat irritable bowel disease, ulcers, motion sickness, seizures, urinary problems, and Parkinson's disease
Medications used to treat migraine headaches

This list does not describe all possible Norco interactions. Other medications may also interact with hydrocodone combination products, so tell your doctor about all the medications you are taking, even those that do not appear on this list. Also, tell your healthcare provider if you drink alcohol or use recreational drugs because some of these substances can cause serious health complications when used with prescription drugs.

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