Key Points
- Lortab and Norco are brand names of the drug hydrocodone acetaminophen.
- Both Lortab and Norco, along with all other brand names of this medication, have been discontinued.
- The generic form, hydrocodone acetaminophen, is still prescribed for moderate to severe pain.
- When prescribed, hydrocodone acetaminophen should be taken at the lowest possible dose for the shortest possible duration for pain relief.
- Hydrocodone acetaminophen is a schedule II controlled substance that carries a high risk of abuse, addiction, and physical dependence.
- There are many serious side effects and harmful drug interactions associated with hydrocodone acetaminophen.
- People who take hydrocodone acetaminophen may develop a serious substance use disorder known as opioid use disorder (OUD).
- People with OUD are at risk of a potentially fatal opioid overdose.
- If a loved one is showing signs of an overdose or is unresponsive, call 911 immediately.
- Effective treatments for opioid use disorder are available, including several medications as well as mental and behavioral health services.
Lortab and Norco are very similar drugs. They both contain the active ingredients acetaminophen and hydrocodone. Since hydrocodone is an opioid pain reliever, both Lortab and Norco are considered Schedule II controlled substances that have a high risk for addiction and abuse.
What Is Hydrocodone-Acetaminophen?
Some brand names of hydrocodone-acetaminophen, such as Lortab and Norco, are less commonly used or no longer widely marketed, but not all have been formally discontinued. Hydrocodone-acetaminophen is part of a class of drugs known as narcotic analgesics. It is available in both tablet and oral solution formulations.
Hydrocodone-acetaminophen works by blocking pain signals to the brain. This drug is FDA-approved and commonly prescribed to treat moderate to severe pain. [1] Because it has the potential to be habit-forming, doctors usually prescribe it as a last resort when other prescription medications have failed to reduce pain.
Hydrocodone Acetaminophen Dosage
Because of the high potential for abuse, clinicians are advised to prescribe hydrocodone acetaminophen at the lowest possible dose for the shortest period for it to be effective. A starting dose is typically 2.5 mg hydrocodone and 325 mg acetaminophen to be taken every four to six hours as necessary. [2] The maximum recommended dose is usually not to exceed 8 tablets (containing 325 mg acetaminophen each) per 24 hours due to the risk of acetaminophen toxicity.
People who are prescribed hydrocodone acetaminophen for pain should exercise extreme caution when taking this drug because it risks adverse effects, including respiratory depression, addiction, and overdose. Hydrocodone acetaminophen should be taken exactly as prescribed by a doctor. The dosage should never be increased without first consulting your healthcare provider, even if it doesn’t seem to be working. If you have a desire to take more of this drug than prescribed, tell your doctor immediately, as this is a risk factor for addiction and physical dependence.
Side Effects of Hydrocodone-Acetaminophen
Like other prescription medications, hydrocodone-acetaminophen is linked to both mild and severe side effects.
Mild Side Effects
When taking this medication, you may experience mild side effects, including: [3]
- Nausea
- Headache
- Insomnia
- Dry mouth
- Dizziness
- Drowsiness
- Constipation
- Vomiting
Serious Side Effects
If you experience any of these severe side effects of hydrocodone acetaminophen, contact your healthcare provider or seek emergency medical care right away: [4]
- Skin rash
- Swelling of the face, tongue, or throat
- Shortness of breath
- Trouble staying awake; extreme sedation
- Unusual weakness or fatigue
- Right upper belly pain
- Yellowing skin or eyes
- Low blood pressure
Hydrocodone Acetaminophen Drug Interactions
There is a long list of medications that could have harmful interactions with hydrocodone acetaminophen. Always tell your doctor about any other medications you’re taking before starting a new one. Possible drug interactions associated with hydrocodone acetaminophen include: [5]
- Other narcotic medications like oxycodone or codeine
- Alcohol
- Some allergy medications
- Some sleep medications
- Some anxiety medications
- Local anesthetics
- Antihistamines
- Some antibiotics
- Antiviral medications
- Ipratropium
- Some Parkinson’s medications
- Certain medications for stomach issues
- Certain medications for depression
- Some medications for seizures
- Certain medications for bladder issues
- Some medications for fungal infections
Signs of Hydrocodone Acetaminophen Addiction
Hydrocodone acetaminophen contains the opioid hydrocodone, which carries a high risk of addiction. People who are prescribed this medication should take it only as advised by their doctor. You should never take someone else’s prescription painkillers or any other prescription medication. Don’t use hydrocodone for purposes other than chronic pain. Signs of hydrocodone-acetaminophen addiction may include: [6]
- Intense cravings for the drug
- Spending a lot of time obtaining, using, or recovering from hydrocodone acetaminophen use
- Dangerous or risky behavior while using the drug
- Dropping other social or work-related activities to use hydrocodone acetaminophen
- Needing more of the drug to achieve the same effects
- Taking more hydrocodone acetaminophen than you meant to, or for longer periods of time
- Unsuccessful attempts to stop using or limit use of the drug
- Experiencing withdrawal symptoms when not using hydrocodone acetaminophen
Hydrocodone Acetaminophen Withdrawal
Experiencing withdrawal symptoms when you stop using opioid medications like hydrocodone acetaminophen is a sign that you’ve developed a physical dependence on the drug. Signs of withdrawal include: [7]
- Intense cravings for the drug
- Insomnia
- Excessive sweating
- Diarrhea
- Anxiety
- Increased heart rate
- Increased blood pressure
- Nausea
- Vomiting
- Dilated pupils
- Chills
- Fever
- Crying
Signs of Hydrocodone-Acetaminophen Overdose
An addiction or physical dependence on hydrocodone acetaminophen may increase the chance of a life-threatening opioid overdose. If you or a loved one is showing signs of an opioid use disorder, it’s important to know the warning signs of an overdose so you can call for emergency assistance if needed. Signs of a hydrocodone acetaminophen overdose include: [8]
- Extreme weakness
- Limp arms or legs
- Pinpoint pupils
- Snoring or gurgling
- Unresponsiveness
- Cold, clammy skin
- Blue-colored lips or fingernails
- Vomiting
- Slow breathing
- Slow heart rate
If a loved one is experiencing any of the above symptoms after taking hydrocodone acetaminophen or any other opioid drugs, administer Naloxone if you have it and call 911. These are signs of a life-threatening emergency.
Who should not use hydrocodone acetaminophen?
Hydrocodone acetaminophen carries a high potential for abuse, addiction, and dependence, but it can be used safely under strict medical supervision. Someone with a history of substance use should avoid this opioid drug, though anyone can become addicted.
Hydrocodone Acetaminophen Overdose Risk Factors
Certain risk factors can make you more prone to overdosing on an opioid analgesic like hydrocodone acetaminophen, including: [9]
- Taking high doses of hydrocodone and acetaminophen
- Mixing this drug with other opioids, sedatives, or benzodiazepines
- Mixing hydrocodone acetaminophen with alcohol
- Combining this drug with stimulant drugs such as amphetamines
- Being over the age of 65
- Having certain medical conditions like HIV, liver disease, sleep apnea, or lung disease
- Injecting this medication
- Stopping use and then starting again
- A previous overdose
Opioid Use Disorder Treatment
Opioid use disorder can be frightening, but you’re not alone. Treatment for opioid use disorder is available. Several medications have been approved by the Food and Drug Administration to treat this condition, including: [10]
- Buprenorphine
- Naltrexone
- Methadone
Medication-assisted treatment of opioid use disorder has been linked to better outcomes, including a reduction in the number of opioid overdoses. Mental and behavioral health services are also recommended for individuals with an opioid addiction. A comprehensive treatment plan for opioid use disorder could include several different treatments and services, depending on the provider. Some of these OUD services may include:
- Medical opioid detoxification
- Inpatient rehabilitation services
- Intensive outpatient services
- Mental health services
- Cognitive behavioral therapy (CBT)
- Eye movement desensitization and reprocessing therapy (EMDR)
- Residential services
- Aftercare services
- Relapse prevention services
Find A Treatment Center
If you or a loved one becomes addicted to hydrocodone acetaminophen, it’s not recommended to try to discontinue use on your own. Experts advise finding a treatment center or contacting a physician for medical detoxification services. Opioid use disorder is treatable, but it isn’t something you should have to face alone.