Norco vs. Vicodin: What’s the Difference?

Norco and Vicodin are both hydrocodone-containing opioid pain relievers. Norco and Vicodin generics are similar and can lead to hydrocodone addiction and liver damage.

Norco and Vicodin are both brand names for two prescription opioids used to treat moderate to severe pain. Both medications contain hydrocodone, a prescription-only opioid, and acetaminophen (APAP), an over-the-counter pain medication most commonly known as Tylenol. These medications are no longer available under the brand names Norco and Vicodin. They are now dispensed only as generic drugs. The generic versions of these opioid pain medications may be referred to as hydrocodone and acetaminophen, hydrocodone/acetaminophen or hydrocodone/APAP.

What Is Hydrocodone Used For?

Hydrocodone, a prescription opioid, is one of the ingredients found in several prescription pain medications. It’s an ingredient in various medications used to treat:

• Severe acute pain (often after surgery or injury)
• Severe, long-lasting pain
• Cough

Hydrocodone is chemically similar to endorphins, our body’s natural painkillers released in response to pain or stress. It helps to relieve pain by changing how the brain and nervous system respond to pain. It also works to relieve cough by decreasing activity in the part of the brain that causes cough. 

Several prescription pain medications contain hydrocodone either as a single ingredient or in combination with other ingredients. Examples of pain medications that contain hydrocodone include:

• Hysingla
• Lorcet**
• Lortab**
• Norco*
• Vicodin*
• Zohydro

*Brand name versions of this drug have been discontinued, while generic forms still exist.
**Brand name and generic versions of this drug have been discontinued.

What Is Norco?

Norco was a prescription-only opioid pain medication that contained hydrocodone and acetaminophen. It is now only available as a generic medication, but it may still be prescribed by an authorized practitioner as “Norco.” Norco was available in four different strengths:

• Norco 2.5/325 tablet (hydrocodone 2.5 mg and acetaminophen 325 mg)
• Norco 5/325 tablet (hydrocodone 5 mg and acetaminophen 325 mg)
• Norco 7.5/325 tablet (hydrocodone 7.5 mg and acetaminophen 325 mg)
• Norco 10/325 tablet (hydrocodone 10 mg and acetaminophen 325 mg)

What Does Norco Look Like?

Norco generic equivalents are available in tablet form. The shape and size of the tablet can vary depending on the manufacturer and strength. Some available generic products may look like this:

• Norco 5/325 tablet (hydrocodone 5 mg and acetaminophen 325 mg)
  • White, oblong tablet with IP 109 imprinted on one side
  • White, round tablet with U01 imprinted on one side
  • White, oblong tablet with G035 imprinted on one side
  • Peach, oblong tablet with T257 imprinted on one side
• Norco 7.5/325 tablet (hydrocodone 7.5 mg and acetaminophen 325 mg)
  • White, oblong tablet with M366 imprinted on one side
  • White, oblong tablet with U02 imprinted on one side
  • White, oblong tablet with G036 imprinted on one side
  • Pink, oblong tablet with E112 imprinted on one side
• Norco 10/325 tablet (hydrocodone 10 mg and acetaminophen 325 mg)
  • Yellow, oblong tablet with 3601 imprinted on one side and V imprinted on one side
  • White, oblong tablet with IP110 imprinted on one side
  • White, oblong tablet with U03 imprinted on one side
  • White, oblong tablet with M367 imprinted on one side

What Is Vicodin?

Vicodin was a prescription-only opioid pain medication available under the trade names Vicodin, Vicodin ES and Vicodin HP. All three formulations contained hydrocodone and acetaminophen, but each ingredient’s amount was slightly different. When it was initially approved, each version of Vicodin had different amounts of hydrocodone and acetaminophen. On January 13, 2011, the FDA requested that all drug manufacturers limit the amount of acetaminophen in prescription drug products to no more than 325 mg per dosage unit. This was because high levels of acetaminophen can cause hepatotoxicity, or liver damage.

In May 2012, the brand manufacturer of Vicodin discontinued all previous versions of Vicodin, Vicodin ES and Vicodin HP. They later introduced a reformulated version that contained only 300 mg of acetaminophen per tablet with varying amounts of hydrocodone. These reformulated versions have been discontinued under their brand name; however, they may still be prescribed as “Vicodin.” They are currently available as a generic in the following strengths:

• Vicodin 5/300 mg tablet (hydrocodone 5 mg and acetaminophen 300 mg)
• Vicodin ES 7.5/300 mg tablet (hydrocodone 7.5 mg and acetaminophen 300 mg)
• Vicodin HP 10/300 mg tablet (hydrocodone 10 mg and acetaminophen 300 mg)

What Does Vicodin Look Like?

Vicodin generic equivalents are available in tablet form. The shape and size of the tablet can vary depending on the manufacturer and strength. Some available generic products may look like this:

• Vicodin 5/300 mg tablet (hydrocodone 5 mg and acetaminophen 300 mg)
  • White, oblong tablet with A41 imprinted on one side
  • White, oblong tablet with C114 imprinted on one side
  • White, oblong tablet with n351 imprinted on one side
• Vicodin ES 7.5/300 mg tablet (hydrocodone 7.5 mg and acetaminophen 300 mg)
  • White, oblong tablet with A42 imprinted on one side
  • White, oblong tablet with n352 imprinted on one side
  • White, oblong tablet with C115 imprinted on one side
• Vicodin HP 10/300 mg tablet (hydrocodone 10 mg and acetaminophen 300 mg)
  • White, oblong tablet with C116 imprinted on one side
  • White, oblong tablet with n353 imprinted on one side
  • White, oblong tablet with A43 imprinted on one side

Norco vs. Vicodin: Side Effects

Because Norco and Vicodin both contained hydrocodone and acetaminophen, they have the same side effects, which include:

• Constipation
• Drowsiness
• Lightheadedness
• Anxiety
• Mood changes (abnormally happy or sad)
• Dry throat
• Difficulty urinating
• Rash
• Itching
• Narrowing of the pupils in the eyes
• Clouded thinking

More severe side effects or signs of an overdose may include:

• Slow or irregular breathing
• Hallucinations (seeing things that are not there)
• Confusion
• Sweating or clammy skin
• Rapid heartbeat
• Shivering
• Nausea, vomiting or diarrhea
• Chest tightness
• Unable to respond or wake up

Most of the noticeable side effects from combination medications containing hydrocodone and acetaminophen are from the ingredient hydrocodone. However, acetaminophen can cause hepatotoxicity, or liver failure. The signs of liver failure can be much harder to see than other side effects from these medications. Signs of hepatotoxicity include:

• Fatigue (tiredness)
• Nausea
• Weakness
• Abdominal pain
• Itching
• Jaundice (yellowing of the skin)

Norco vs. Vicodin: Strength and Effectiveness

Norco and Vicodin generics are very similar in strength and effectiveness. The main difference in strength is the amount of acetaminophen in each tablet. Vicodin generics contain 300 mg of acetaminophen, and Norco generics contain 325 mg of acetaminophen. This is important for those who have liver disease, consume acetaminophen while drinking or take other acetaminophen-containing medications. It is very important to be careful how much acetaminophen is taken in a 24-hour period. The maximum recommended amount of acetaminophen each day is 4000 mg. Consuming more than this amount can lead to liver damage.

Since both Vicodin and Norco generics are available with similar amounts of hydrocodone, their effectiveness is similar. Studies have shown that hydrocodone and acetaminophen combination products effectively reduce pain. It is recommended to take the lowest dose possible for the shortest amount of time, depending on how severe the pain is and the person’s response to the pain medication. It is recommended that initial opioid prescriptions be limited to seven days or less so that pain levels can be reevaluated and treatment adjusted based on the person’s unique situation. Taking prescription opioid pain medications for an extended period of time may lead to drug tolerance, dependence or addiction.

Norco and Vicodin Addiction

In 2020, 9.5 million people aged 12 or older misused opioids (heroin and prescription pain relievers). Of these people, 9.3 million misused opioid prescription pain relievers. Opioid prescription pain relievers containing hydrocodone are included, such as Norco and Vicodin generics. Opioid misuse includes taking medication in a different way than prescribed, taking too much medication, taking someone else’s medication or taking medication to get high. Hydrocodone misuse can lead to hydrocodone addiction. 

Hydrocodone addiction involves using hydrocodone medications like Norco and Vicodin even when they cause significant distress or impairment in daily life. Anyone that takes hydrocodone-containing medications is at risk for addiction. Still, the risk of addiction increases with prolonged use or misuse of the medication. Signs of hydrocodone addiction include:

• Continued use despite worsening physical or psychological health
• Negative effects on relationships with friends, families and work
• Participating less in activities once enjoyed
• Difficulty completing duties at school or work
• Excessive time spent to get opioids or recover from taking them
• Taking more than intended
• Cravings
• Inability to decrease the amount used
• Tolerance, where the person needs a higher dose to feel the same effects
• Drug use even in a physically dangerous setting
• Withdrawal symptoms when stopping 

Fortunately, treatment is available for those suffering from a hydrocodone addiction. 

Hydrocodone Addiction Treatment

Hydrocodone addiction treatment can help people stop compulsive drug-seeking behavior and return to a healthy, productive life. Research has shown that individuals who remain in treatment over an extended period of time are able to stop using drugs, decrease their criminal activity and improve their mental health, relationships and work performance. 

It is important to explore all options available when choosing to begin hydrocodone addiction treatment. A medical professional can help determine the right treatment plan depending on the person’s needs. Several treatment programs are available, including:

• Medical detox
• Inpatient drug rehab
• Partial hospitalization programs (PHP)
• Intensive outpatient programs (IOP)
• Outpatient drug rehab
• Teletherapy or online drug rehab

At The Recovery Village Columbus, licensed addiction specialists will evaluate each person’s unique situation and develop a personalized treatment plan. With long-term healing in mind, patients are supported by their medical team through their hydrocodone detox to make it as safe and comfortable as possible. Following detox, therapists work with each patient to identify individual triggers and develop effective coping strategies to stay substance-free.

If you or someone you love is struggling with hydrocodone addiction in Ohio, The Recovery Village Columbus is here to help. Contact us today to learn more about hydrocodone addiction treatment programs that can help you on your road to recovery.