I have a question. I have been reading here and other forums. I keep reading doctors don't like to Rx Norco...which has less tylenol. Why would a doctor not prescribe a medication that had fewer bad effects? I was thinking of asking to be switched to Norco from Lortab 7.5...but now I am scared. I don't take many a day...usually one or two...at the most 4 in a 24 hr period. I am concerned about the amount of tylenol on my liver long term.
Any advice would be great.
Last edited by HappyFlower; 10-25-2007 at 10:39 PM.
you need not be worried......if you only take 4 per day then you are fine. Max dose of tylenol per day for an adult is 4 grams(4000mg) and your not near that. If the meds work then i would stay where you are.
the reason they like to prescribe narcotics that also have the full dose of tylenol in is so that you can't choose to take more without exceeding the safe dose of tylenol. if you had pills that only had whichever narcotic, and no tylenol, then you could (some people would, i'm not implying anything about you personally) take as much as you wanted, just to get high, without worrying about liver damage from the tylenol - this is what they're trying to avoid.
i understand your concern about having tylenol in your system long term, i had the same worries when my doctor told me i should be taking it four times a day along with my tramadol, but what you're taking now is definitely not enough to cause any damage, so try not to worry
i was taking the 7.5 lortab until i started pain management then he switched me to the 10/325 norco. if the reasoning behind not prescribing is so you won't take more, than that's silly. if someone is gonna abuse a medication, do you think they really care about the amount of acetaminophen they are taking? i can't handle the tylenol and ibuprophen in ES doses because of stomach issues so the norco works great for me. also with the norco and taking 4 a day that is only 1300 mg of acetaminophen which leaves me the option to take an additional ibuprophen here and there if need be. god bless, morgy porgy
Last edited by morgyporgy; 10-27-2007 at 05:12 AM.
Thanks, guys. I suppose that makes sense...but I agree with Morgy...anybody I've ever known that abuse ANY drug don't care about much of anything other than getting that drug into them.
I think I am just going to mention it and see what she says...no harm in asking. She can look at my chart and see I don't abuse. Don't the Norco come in a 7.5 strength as well? I can't take 10's...they knock me for a loop and bother my tummy.
They do come in 7.5/325. As I said that is what they started me on and then upped it to the 10's. You know it's weird but the norco with 325 mg's acetaminophen do not give me that euphoric loopy feeling but the lortab with the 500 mg's does. I think i read somewhere that the more acetaminophen in the pill the more you feel the effects. Seems to be true. (with me at least). Now i was given 5mg percocet for a pulled tooth about 4 yrs. ago and man i was out of it. I took 1 and then switched to tylenol LOL. I thank god that i have a high tolerance for pain but a low tolerance for medications. It will keep me from topping out on my meds too soon. I have been on the norco for over 2 yrs. now and it still pretty much handles my pain. I have really bad days where nothing helps but over-all i am satisfied with the relief i get from it. GL and god bless, morgy porgy
My PM doctor prescribes Norco 7.5/325 for me along with my other meds. The reason he prescribes Norco and not Vicodin is because of the lower APAP content. I like the fact that there is less APAP, and I have never once had any kind of euphoria, or loopines from the Norco. It helps in conjunction with my other meds, and is one of the few meds I've taken that didn't have to work through or wait for several weeks for the bothersome side effects to go away.
As always, though, different medications react differently with each person and different doctors have different plans for treating their patients. If you doctor already has you taking Vicodin, it might be worth asking about switching to the Norco because of the lower APAP content. I'd think it's worth bringing up if you are already on Vicodin.
Of course we all know that the ingredients in norco, vicodin, etc. are all the same.... hydrocodone and tylenol (apap). The variation is in the dose amount of each.
I have to somewhat disagree with the responders about the risks involved in taking tylenol daily, even in amounts below the dangerous levels. Several docs, including my pain management doctor have advised me of the potential liver and kidney damage of long term use of tylenol (apap component). The PM doc has me on compounded hydrocodone which removes the tylenol component altogether. He informed me that long term (more than a few months is what I understood) use of tylenol on a daily basis would "shred the liver" and damage the kidneys. I have read several articles saying the same thing. So, it would depend on how long you will be taking this product.
For pain I take 30 mg of compounded hydrocodone x 3 daily. A little pricey, but essential as I have been on it for several years. I have a 10/325 norco available for breakthrough pain. By the way norco 10/325 comes in a generic, which costs me just a few dollars a month. My suggestion is if you will be on opiate pain med for over 3 months or so, try and get the lowest possible tylenol component....generic norco 10/325, and break them in half for equivalent of 5/162.5. If necessary you can always supplement with ibuprofen to aid in pain relief as needed.
Thanks and interesting. Let me ask you a couple of questions...
Is there a greater risk of dependence with the compound? Do you apply it to the wrist as you do phenegren compound? what are the major differences in the way the compound and the pill form work? Do yo get enough relief?
Whew....many questions. But I do find the idea of a compound interesting. If doctors know this stuff exists...you would think they would want to give their patients the least amount of tylenol possible....I can understand the concern wiht abuse...but if a patient shows no signs of over medicating, then what is the big deal?
Good questions.... 1) There is the same risk of dependence with the compound. 2) The compounded hydrocodone is not prepared as a salve, but rather in capsule form; so it is taken orally every 8 hours.
There are two primary advantages of the compounded hydrocodone over norco, vicodin, etc. and one disadvantage. Advantages: No tylenol component so less potential damage to liver and kidneys. Secondly, it last longer, 8 hours, so you have more constant and consistent pain relief over a longer period of time. With a four hour norco for instance, the relief level peaks as the med gets in your system then quickly drops off. With an 8 hour med such as compounded hydrocodone (or a longer lasting extended release) it reaches it peak blood concentration level and stays at that level for about six hours, plus or minus, then begins to gradually decrease until the next dose is taken. Bottom line, more consistent pain relief for longer period of time, with less peaks and valleys in relief. Remember, this med is for chronic pain patients who have to taken pain meds around the clock. It is not a "take as needed" type medicine. I spent a couple of years on the short acting meds before moving to around the clock pain meds. Many GP docs will not be familiar with compounding, while pain mgmt.l docs will. Disadvantage: Cost. A 30 day supply of 90 capsuls of 30 mg costs about $150 a month before insurance. It really depends on how well your insurance pays on this med. I can tell you that it is in a more restrictive narcotic class as it does not contain apap, so the Rx script has to be picked up and hand delivered to the pharmacy .... no faxing, no refills, etc. Somewhat of a pain (however my pharmacy picks the script up for me and delivers to my home), but worth saving my liver and kidneys, which is a real risk. If I recall correctly, the caution on a bottle of regular tylenol tells you not to take it more than two weeks. There is a good reason for this warning.
Concerning the APAP component of Norco, I still remember the shock of the revelation that my doctor had given me, deliberately, a medication that if I tried to increase my pain relief, I would poison myself. This was the beginning of the end of my naivete about chronic pain and it's treatment, and I began to understand many things which did not make sense from a strictly logical point of view.