Discussions that mention norco

Pain Management board


Hey everyone, As you may know, I have been anticipating med changes and will finally be getting them in a couple of weeks. Here's the question(s) that I have.........

My oxycontin is being increased from 20mg 3x/day to 30mg/a.m., 20mg/mid-day and 30mg/bedtime. The question I have is for anyone who takes this type of split dose. How does your doc Rx this? We figured that he will have to write for 8 10mg tabs per day, so that he is not writing 2 scripts for the same med each month. This way I will take 3 in the morning, 2 mid-day and 3 at bedtime. Is this an effective/ineffective way to take a time released med?

Also, he is changing my BT med from Vicodin 7.5/500 up to 6/day to Norco 10/325, up to 4/day. I am wondering if anyone knows if Norco has any different advantages/disadvantages from Vicodin, even though they are both Hydrocodone?

Thanks in advance for any advice/info. Ever grateful, CMP/MM
Hey CMP, I take oxy 10mgs morning and afternoon and oxy 20mgs at night. My dr rxs it as two 10mgs scripts and one 20mgs script each 20 days - does this make sense? It is better pharmacologically to only take one tablet rather than three, even if only for your stomach lining but isn't always possible. Your dr sounds pretty awesome so I imagine he'll have a handle on it.
I can't comment on the vicodin or norco as we have short acting oxy instead - endone 5mg tabs for bt. May I ask though, isn't norco less strong than vicodin? If that's the case and you're experiencing nerve pain, will this be strong enough to give you relief if you have bad nerve pain bt? My pain is nerve pain and although I don't often have flare ups (just a very high level of daily pain), when I do, not much covers it.
I really hope that this med change will help. Good luck CMP and please let us know how you go.
cmpgirl,

Hey there!

I take 30mgs of morphine sulphate 3x a day so I can't help you on that one.

The Norco just has more of the narcotic in it and less of the acetomenophen or whatever the other ingredient is.
so Norco 10/325 is 10=the narcotic part and the 325 is the other acetomenaphen or tylenol...I forget what the other half is. I bet Conductor or Ex would know more abou that.

I have a hard time taking the Vicodin or Norco. really reaks havoc on my digestive system.
I am not really sure there is any advantage or disadvantage to taking them . I think it depends on what will work out the best for you.

I hope this appointment will end of giving you better pain control.

Chrissy
Finally one question I can answer with some experience for you :)

Norco is better than Vicodin 7.5 because as Chrissy mentions there is less tylenol. I actually liked the Norco when I was taking it for endo as it really helped with pain levels. I did receive generic and they were fine compared to generic percocet.

Norco and Vicodin are the same - instead of 750 mg of tylenol you'll be taking only 325 mg of tylenol for breakthrough - better for the liver.

I used to take Vicodin HP and it was my pharmacist who suggested (quietly) to ask for a change to Norco as the HP has 650 mg of tylenol and if you're taking it daily it was his view to keep tylenol under 2000 mg daily though you can safely take up for 4000 mg per the literature that came with the meds.

Good luck with the switch. You do have an awesome doctor it seems.

You sound like you're really hurting and I'm sending you huge hugs. Sorry about missing your daughter - I'll have to remember this when my little one drives me batty ;)
T
Thanks everyone!

Juliet and Round1: I think there might be a problem with my insurance. Here in the states, you even have to get a special authorization from the insurance companies to get Oxycontin 3x/day, instead of 2x. So I don't know if they will allow 2 different scripts for the same exact med in one month. I have a feeling, as does my doc, that the computers would kick this out as not covered. Hence, multiple 10mg tabs, taken 2 or 3 at a time.

Chrissy and T: I am aware of the reduced APAP, but because both Vicodin and Norco are hydrocodone, I was wondering if there was some difference in the way one version of hydro behaves vs. the other. In other words, are there other active ingredients in the Norco, that make it better or worse than Vicodin?

Pepper: Do you notice any immediate difference when taking 2 or 3 10mg. tabs vs. taking one 20mg or 30mg tab at a time? Do they release differently? Or have you always taken them this way?

Juliet: I have severe muscle and joint pain along with the nerve pain, so the opiates/opioids are more helpful with these types of pain. The nerve pain, while not new to me, seems to be increasing. I am hoping he can find something other than the "usual" meds prescribed for nerve pain, because I have taken most of them in the past with little or no pain relief, and a host of nasty side effects.

Round1: I take prescription Nexium for my stomach. I have had issues since way back when I was taking massive doses of anti-inflams. They ruined my stomach, but the Nexium really helps. I'm still pretty careful about taking Ibuprofen or the like. Don't want to tempt fate!

For someone who has had CP for so many years, you'd think I would know a little more about the meds, but I've been on most of the meds I take now, for quite some time. I guess I've been really lucky that they have worked so well for so long. Thank you all again. I always know I can count on all of my friends here. God Bless, CMP/MM
Hi CMP/MM,

Took me long enough to post, eh?

In fact, waiting was good because you've already been given outstanding advice and guidance.

Here's some thoughts from my experience:

- The tylenol in these mixed tabs like with hydrocodone does help to make the hydro an even better pain reliever. So many studies have supported this and it's one of many reasons why they are mixed together. So you have a trade-off. Less tylenol is always better for the liver, IF you are chronically taking an amount close to whatever is the truly appropriate ceiling for chronic consumption. I hear so many opinions about how much tylenol is safe. Of course, the basic ceiling is 4 grams, or 4,000mg per day. Taken chronically, some advocate as low as 2,000mg daily. I imagine the true safe ceiling is somewhere between 2,000 and 4,000mg daily. You be the judge. Anyone consuming tylenol chronically s/b getting liver function tests regularly anyway.

- As already written, Vicodin and Norco and their various generic brands are all hydrocodone and tylenol. None is better than the other and hydrocodone has only one correct chemical makeup. As we have learned from Ex, the generics have a wide margin as far as amounts of the hydro allowed in each tablet, so choose wisely.

- About the scripting of OxyContin. Here in the US docs can and do script for different tablet amounts in the same monthly regimen, as others have explained. I find that by getting the lowest tablet size you are left with lots of wiggle room if the doc allows. If you are scripted 10mg tabs, and the doc leaves it to you to decide how best to take them, then you can adjust amounts as often as you like in order to find the most optimal dosing strategy. I am prescribed MS Contin. My doc prescribes 2-3 tablets every eight hours. In the beginning, when I was transitioned off of the methadone, I was allowed 2 tabs every eight hours, but the doc wrote for 2-3 tabs every eight hours. That method meant that my monthly amount was only 180 tablets out of an allowable 270. As we titrated upward it then went to 3 tabs in the AM, 3 tabs in the midday and 2 tabs at night. Finally, last month he switched it to 3 tablets every 8 hours, so now I get the full 270 tablets per month allowed according to his instructions. And, he allows me to shuffle amounts within the max number of tablets allowed daily. He could have written for a higher tablet content and I'd be taking less total tablets daily, but that eliminates the flexibility he's allowed, and he'd have to write for two different strengths monthly, which he doesn't want to do unless he must.

- As far as the literature goes, one 20mg tablet has the same amount of drug as two 10mg tablets. I've never heard of this failing to be true. As far as how much is released and bioavailability factors in, there s/b no difference between one 20mg tab and two 10mg tabs.

WOW. That's alot of words to say "your doc seems to have it right." Sorry about that. I get wordy when I'm in pain. I guess it's distracting. I need lots and lots of distraction this week.

I'm really hoping you get the relief you deserve when you get to this upgrade in dose. It's been too long IMHO.

steve
Thanks everyone. It's really good to know that people have had good luck with both dispensing applications. I think I like the flexibility of having multiple 10mg. tabs vs. 60 tabs of one dose and 30 of the other. My PM doc has always been fine with me tailoring my meds to fit my daily schedule or needs, so this seems to be the best route.

I am hoping the 10mg Norco will give a better "punch" when BT are needed. Even though my liver has been fine, so far, I still worry because of the length of time I have been taking a med with APAP. My mom passed due to a fluke GI bleed, and even though they weren't 100% sure, the docs believed it was likely a result of some of the meds she took for years. You just never know how a particular drug will affect your body.

I so appreciate everyone's input and of course support. You are all my shining stars! I'll keep you posted as I go along. Many, many hugs, CMP/MM

Steve: You're apologizing to me for being wordy??? I have been cursed with verbosity my whole life! As I've said, I am 100% Irish and didn't dare kiss the Blarney Stone when I was in Ireland, for fear of cracking it!