Updated on December 6, 2023
8 min read

Norco Effects, Risks & Addiction

What is Norco (Acetaminophen-Hydrocodone)?

Norco is an opioid analgesic prescribed for moderate to moderately severe pain. It’s a combination medication containing acetaminophen and hydrocodone bitartrate.

The way Norco works comes down to its two main ingredients:

  • Acetaminophen: Acts as a pain reliever and fever reducer
  • Hydrocodone: Intensifies the pain-relieving effect by binding to specific receptors in the brain and spinal cord

Norco is similar to other opioid analgesics like codeine, a highly addictive pain medication in cough syrups. Depending on the dose, the effects of Norco can take 30 to 60 minutes to begin and usually last between four and eight hours.

Other brand names for acetaminophen-hydrocodone bitartrate include:

  • Hycet
  • Lorcet
  • Lortab
  • Verdrocet
  • Vicodin
  • Xodol

Is Norco Addictive?

Yes, the Drug Enforcement Administration (DEA) classifies Norco as a Schedule II drug. This means it has a high potential for abuse and addiction. 

In 2021, approximately 8.7 million people, accounting for 3.1% of the population, acknowledged misusing prescription pain relievers.1  Although Norco is approved for medical use, its misuse can lead to consequences ranging from addiction to overdose. 

Repeated use can lead to a higher tolerance for the drug, so you'll need more of it to achieve the same effects. This increases the likelihood of an opioid overdose.


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What are Norco's Side Effects?

Pain medications like Norco can affect people differently and may cause side effects. The most common side effects of Norco include:

  • Pain relief
  • Nausea and vomiting
  • Dizziness
  • Loss of appetite
  • Sedation or sleepiness
  • Lightheadedness
  • Constipation

Severe Side-Effects of Norco

In rare cases, Norco may cause more serious side effects, including:

  • Hearing impairment or permanent loss
  • Skin rashes
  • Impairment of mental and physical performance
  • Severe constipation
  • Anxiety or fear
  • Mood changes
  • Upper stomach pain
  • Nausea
  • Jaundice
  • Liver damage
  • Kidney disease
  • Chronic breathing disorders

Call your doctor or healthcare provider if you experience these adverse side effects.

Allergic Reaction to Norco

If you’re sensitive to hydrocodone or acetaminophen, don’t take Norco to avoid an allergic reaction.

Signs of a Norco allergy include:

  • A severe skin reaction like rash and hives
  • Vomiting
  • Swelling of the face, lips, or throat
  • Difficulty swallowing
  • Trouble breathing

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What are the Risks of Norco?

Acetaminophen can cause liver damage in high doses. In some cases, acute liver failure occurs, resulting in a liver transplant or death. 

Because of this, limiting your consumption to 3,000 to 4,000 milligrams (mg) per day is essential. Norco's effects on the liver can also worsen if you mix it with alcohol. 

The liver processes both substances. Therefore, this interaction may result in liver disease or other liver problems.

Skin-Related Risks of Norco

Norco can cause skin reactions that can be fatal. If you develop a skin rash or dark urine while taking the drug, stop using it and contact your local health department immediately. 

Other conditions that can occur include:

  • Stevens-Johnson Syndrome (toxic epidermal necrolysis): People with this condition develop flu-like symptoms and then a red/purple rash that blisters and peels
  • Acute generalized exanthematous pustulosis: Those with this condition develop small pustules that look like pimples or blisters on the skin, which can last for a few weeks

Who is At Risk When Taking Norco?

To make sure Norco is safe for you, tell your doctor if you have:

  • Difficulty breathing or sleep apnea
  • Liver or kidney disease
  • Severe asthma
  • Substance abuse problems
  • Seizures
  • Difficulty urinating
  • Problems with your thyroid, pancreas, or gallbladder
  • Pregnancy or breastfeeding
  • Blockages in your stomach or intestines

Don't take Norco if you have a head injury because it can elevate cerebrospinal fluid pressure. This elevation may become exaggerated with a head injury and can become dangerous.

What are Norco Overdose Symptoms?

Taking too many Norcos in one dose can lead to an opioid overdose. This can also happen if you abuse Norco or mix it with other medications and alcohol.

A Norco overdose can lead to life-threatening respiratory depression and serious breathing problems.

Signs of a Norco overdose to look out for include:   

  • Vomiting
  • Limp body
  • Extreme tiredness
  • Trouble speaking
  • Purple or blue lips and fingernails
  • Pale and clammy skin
  • Shallow breathing

If you or someone else is experiencing these symptoms, call your local poison control center, 911, or emergency medical help immediately.

What to Do During a Norco Overdose

In the event of an opioid overdose, you may administer a dose of naloxone if it’s available to you. Naloxone is an FDA-approved antidote for opioid overdoses and is also known by the brand name Narcan.

Naloxone can rapidly reverse the effects of an overdose and restore a person’s normal breathing. Once you’ve administered a dose of the antidote, contact emergency medical help immediately. 

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What are Norco's Addiction Symptoms?

Opioids like Norco can quickly become addictive because of their euphoric side effects. Open communication is crucial to accurately assess the presence or degree of addiction symptoms in a person.

A healthcare provider must consider factors like age and health status to make their assessment. Other signs of opioid addiction they will assess include:

  • Lack of hygiene
  • Changes in exercise habits
  • Frequent flu-like symptoms
  • Changes in sleep patterns
  • Drowsiness
  • Decreased libido (sex drive)
  • Weight loss
  • Isolation from family or friends
  • Associating with people who encourage drug or alcohol addiction
  • Changes in urination and bowel habits

What are Opioid Withdrawal Symptoms?

Opioids have potentially life-threatening withdrawal symptoms, including:

  • Increased pain
  • Diarrhea
  • Mood changes like Irritability or agitation
  • Anxiety or restlessness
  • Muscle cramps/aches
  • Yawning
  • Rapid heart rate (tachycardia)
  • Watery eyes, runny nose
  • Difficulty sleeping
  • Chills, sweating, or goosebumps
  • Changes in blood pressure
  • Stomach cramps
  • Suicidal thoughts
  • Nausea/vomiting

Don't attempt to withdraw from Norco on your own. It can be hazardous, and sudden changes in drug use can lead to seizures or death.

How to Avoid Withdrawl Symptoms

Call your doctor to discuss safe options if you're considering quitting Norco. They can develop a plan that you can follow to discontinue using the drug successfully.

One supervised method of stopping Norco use is tapering off the drug. This process gradually reduces Norco dosage over time to prevent shock to the body's systems.

This means withdrawal symptoms will be less severe and manageable with other medications. You must only taper drugs under your doctor's supervision.

Treatment Options for Opioid Abuse & Addiction

Available treatment options for opioid addiction include:

What are Norco Drug Interactions?

If you mix acetaminophen-hydrocodone with alcohol, it can increase sedative side effects. If you mix the drug with other medications containing acetaminophen, it can increase the risk of liver damage. These interactions can change how Norco works.

Other substances that can interact with Norco include:

  • Marijuana
  • Monoamine oxidase inhibitors (MAOIs)
  • Muscle relaxants
  • Certain pain medications such as butorphanol, nalbuphine, pentazocine
  • A full opioid agonist like codeine or oxycodone
  • Other opioid antagonists like naltrexone samidorphan

Talk to your doctor about any prescription medications before taking Norco. This includes over-the-counter drugs, vitamins, herbal products, and dietary supplements.


Norco is the brand name of acetaminophen-hydrocodone bitartrate, a prescription medication for pain. It affects the opioid receptors to reduce your response to discomfort.

However, Norco has adverse side effects. It's also a Schedule II controlled substance with a high potential for addiction and abuse. 

Mixing Norco with other drugs and alcohol can lead to dangerous drug interactions and overdose. Contact a doctor immediately if you or someone you know is abusing Norco. 

Common Questions on Norco

How does Norco work?

Norco's two active ingredients, acetaminophen and hydrocodone bitartrate, affect the brain differently. However, both work to alleviate pain.

As an opioid antagonist, hydrocodone attaches to your brain's mu-opioid receptors to lower your response to pain. Meanwhile, acetaminophen is an analgesic that stops the production of certain chemicals in your brain to relieve moderate pain.

Hydrocodone is an opioid pain reliever that treats severe pain around-the-clock. Meanwhile, acetaminophen is an over-the-counter drug that addresses mild aches, pains, and fevers.

How do you take Norco?

Norco is available as a capsule, liquid solution, and tablet. Follow your doctor's directions, the medication's prescription label, or medication guide. 

Each pill contains 325 mg of acetaminophen with either 2.5, 7.5, or 10mg of hydrocodone. Your dosage will depend on the condition being treated, the strength of the medication, your age, and the severity of your pain.

What happens if you miss a dose of Norco?

In case of a missed dose, take it as soon as possible. If it's almost time for your next one, skip the missed dose and take the next one as usual. Don't double up on doses to compensate for the missed dose.

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Updated on December 6, 2023
17 sources cited
Updated on December 6, 2023
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  2. Drug Enforcement Administration. “Drug Scheduling.” DEA.
  3. Feldmeyer et al. “Acute Generalized Exanthematous Pustulosis: Pathogenesis, Genetic Background, Clinical Variants and Therapy.” International Journal of Molecular Sciences, 2016.
  4. Norco (Hydrocodone Bitartrate 2.5 mg and Acetaminophen 325 mg Tablets.” U.S. Food and Drug Administration, 2014.
  5. Stevens-John syndrome/toxic epidermal necrolysis.” MedlinePlus, 2020.
  6. Opioid Abuse Disorder.” Johns Hopkins Medicine.
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  13. 2018 National Survey on Drug Use and Health Annual National Report.” Substance Abuse and Mental Health Services Administration, 2019.
  14. NORCO®." Food and Drug Administration.
  15. "Serotonin Syndrome." Mayo Clinic, 2022.
  16. "Hydrocodone And Acetaminophen (Oral Route)." Mayo Clinic, 2023.
  17. Habibi et al. "Hydrocodone and Acetaminophen." StatPearls Publsihing, 2022.

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