Comparative Pharmacology
Head-to-head clinical analysis: NORCO versus PROPOXYPHENE HYDROCHLORIDE.
Peer-Reviewed Evidence
Head-to-head clinical analysis: NORCO versus PROPOXYPHENE HYDROCHLORIDE.
NORCO vs PROPOXYPHENE HYDROCHLORIDE
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
NORCO is a combination of hydrocodone, a mu-opioid receptor agonist that inhibits ascending pain pathways and alters pain perception, and acetaminophen, which inhibits cyclooxygenase (COX) enzymes, particularly in the CNS, leading to decreased prostaglandin synthesis and antipyresis.
Propoxyphene hydrochloride is a centrally acting opioid analgesic that binds to mu-opioid receptors in the central nervous system, inhibiting ascending pain pathways and altering perception of and response to pain.
One tablet (5 mg hydrocodone/325 mg acetaminophen, 7.5 mg/325 mg, 10 mg/325 mg) orally every 4-6 hours as needed for pain. Maximum acetaminophen dose 4000 mg/day; maximum hydrocodone dose 60 mg/day.
65 mg orally every 4 hours as needed for pain; maximum 390 mg per day.
None Documented
None Documented
Hydrocodone: terminal elimination half-life is 3.8 to 6.0 hours (mean 4.5 hours) in adults; prolonged in hepatic or renal impairment. Acetaminophen: half-life 1.5–3 hours.
6–12 hours (parent drug); norpropoxyphene metabolite half-life 30–36 hours, accumulates with repeated dosing, increasing risk of toxicity, especially in elderly or renal impairment.
Hydrocodone: primarily renal (approximately 60% as unchanged drug and metabolites, including norhydrocodone, hydromorphone, and conjugated metabolites). Biliary/fecal excretion accounts for <10%.
Primarily renal (70-90% as unchanged drug and metabolites, including norpropoxyphene); biliary/fecal excretion accounts for less than 10%.
Category C
Category C
Opioid Analgesic
Opioid Analgesic