Comparative Pharmacology
Head-to-head clinical analysis: NORCO versus PROPOXYPHENE HYDROCHLORIDE 65.
Peer-Reviewed Evidence
Head-to-head clinical analysis: NORCO versus PROPOXYPHENE HYDROCHLORIDE 65.
NORCO vs PROPOXYPHENE HYDROCHLORIDE 65
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 is a centrally acting opioid agonist that binds to mu-opioid receptors in the central nervous system, inhibiting pain signal transmission and altering pain perception. It also has local anesthetic effects.
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/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 (mean ~8 hours); prolonged in hepatic impairment and elderly; accumulation possible with repeated dosing.
Hydrocodone: primarily renal (approximately 60% as unchanged drug and metabolites, including norhydrocodone, hydromorphone, and conjugated metabolites). Biliary/fecal excretion accounts for <10%.
Renal excretion of unchanged drug (approximately 20-30%) and metabolites; approximately 40-60% as conjugated metabolites; minor biliary/fecal elimination.
Category C
Category C
Opioid Analgesic
Opioid Analgesic