Comparative Pharmacology
Head-to-head clinical analysis: NORCO versus VICODIN.
Peer-Reviewed Evidence
Head-to-head clinical analysis: NORCO versus VICODIN.
NORCO vs VICODIN
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.
VICODIN (hydrocodone/acetaminophen) is a combination opioid agonist and analgesic. Hydrocodone acts on mu-opioid receptors in the CNS to alter pain perception and response; acetaminophen inhibits cyclooxygenase (COX) activity, likely in the CNS, reducing prostaglandin synthesis and providing antipyretic 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.
1-2 tablets (hydrocodone 5-10 mg and acetaminophen 300-325 mg) orally every 4-6 hours as needed for pain; maximum daily acetaminophen dose 4 g.
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.
Hydrocodone: 3.8-6.4 hours (terminal); Acetaminophen: 2-3 hours (terminal). Clinically, steady-state achieved in 1-2 days.
Hydrocodone: primarily renal (approximately 60% as unchanged drug and metabolites, including norhydrocodone, hydromorphone, and conjugated metabolites). Biliary/fecal excretion accounts for <10%.
Hydrocodone: primarily renal (~60% as metabolites, 12% unchanged); minor biliary. Acetaminophen: renal (90-100% as metabolites, 2-4% unchanged).
Category C
Category C
Opioid Analgesic
Opioid Analgesic