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Side Effects & Adverse Reactions

Respiratory Depression:

At high doses or in sensitive patients, hydrocodone may produce dose-related respiratory depression by acting directly on the brain stem respiratory center. Hydrocodone also affects the center that controls respiratory rhythm, and may produce irregular and periodic breathing.

Head Injury and Increased Intracranial Pressure:

The respiratory depressant effects of narcotics and their capacity to elevate cerebrospinal fluid pressure may be markedly exaggerated in the presence of head injury, other intracranial lesions or a preexisting increase in intracranial pressure. Furthermore, narcotics produce adverse reactions which may obscure the clinical course of patients with head injuries.

Acute Abdominal Conditions:

The administration of narcotics may obscure the diagnosis or clinical course of patients with acute abdominal conditions.

Misuse, Abuse, and Diversion of Opioids:

Hydrocodone bitartrate and acetaminophen tablets contain hydrocodone, an opioid agonist, and is a Schedule III controlled substance. Opioid agonists have the potential for being abused and are sought by abusers and people with addiction disorders, and are subject to diversion.

Hydrocodone bitartrate and acetaminophen tablets can be abused in a manner similar to other opioid agonists, legal or illicit. This should be considered when prescribing or dispensing hydrocodone bitartrate and acetaminophen tablets in situations where the physician or pharmacist is concerned about an increased risk of misuse, abuse or diversion (see DRUG ABUSE AND DEPENDENCE).

Respiratory Depression:

At high doses or in sensitive patients, hydrocodone may produce dose-related respiratory depression by acting directly on the brain stem respiratory center. Hydrocodone also affects the center that controls respiratory rhythm, and may produce irregular and periodic breathing.

Head Injury and Increased Intracranial Pressure:

The respiratory depressant effects of narcotics and their capacity to elevate cerebrospinal fluid pressure may be markedly exaggerated in the presence of head injury, other intracranial lesions or a preexisting increase in intracranial pressure. Furthermore, narcotics produce adverse reactions which may obscure the clinical course of patients with head injuries.

Acute Abdominal Conditions:

The administration of narcotics may obscure the diagnosis or clinical course of patients with acute abdominal conditions.

FDA Safety Alerts

There are currently no FDA safety alerts available for this drug.

Manufacturer Warnings

There is currently no manufacturer warning information available for this drug.

FDA Labeling Changes

There are currently no FDA labeling changes available for this drug.

Uses

Hydrocodone bitartrate and acetaminophen tablets are indicated for the relief of moderate to moderately severe pain.

History

There is currently no drug history available for this drug.

Other Information

Hydrocodone bitartrate and acetaminophen is supplied in tablet form for oral administration.

Hydrocodone bitartrate is an opioid analgesic and antitussive and occurs as fine, white crystals or as a crystalline powder. It is affected by light. The chemical name is 4,5α-epoxy-3-methoxy-17-methylmorphinan-6-one tartrate (1:1) hydrate (2:5). It has the following structural formula:

This is an image of the structural formula of Hydrocodone bitartrate.

Acetaminophen, 4′-hydroxyacetanilide, a slightly bitter, white, odorless, crystalline powder, is a non-opiate, non-salicylate analgesic and antipyretic. It has the following structural formula:

This is an image of the structural formula of Acetaminophen.

Hydrocodone Bitartrate and Acetaminophen Tablets, USP 5 mg/325 mg

Each tablet contains:

    Hydrocodone Bitartrate………….5 mg
    Acetaminophen…………………….325 mg

In addition each tablet contains the following inactive ingredients: colloidal silicon dioxide, croscarmellose sodium, crospovidone, FD&C Yellow #6, microcrystalline cellulose, povidone, pregelatinized corn starch, stearic acid, and sucrose.  Meets USP Dissolution Test 1.

Hydrocodone Bitartrate and Acetaminophen Tablets, USP 5 mg/325 mg

Each tablet contains:

    Hydrocodone Bitartrate………….5 mg
    Acetaminophen…………………….325 mg

In addition each tablet contains the following inactive ingredients: colloidal silicon dioxide, croscarmellose sodium, crospovidone, FD&C Yellow #6, microcrystalline cellulose, povidone, pregelatinized corn starch, stearic acid, and sucrose.  Meets USP Dissolution Test 1.

Norco Manufacturers

  • Keltman Pharmaceuticals Inc.
    Norco | Keltman Pharmaceuticals Inc.
    No Recall

    Norco | Keltman Pharmaceuticals Inc.

    Norco | Keltman Pharmaceuticals Inc.

    Dosage should be adjusted according to the severity of the pain and the response of the patient. However, it should be kept in mind that tolerance to hydrocodone can develop with continued use and that the incidence of untoward effects is dose related.

    Hydrocodone Bitartrate and Acetaminophen Tablets, USP 5 mg/325 mg

    The usual adult dosage is one or two tablets every four to six hours as needed for pain. The total daily dosage should not exceed 8 tablets.

    Hydrocodone Bitartrate and Acetaminophen Tablets, USP 5 mg/325 mg

    The usual adult dosage is one or two tablets every four to six hours as needed for pain. The total daily dosage should not exceed 8 tablets.

  • Norco | Cardinal Health
    No Recall

    Norco | Cardinal Health

    Norco | Cardinal Health

    Dosage should be adjusted according to the severity of the pain and the response of the patient. However, it should be kept in mind that tolerance to hydrocodone can develop with continued use and that the incidence of untoward effects is dose related.

    The usual adult dosage is one tablet every four to six hours as needed for pain. The total daily dosage should not exceed 6 tablets.

  • Physicians Total Care, Inc.
    Norco | Physicians Total Care, Inc.
    No Recall

    Norco | Physicians Total Care, Inc.

    Norco | Physicians Total Care, Inc.

    Dosage should be adjusted according to the severity of the pain and the response of the patient. However, it should be kept in mind that tolerance to hydrocodone can develop with continued use and that the incidence of untoward effects is dose related.

    The usual adult dosage is one tablet every four to six hours as needed for pain. The total daily dose should not exceed 6 tablets.

  • Norco | A-s Medication Solutions Llc
    No Recall

    Norco | A-s Medication Solutions Llc

    Norco | A-s Medication Solutions Llc

    Dosage should be adjusted according to the severity of the pain and the response of the patient. However, it should be kept in mind that tolerance to hydrocodone can develop with continued use and that the incidence of untoward effects is dose related.

    The usual adult dosage is one tablet every four to six hours as needed for pain. The total daily dose should not exceed 6 tablets.

  • Norco | Mylan Pharmaceuticals Inc.
    No Recall

    Norco | Mylan Pharmaceuticals Inc.

    Norco | Mylan Pharmaceuticals Inc.

    Enalapril and hydrochlorothiazide are effective treatments for hypertension. The usual dosage range of enalapril is 10 mg to 40 mg per day administered in a single or two divided doses; hydrochlorothiazide is effective in doses of 12.5 mg to 50 mg daily. The side effects (see WARNINGS) of enalapril are generally rare and apparently independent of dose; those of hydrochlorothiazide are a mixture of dose-dependent phenomena (primarily hypokalemia) and dose-independent phenomena (e.g., pancreatitis), the former much more common than the latter. Therapy with any combination of enalapril and hydrochlorothiazide will be associated with both sets of dose-independent side effects but the addition of enalapril in clinical trials blunted the hypokalemia normally seen with diuretics. To minimize dose-independent side effects, it is usually appropriate to begin combination therapy only after a patient has failed to achieve the desired effect with monotherapy.

    Dose Titration Guided by Clinical Effect

    A patient whose blood pressure is not adequately controlled with either enalapril or hydrochlorothiazide monotherapy may be given enalapril maleate and hydrochlorothiazide tablets 5 mg/12.5 mg or enalapril maleate and hydrochlorothiazide tablets 10 mg/25 mg. Further increases of enalapril, hydrochlorothiazide or both depend on clinical response. The hydrochlorothiazide dose should generally not be increased until 2 to 3 weeks have elapsed. In general, patients do not require doses in excess of 20 mg of enalapril or 50 mg of hydrochlorothiazide. The daily dosage should not exceed two tablets of enalapril maleate and hydrochlorothiazide 10 mg/25 mg.

    Replacement Therapy

    The combination may be substituted for the titrated components.

    Use in Renal Impairment

    The usual regimens of therapy with enalapril maleate and hydrochlorothiazide tablets need not be adjusted as long as the patient's creatinine clearance is > 30 mL/min/1.73m2 (serum creatinine approximately ≤ 3 mg/dL or 265 µmol/L). In patients with more severe renal impairment, loop diuretics are preferred to thiazides, so enalapril maleate-hydrochlorothiazide is not recommended. (See WARNINGS: Anaphylactoid Reactions during Membrane Exposure.)

  • Norco | Actavis Pharma, Inc.
    No Recall

    Norco | Actavis Pharma, Inc.

    Norco | Actavis Pharma, Inc.

    Dosage should be adjusted according to the severity of the pain and the response of the patient. However, it should be kept in mind that tolerance to hydrocodone can develop with continued use and that the incidence of untoward effects is dose related.

    The usual adult dosage is one or two tablets every four to six hours as needed for pain. The total daily dosage should not exceed 8 tablets.