by Nicole Evans M.D.

Created on: March 26, 2010

Norco and Vicodin are very similar prescription medications.  Both medicines are used to relieve moderate to severe pain and both medications contain the prescription narcotic pain reliever known as hydrocodone, as well as the over-the-counter pain relieving agent known as acetaminophen.

In fact, Norco and Vicodin share the same active medicinal agents as many other prescription pain relieving agents.  Other drugs that contain acetaminophen (also called Paracetamol) and hydrocodone as the active agents include: Co-Gesic®; Lorcet®; Lortab®; Norco®; Margesic® H; Maxidone®; Stagesic™; Xodol®; Zamicet™; Zydone®.

Norco specifically uses a compound called Hydrocodone bitartrate.  The tablet form of Norco can contain varying amounts of hydrocodone and acetaminophen.  A physician will write a prescription for Norco and then indicate specifically how much hydrocodone each tablet should contain.  Importantly, the acetaminophen component of Norco stays at 325 mg no matter the strength of hydrocodone used.

There are three available strengths of Norco. One formulation has 5 mg of  Hydrocodone bitartrate and 325 mg of acetaminophen.  The second has 7.5 mg of Hydrocodone bitartrate and acetaminophen 325 mg.  Finally, the third Norco tablet has Hydrocodone bitartrate 10 mg and acetaminophen 325 mg.

Vicodin also uses the Hydrocodone bitartrate compound in combination with acetaminophen.  In comparison to Norco, Vicodin has specifically lettered tablets that indicate the amount of hydrocodone and acetaminophen the tablets will contain.  Vicodin, Vicodin ES, and Vicodin HP are the available formulations.  It is important to note that the amount of acetaminophen will vary with the specific form of Vicodin used.

Vicodin has hydrocodone bitartrate in 5 mg and acetaminophen in 500 mg amounts. Vicodin ES has Hydrocodone bitartrate in 7.5 mg and acetaminophen in 750 mg amounts. Finally, Vicodin HP has Hydrocodone bitartrate in 10 mg and acetaminophen in 660 mg amounts.

Additional differences between Vicodin and Norco exist in the costs of the available tablets.  Here is a sample of costs as noted from the drug database Lexi-Comp Online.  The dosages indicate amount of hydrocodone to amount of acetominophen:

Tablets (Norco) 5-325 mg (30 pills): $43.04

Tablets (Norco) 7.5-325 mg (30 pills): $48.29

Tablets (Norco) 10-325 mg (30 pills): $64.29

Tablets (Vicodin) 5-500 mg (30 pills): $51.14

Tablets (Vicodin ES) 7.5-750 mg (30 pills): $49.43

Tablets (Vicodin HP) 10-660 mg (30 pills): $54.35

There are several differences between Vicodin and Norco.  Be particularly careful about the acetaminophen component of these medications.  Acetominophen is highly toxic to the liver in high doses.  Work with your physician to determine whether Norco or Vicodin is right for you. 

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