What Is Norco Used For? MOA And Ingredients

Last Updated: December 18, 2019

Authored by Nena Messina, Ph.D.

Norco ingredients have antitussive and semisynthetic narcotic analgesic effects with multiple actions, most of them similar to codeine. One of the main Norco uses is the relief of moderate to severe pain, by acting on the smooth muscle and central nervous system.

Ingredients in Norco

The main Norco ingredients are acetaminophen and hydrocodone, plus several inactive ingredients such as:

  • croscarmellose sodium
  • colloidal silicon dioxide
  • povidone
  • crospovidone
  • stearic acid
  • pregelatinized starch
  • microcrystalline cellulose
  • sugar spheres

Mechanism of Action of Norco


Hydrocodone is an opioid pain-relieving medication and a cough suppressant. It acts by blocking the brain’s nerve cells receptors responsible for giving rise to the pain sensation. The drug binds to the MOR (mu-opioid receptor) and the DOR (delta opioid receptors). By activating the MOR in the PAG (periaqueductal gray), hydrocodone inhibits the GABAergic tone on medulla-spinal neurons allowing them to suppress pain. MOR also contributes to the sedation, respiratory depression, and suppression of the cough reflex.

Hydrocodone is well absorbed orally, and it has six times the effect of codeine, with a moderate opiate activity.

doctor telling the patient about medication


Acetaminophen is a fever reducer and non-narcotic pain reliever. It acts by increasing the threshold to pain. In other words, the pain is felt when there is an increase in the stimulation of the nerves responsible for this sensation. By increasing this threshold, the pain will be perceived at less intensity than before. This drug also reduces fever by acting on the temperature-regulating center in the brain.

The hydrocodone-acetaminophen combination is efficient in improving moderate and moderately severe pain, therefore being frequently used for both temporary and chronic management of pain. There is a high similarity in Percocet vs. Norco, with the first one containing oxycodone and acetaminophen. Percocet is also prescribed for moderate to severe pain.

Also, acetaminophen overdose can severely damage the liver and even cause death. The patient should promptly inform the doctor if they have upper stomach pain, nausea, loss of appetite, dark urine, itching, jaundice, or clay-colored stools.

Due to the risks, doctors avoid prescribing Norco during pregnancy. The drug can cause neonatal abstinence syndrome and premature birth, among others.

What Is Norco Used For?

Conditions treated with Norco:

  • Pain after tooth removal – the drug showed positive results in a study made on a patient with a third molar tooth extraction.
  • Pain after surgery – this drug is one of the prescription medications mentioned by the FDA as being efficient in treating pain after surgery. Another potent medicine for pain is Tramadol. It is also should be noted that Tramadol and Norco must not be used together as they interact severely.
  • Norco for back pain – The National Institute of Neurological Disorders and Stroke mentions Norco as an efficient analgesic medication for low back pain
  • Chronic cancer pain – a study showed that from 121 patients with cancer-related pain, 56% of them reported as absent or mild pain after receiving Norco (hydrocodone with acetaminophen).
  • Fractures – Norco proved efficient in relieving severe pain in a study made on 67 patients with acute fractures.
  • Chronic cough –  Norco is recommended for patients with cough and lung cancer.

Norco Recreational Use

Norco, a Schedule II drug, is being misused in the US more than any other opioid. In many countries in Europe, the drug has been highly restricted for years.

Like heroin, hydrocodone can give a euphoric body high. Norco has a lower ratio of hydrocodone-acetaminophen (7.5-10 mg hydrocodone and 325 mg acetaminophen) compared to Lortab and Vicodin, which makes it more attractive for recreational uses.

man feeling sedated

Other side effects of hydrocodone include mental clouding, sedation, and euphoria.

The danger is that dealers sell a new drug, which resembles Norco and with the manufacturer’s imprint. It can be lethal because it causes severe respiratory and central nervous system depression. It contains fentanyl and a novel synthetic opioid. This counterfeit Norco has led to the highest rise in death rates in the US in recent years.

In the case of addiction, the sudden stop of the treatment can lead to withdrawal symptoms. The doctor might choose to slowly lower the dosage until it is safe to stop the medication.

Norco MOA and Dependence

Norco package insert comes with a black box warning which alerts patients and doctors that this drug can cause abuse, addiction, and misuse. Even when taking precisely as prescribed and at low doses, it can be habit-forming. Misuse of Norco can not only lead to addiction, but also overdose, poisoning, and even death. Fortunately, there are drug addiction treatment options that can be accessed by those who deal with such an issue.

The administration of Norco for a long time and in high doses can lead to physical and psychic dependence. That is why extreme caution is required when taking this drug. The drug detox symptoms can be safely and efficiently handled under professional supervision. Asking the help of the best drug addiction treatment centers is the first step in dealing with addiction.

Knowing what Norco is, what it contains, and how it acts is very important in preventing developing an addiction to this drug.

Page Sources

  1. Hydrocodone/Acetaminophen for Acute Pain Following Third Molar Tooth Extraction. Clinical Trial. U.S. National Library of Medicine. https://clinicaltrials.gov/ct2/show/results/NCT00935311?view=results
  2. A Guide to Safe Use of Pain Medicine. U.S. Food and Drug Administration. https://www.fda.gov/consumers/consumer-updates/guide-safe-use-pain-medicine
  3. Low Back Pain Fact Sheet. The National Institute of Neurological Disorders and Stroke. https://www.ninds.nih.gov/DISORDERS/PATIENT-CAREGIVER-EDUCATION/FACT-SHEETS/LOW-BACK-PAIN-FACT-SHEET
  4. Rodriguez RF, Castillo JM, Del Pilar Castillo M, Nuñez PD, Rodriguez MF, Restrepo JM, Rodriguez JM, Ortiz Y, Angel AM. Codeine/acetaminophen and hydrocodone/acetaminophen combination tablets for the management of chronic cancer pain in adults: a 23-day, prospective, double-blind, randomized, parallel-group study. Clin Ther. 2007 Apr;29(4):581-7. https://www.ncbi.nlm.nih.gov/pubmed/17617281
  5. Marco CA, Plewa MC, Buderer N, Black C, Roberts A. Comparison of oxycodone and hydrocodone for the treatment of acute pain associated with fractures: a double-blind, randomized, controlled trial. Acad Emerg Med. 2005 Apr;12(4):282-8. https://www.ncbi.nlm.nih.gov/pubmed/15805317
  6. Richard S. Irwin, Michael H. Baumann, Donald C. Bolser, Louis-Philippe Boulet, et al. Diagnosis and Management of Cough Executive Summary. ACCP Evidence-Based Clinical Practice Guidelines. Chest. 2006 Jan; 129(1 Suppl): 1S–23S. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3345522/
  7. Kathy T. , Xander M.R. van Wijk, Kara L. Lynch, Alan H.B. Wu, Craig G. Smollin. Counterfeit Norco Poisoning Outbreak — San Francisco Bay Area, California, March 25–April 5, 2016. Morbidity and Mortality Weekly Report (MMWR). Centers for Disease Control and Prevention. https://www.cdc.gov/mmwr/volumes/65/wr/mm6516e1.htm

Published on: November 7th, 2019

Updated on: December 18th, 2019

About Author

Nena Messina, Ph.D.

Nena Messina is a specialist in drug-related domestic violence. She devoted her life to the study of the connection between crime, mental health, and substance abuse. Apart from her work as management at addiction center, Nena regularly takes part in the educational program as a lecturer.


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