Re: Need information about Norco
Different Pt's, different responses.
And of course some MD's have their preferences too...
Generally APAP is a very good general physiologic pain reliever all by itself.
Vicodin and Lortab have higher APAP/hydrocodone ratios per tab, Norco has a lower APAP/hydrocodone ratio per tab.
1. Some Pt's respond better to the stronger hydrocodone buzz of Norco (emotional response is one of the two generally recognized components of pain, ya?).
2. Some Pt's respond very well to APAP, but the differential of a little hydrocodone kick takes off the additional edge of their acute episode pain. Occasionally these Pt's may be prescribed APAP scheduled, sub Vicodin prn.
3. Hepatic load must always be considered with APAP: several pharmacies have given me the guideline: no more than 1 gm per 4 hours sustained, no more than 4 gm per 24 hours sustained. Vicodin ES ii q 6 hrs already exceeds this by over a gram a day. Any other APAP-containing Rx must be included in the equation as well.
4. Especially for longer episodes of more acute pain, Norco may handle the need without challenging the liver, and without escalating medication need to a stronger drug, allowing to taper to APAP as pain resolves.
5. Drug sensitivities are peculiar: some are very sensitive to oxycodone, but do fine with hydrocodone, just because. Others are less effected by oxycodone than hydrocodone (I've seen this less often). Still others can take neither, but do just fine with codeine.
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