One tenth of the adult US population use prescription painkillers once a month. Usage statistics increases with age, as individuals rely on a variety of medications and options to alleviate pain. Norco is one among the many options used for relieving pain that extends from moderate to severe. Without exception most painkiller medications have side effects as a result of the mechanism of action and the desired outcomes. Here is a detailed look at the side effects of Norco and all related information necessary to ensure that the impact is not adverse or long term in nature.

Drug overview and side effects of Norco

A combination medication containing hydrocodone, a synthetic opioid derivative and acetaminophen, Norco is a popular prescription painkiller. Before we look at the side effects of Norco here is an overview of the drug and its mechanism of action. In use for more than seven decades since approval by the FDA for use as a cough suppressant, the metabolite of hydrocodone is a potent cough suppressant. It works by preventing pain signals from moving in the spinal cord and the brain. Hydrocodone is also known to have a sedative effect in addition to creating euphoric sensations in the mind. The primary reason why children below six years are not prescribed this combination medication is the respiratory depression that is attributed to hydrocodone.

The opioid derivative of codeine binds itself to opioid receptors, which contribute to the analgesic properties of the medication. Consequently, neurotransmitters are prevented from being released, and as a result there is an analgesic effect. By virtue of being an opioid derivative, the drug also triggers actions in the brain, which has an effect on the reward/addiction pathways that are responsible for the feel good effect. However, the side effects of Norco are also attributed to the inhibitory effect, wherein the patient experiences respiratory depression alongside cough suppression.

Acetaminophen mechanism of action – The second molecule in the combination medication – Acetaminophen is one of the most common analgesic in the world. It is commonly used as an over the counter medication for controlling fever, and is available in different presentations since FDA approval almost seven decades ago. To get a better understanding of the side effects of Norco, it is necessary to understand the mechanism of action of the second molecule in the combination medication. It is broadly classified as an non-steroidal anti-inflammatory drug, by virtue of its impact on the COX pathway that is responsible for reducing pain. The molecule is known to inhibit both COX-1 and 2, that are identified as responsible for prostaglandins – which trigger pain. Additionally, the molecule exercises a regulating effect on the heat in the body, thereby controlling fever by triggering sweating.

Commonly known side effects of Norco

The side effects of Norco belong to two categories – common and rare. Common side effects are relatively moderate in nature and tend to resolve naturally without the need for medical attention or intervention. Rare side effects require medical intervention and could also have a serious/adverse effect on the patient. Here is a look at the side effects to understand the difference and take suitable remedial actions as necessary.

#1 Side effects that are not serious or intense in nature : Side effects of Norco that are not serious in nature include a relaxed feeling for no particular reason. Attributed to the euphoric effects of the medication, the patient is likely to feel extremely relaxed and light. A lowering of blood pressure levels is a possibility, and the patient may not be aware of the condition, till other symptoms indicate lowered blood pressure. Individuals are likely to experience nausea and dizziness, and sometimes feel faint as a result of the mechanism of action of the combination medication. Constipation is another manifestation that could be experienced by a section of patients. Overall weakness that cannot be attributed to any particular reason is another outcome of the medication.

#2 Side effects that are not common in nature : There are side effects of Norco that are not common in nature, yet could have effects that are either not serious or serious in nature. For instance, individuals are likely to experience a decrease in rate of heartbeat, after taking the medication. There could be impaired liver functions in the patients that can be discerned from tests, apart from a similar impact on the lungs. Individuals are likely to experience bronchospasm as a result of the mechanism of action of the drug’s cough suppressant properties. Patients may also experience difficulty in breathing easily, while in some cases there could also be a partial collapse of the lung airways. Medically known as atelectasis, this condition could sometimes be severe. Additionally, patients may experience angioedema, an allergic reaction apart from a negative impact on the nervous system that impairs the ability to remain alert.

#3 Side effects that are rare in nature : Certain side effects of Norco are rare in nature and can either have a serious impact on health or could have a moderate impact on health. For instance, patients may experience a decreased platelet count, and tests may reveal low levels of white blood cells, specifically granulocytes. Patients are likely to end up with impaired liver function, accompanied by inflammation of the liver. Some individuals are known to experience problems in the adrenal gland as a result of the mechanism of action of the drug. Female patients are likely to experience a dip in hormone levels, that is attributed to hypogonadism. Various skin allergies are a possibility – patients may experience inflammation of the skin, toxic epidermal necrolysis, Stevens-Johnson syndrome, and acute generalized exanthematous pustulosis. Swelling of the vocal cords is another possibility as an outcome of the condition, while some patients are known to experience dehydration. The likelihood of developing an addiction is a possibility due to the euphoric properties, while patients are also known to experience some form of depression when the medication is taken for a long period. Lower levels of potassium in the blood are reported in patients, while in some cases there is impaired hearing and a ringing sensation in the ears.

Some side effects of Norco are rare in occurrence and could have outcomes that are not serious in nature. For instance, patients may experience difficulty while swallowing, and some may have problems related to sexual function. Males reportedly experience difficulty is sustaining an erection when on the medication. Patients are likely to experience difficulty in falling asleep while some may experience pain in the neck. An irritation in the stomach is possible while some patients experience impaired taste. Involuntary muscle movements are also a distinct possibility, while some experience a lack of control over muscle co-ordination. As a result of the effect of the medication on the neurotransmitters, patients may experience sudden nightmarish feelings.

How to deal with overdose

In addition to side effects of Norco it is necessary to deal with possible overdose related complications. Some of the complications that arise from overdose include respiratory depression, cold skin, flaccid skeletal muscles, obstruction of the airways, hypotension and constricted pupils. Overdose could actually be fatal in some cases. The first priority in treating an overdose is to protect the airway, and follow it up with measures that are supportive in nature – oxygen support, IV infusion, and vasopressors. Depending on the symptoms and conditions, it may be necessary to offer advanced support in cases where cardiac arrest is a possibility. The effects of the drug are typically reversed with opioid antagonists accompanied by emergency triage measures.


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