How Long Does Norco Stay in Your System?

 Norco is the brand name for a prescription medication that combines hydrocodone, an opioid (narcotic) pain reliever with acetaminophen. As you probably know, acetaminophen is an over-the-counter (OTC) non-opioid pain reliever. It's often sold under the brand name Tylenol and also is a common active ingredient in OTC cough, cold, and fever medications.

There are quite a few prescription pain relievers that have these same two components. One of the most familiar is Vicodin; other hydrocodone/acetaminophen combination drugs include Anexsia, Lorcet, and Lortab. The main difference between most of these medications is the amount of hydrocodone and acetaminophen in each one. They're all prescribed to treat moderate to severe pain. All versions of Norco come as a tablet.

Why It Is Important to Know How Long a Drug Like Norco Stays in the Body

It's important to know how long a medication like Norco stays in the body after being taken since substances such as alcohol as well as other medications can lead to often-dangerous interactions with either hydrocodone or acetaminophen. This information also is vital for preventing overdoses of either ingredient.

For example, if you were to take Tylenol or an OTC cold or cough medication containing acetaminophen before Norco has cleared from your system, you potentially could wind up with an overdose of acetaminophen in your body—a situation that has been found to lead to severe liver damage, according to the U.S. Food and Drug Administration (FDA).

By understanding how long Norco remains active in the body and when it will clear can help you and your doctor time your doses so that you get the most benefit without the risk of side effects.

Half-Life of the Medications in Norco

When talking about how long a particular medication remains active in the body it helps to understand the term half-life. Half-life refers to the amount of time it takes for half of the dose of a particular drug to be eliminated from the bloodstream. When discussing Norco, of course, it's necessary to consider both the half-life of hydrocodone and the half-life of acetaminophen.

The half-life of hydrocodone is about four hours, the time in which half of it is no longer acting in your system. After five or six half-lives, the drug has been mostly eliminated but note that even at this point hydrocodone can be detected in the urine for up to three days. This means that if you take a urine drug screen after being on Norco, it is likely to test positive for opiates even if your last dose was days earlier.

The acetaminophen in Norco has a half-life in the blood of one and a quarter hours to three hours. Most acetaminophen has passed out of the body through the urine after 24 hours. 

Risks of Having Norco in Your System

Because hydrocodone is an opiate narcotic, it brings a risk of dangerous interactions with a number of different substances.

One of these is alcohol—drinking while taking Norco can lead to serious side effects caused by either the combination of alcohol with hydrocodone or the combination of alcohol with acetaminophen, according to the National Institute on Alcohol Abuse and Alcoholism, a division of the National Institutes of Health (NIH).

Alcohol Risks With Norco

  • Alcohol and hydrocodone can cause drowsiness, dizziness, an increased risk of overdose, breathing problems, impaired motor control, unusual behavior, and memory problems.
  • Alcohol plus acetaminophen can lead to stomach problems, including bleeding and ulcers; liver damage, increased heart rate; and liver damage.

Liver damage caused by acetaminophen is a particularly serious problem. That may seem odd since Tylenol and other medications containing acetaminophen are so accessible, but that's part of the problem: People often will unknowingly take more than one medication containing acetaminophen at a time. Research has found that exceeding 4,000 milligrams (mg) a day can lead to irreversible and even fatal liver damage.

In fact, many accidental overdoses and even deaths have occurred under this scenario, research shows. For that reason, any medication that combines acetaminophen with another ingredient can have only 325 mg of acetaminophen. Norco, for example, comes in several strengths of hydrocodone, ranging from 2.5 mg to 10 mg; all of these versions have only 325 mg of acetaminophen. 

Of the medications that can cause problems when taken while Norco is in your system, the ones that are most dangerous are those that can interact with hydrocodone, particularly benzodiazepines. Examples include Xanax (alprazolam), Librium (chlordiazepoxide), Klonopin (clonazepam), Valium (diazepam), Ativan (lorazepam), and Halcion (triazolam). These are prescription depressant drugs used most often to treat anxiety, muscle spasms, and seizures. 

The potential dangers of mixing hydrocodone with a benzodiazepine medication are so potentially serious that ​an August 2016 review by the FDA resulted in the addition of boxed warnings on both types of drugs about side effects of mixing them, including slowed or difficult breathing and even death. 

Other types of medications that can interact with Norco include muscle relaxants, sedatives, sleeping pills, tranquilizers, and certain treatments for mental illness or nausea. The best way to protect yourself from harm while taking Norco is to make sure your doctor knows about all drugs and supplements you take before you begin treatment and to be clear about how long you need to wait after finishing being on Norco before resuming any medications that might interact before it's out of your system. 

Signs of a Norco Overdose

Knowing how long Norco remains in the system also can help prevent an accidental overdose caused by taking too much of the medication too soon. 

Here are some of the signs and symptoms of a Norco overdose:

  • Bluish-colored fingernails and lips
  • Breathing problems
  • Cold, clammy skin
  • Coma
  • Confusion
  • Dizziness
  • Drowsiness
  • Fatigue
  • Lightheadedness
  • Liver failure from acetaminophen overdose
  • Low blood pressure
  • Muscle twitches
  • Pinpoint pupils
  • Seizures
  • Spasms of the stomach and intestines
  • Weakness
  • Weak pulse
  • Loss of consciousness

If you or someone you're caring for is taking Norco and experiences any of these symptoms. Call 911. In the event the overdose has caused loss of consciousness, first responders can administer a drug called Narcan (naloxone) to counteract the effects of the hydrocodone. 

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