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Pain Management Message Board


Pain Management Board Index


Re: Norco question
Oct 27, 2007
the reason they like to prescribe narcotics that also have the full dose of tylenol in is so that you can't choose to take more without exceeding the safe dose of tylenol. if you had pills that only had whichever narcotic, and no tylenol, then you could (some people would, i'm not implying anything about you personally) take as much as you wanted, just to get high, without worrying about liver damage from the tylenol - this is what they're trying to avoid.

i understand your concern about having tylenol in your system long term, i had the same worries when my doctor told me i should be taking it four times a day along with my tramadol, but what you're taking now is definitely not enough to cause any damage, so try not to worry :)
Re: Norco question
Oct 31, 2007
cb...

Thanks and interesting. Let me ask you a couple of questions...
Is there a greater risk of dependence with the compound? Do you apply it to the wrist as you do phenegren compound? what are the major differences in the way the compound and the pill form work? Do yo get enough relief?

Whew....many questions. But I do find the idea of a compound interesting. If doctors know this stuff exists...you would think they would want to give their patients the least amount of tylenol possible....I can understand the concern wiht abuse...but if a patient shows no signs of over medicating, then what is the big deal?
Re: Norco question
Nov 1, 2007
Happy,

Good questions.... 1) There is the same risk of dependence with the compound. 2) The compounded hydrocodone is not prepared as a salve, but rather in capsule form; so it is taken orally every 8 hours.

There are two primary advantages of the compounded hydrocodone over norco, vicodin, etc. and one disadvantage. Advantages: No tylenol component so less potential damage to liver and kidneys. Secondly, it last longer, 8 hours, so you have more constant and consistent pain relief over a longer period of time. With a four hour norco for instance, the relief level peaks as the med gets in your system then quickly drops off. With an 8 hour med such as compounded hydrocodone (or a longer lasting extended release) it reaches it peak blood concentration level and stays at that level for about six hours, plus or minus, then begins to gradually decrease until the next dose is taken. Bottom line, more consistent pain relief for longer period of time, with less peaks and valleys in relief. Remember, this med is for chronic pain patients who have to taken pain meds around the clock. It is not a "take as needed" type medicine. I spent a couple of years on the short acting meds before moving to around the clock pain meds. Many GP docs will not be familiar with compounding, while pain mgmt.l docs will. Disadvantage: Cost. A 30 day supply of 90 capsuls of 30 mg costs about $150 a month before insurance. It really depends on how well your insurance pays on this med. I can tell you that it is in a more restrictive narcotic class as it does not contain apap, so the Rx script has to be picked up and hand delivered to the pharmacy .... no faxing, no refills, etc. Somewhat of a pain (however my pharmacy picks the script up for me and delivers to my home), but worth saving my liver and kidneys, which is a real risk. If I recall correctly, the caution on a bottle of regular tylenol tells you not to take it more than two weeks. There is a good reason for this warning.

I hope this helps you.

cb





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