What is the Percocet (oxycodone and acetaminophen) equivalent of Norco (hydrocodone and acetaminophen) 10-325 every 4 hours?

Percocet Equivalent of Norco 10-325 Every 4 Hours

The equivalent dosage of Percocet (oxycodone/acetaminophen) for Norco 10-325 (hydrocodone/acetaminophen) taken every 4 hours would be approximately Percocet 7.5-325 mg every 4 hours, as hydrocodone 10 mg is roughly equivalent to oxycodone 7.5 mg in analgesic potency. 1

Opioid Equivalence Rationale

• Hydrocodone is approximately equipotent with oral morphine, though equivalence data are not fully substantiated 1
• Oxycodone is generally considered to be 1.5 times more potent than hydrocodone, making 10 mg of hydrocodone roughly equivalent to 6.7-7.5 mg of oxycodone 1
• Both medications contain the same amount of acetaminophen (325 mg) per tablet 1

Dosing Considerations

• Percocet is available in multiple formulations, with the 7.5-325 mg strength being the closest equivalent to Norco 10-325 1, 2
• If Percocet 7.5-325 mg is unavailable, alternatives include:
  • Percocet 5-325 mg, which would provide less analgesia than Norco 10-325 1, 3
  • Percocet 10-325 mg, which would provide more analgesia than Norco 10-325 1, 3
• The every-4-hours dosing schedule should remain the same when converting between these medications 1

Clinical Efficacy Comparison

• Studies comparing oxycodone and hydrocodone combinations with acetaminophen show similar analgesic efficacy at appropriate equivalent doses 3, 4
• A randomized clinical trial found no statistically significant or clinically important differences in pain reduction between hydrocodone/acetaminophen and oxycodone/acetaminophen when dosed appropriately 4
• Both medications effectively reduce moderate to severe pain when dosed at appropriate intervals 2, 5

Important Precautions

• Monitor acetaminophen total daily dose, which should not exceed 3000-4000 mg/day to avoid potential hepatic toxicity 1, 6
• Both medications are Schedule II controlled substances with similar risk profiles for dependence and abuse 1
• Oxycodone may have a slightly higher risk of adverse effects compared to hydrocodone at equipotent doses in some patients 3
• When converting between opioids, start with the calculated equivalent dose but be prepared to adjust based on individual patient response 1

Adverse Effects Considerations

• Common adverse effects for both medications include nausea, vomiting, constipation, and sedation 3
• Some studies suggest that morphine-based formulations (which are related to hydrocodone) may have lower rates of "likeability" compared to oxycodone, potentially affecting abuse potential 3
• Both medications carry risks of respiratory depression, particularly at higher doses or when used in opioid-naïve patients 1

Remember that individual patient response to opioids can vary significantly, and dose adjustments may be necessary based on pain control and side effects 1.