Can Norco (hydrocodone and acetaminophen) cause hypotension (low blood pressure)?

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From the FDA Drug Label

Hydrocodone Bitartrate and Acetaminophen Tablets may cause severe hypotension including orthostatic hypotension and syncope in ambulatory patients. There is increased risk in patients whose ability to maintain blood pressure has already been compromised by a reduced blood volume or concurrent administration of certain CNS depressant drugs (e.g., phenothiazines or general anesthetics) In patients with circulatory shock Hydrocodone Bitartrate and Acetaminophen Tablets may cause vasodilatation that can further reduce cardiac output and blood pressure Avoid the use of Hydrocodone Bitartrate and Acetaminophen Tablets with circulatory shock. Inform patients that Hydrocodone Bitartrate and Acetaminophen Tablets may cause orthostatic hypotension and syncope. Instruct patients how to recognize symptoms of low blood pressure and how to reduce the risk of serious consequences should hypotension occur (e.g., sit or lie down, carefully rise from a sitting or lying position)

Yes, Norco (hydrocodone and acetaminophen) can cause a drop in blood pressure, including orthostatic hypotension and syncope.

  • Patients with compromised ability to maintain blood pressure are at increased risk.
  • The drug should be avoided in patients with circulatory shock.
  • Patients should be instructed on how to recognize and manage symptoms of low blood pressure 1, 1, 1.

From the Research

Yes, Norco (hydrocodone/acetaminophen) can potentially lower blood pressure, as evidenced by a study published in 2023 2, which found that increased opioid administration, including hydrocodone, can lead to hypotension. This medication contains hydrocodone, an opioid that can cause vasodilation and decrease sympathetic tone, which may lead to reduced blood pressure, especially in people who are dehydrated, elderly, or have pre-existing cardiovascular conditions. The effect is typically mild in most patients but can be more pronounced when taking higher doses or when combined with other medications that lower blood pressure. Some key points to consider when taking Norco include:

  • Staying hydrated to minimize the risk of hypotension
  • Changing positions slowly to reduce the risk of dizziness or lightheadedness
  • Monitoring for symptoms of hypotension, such as dizziness, lightheadedness, or feeling faint when standing up
  • Contacting a healthcare provider if significant drops in blood pressure occur, as dosage adjustments or alternative pain management strategies may be necessary It's also worth noting that opioids, including hydrocodone, can affect the central nervous system's regulation of blood vessel tone and cardiovascular function, which can contribute to the risk of hypotension 3, 2. However, the most recent and highest quality study on this topic, published in 2023 2, provides the strongest evidence for the potential of Norco to lower blood pressure. In clinical practice, it's essential to weigh the benefits and risks of using Norco, considering the potential for hypotension and other adverse effects, and to closely monitor patients for any signs of decreased blood pressure.

References

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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