Know your pain reliever blends
by Health Matters, R. D. O'Bryan
Mar 15, 2011 | 2021 views | 0 0 comments | 14 14 recommendations | email to a friend | print
Richard O'Bryan
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After receiving so much positive feedback for my latest column regarding the effectiveness and safety of Tylenol, Advil and Aleve, I thought I would continue along the same vein.

As I mentioned previously, it is important to know the substances inside the pills we take. Last time, I made reference to the brand-name medicines Vicodin, Norco and Lortab. These three brands belong to another class of medicines that is often at the center of misunderstanding, concern and confusion: They are prescription blends of narcotics and non-narcotic pain relievers.

Vicodin, Lortab and Norco are all blends of the narcotic pain reliever hydrocodone and the non-narcotic pain reliever acetaminophen. If you remember from my previous column, acetaminophen is the active ingredient in most Tylenol products. There are different blends, all under the same brand names. For instance, the most common Vicodin blend is 5/500 — 5 milligrams of hydrocodone and 500 milligrams of acetaminophen. However, there are also 7.5/750 and 10/660 blends of Vicodin. Norco and Lortab also have several different blends. The combinations also come generically.

In addition, there are blends between other narcotics and non-narcotic pain medicines. Percocet is a brand-name blend of oxycodone and acetaminophen in varying strengths. Percodan is a blend of oxycodone and aspirin. There are also several different blends of oxycodone or hydrocodone and ibuprofen. And Tylenol is blended with codeine (similar but not identical to hydrocodone) in different strengths.

Darvocet was a blend of yet another narcotic (proproxyphene) and acetaminophen. However, that blend was recently discontinued because the Food and Drug Administration judged it unsafe, linking it to certain heart irregularities.

As one can see, there are many medicines in the class of blended narcotic-non-narcotic pain pills. There may be only one name for one pill, such as Percodan, Vicodin or Norco. However, there are two medicines, two doses, and two numbers that every patient should remember. If you take Vicodin, memorize BOTH of your numbers: 5/500, 7.5/750, 10/660. If you take Percodan or Tylenol with codeine, remember both of your numbers.

Finally, you should absolutely stay on track with the dosing plan you and your health care provider agreed to. If you are prescribed to take one pill three times a day, stay on that plan. A prescription is a contract between you and your practitioner. If you find that the agreed-upon dosing plan is not effective to relieve your pain, talk to your provider before you make any changes on your own.

These drugs can be very beneficial to a patient in pain. However, they are controlled substances and prescription drugs for a reason. With two drugs in one pill, it means that there are two risks and two side-effect profiles. There are two drugs that can interact with other drugs. Only your health care provider can guide you in the safe and effective use of these medicines to address your pain needs.

• Richard O’Bryan is a nationally board-certified and licensed physician assistant and former Patterson paramedic who practices at the Patterson First Care clinic. You can e-mail him questions and suggestions at

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