Lyrica (pregabalin) vs. Norco (hydrocodone and acetaminophen)
- Lyrica (pregabalin) and Norco (hydrocodone and acetaminophen) are both used to treat different types of pain.
- Lyrica is used to treat neuropathic pain associated with diabetic peripheral neuropathy or postherpetic neuralgia, and fibromyalgia. Lyrica is also used in combination with other drugs to treat partial onset seizures in adults.
- Norco is used to treat moderate to severe pain.
- Lyrica and Norco belong to different drug classes. Lyrica is an anti-epileptic drug (AED) and Norco is a combination of a narcotic pain reliever and a cough suppressant, and a non-narcotic analgesic (pain reliever) and fever reducer.
- Side effects of Lyrica and Norco that are similar include dizziness, nausea, vomiting, drowsiness, and constipation.
- Side effects of Lyrica that are different from Norco include dry mouth, fatigue, fluid retention (edema), blurred vision, double vision, weight gain, abnormal gait, tremor, difficulty concentrating, increased appetite, gas, amnesia, disorientation, myoclonus (sudden, involuntary jerking of a muscle or muscle groups), heart failure, low blood pressure, reduced blood platelet counts, and increased blood creatinine kinase levels.
- Side effects of Norco that are different from Lyrica include lightheadedness, sedation, and difficulty urinating.
- Withdrawal symptoms may occur if you suddenly stop taking Norco.
What is Lyrica? What is Norco?
Lyrica (pregabalin) is an oral medication chemically related to gabapentin (Gralise, Neurontin) used to treat pain caused by neurologic diseases such as postherpetic neuralgia as well as seizures. It also is used to treat fibromyalgia.
Norco (hydrocodone and acetaminophen) is a combination of a narcotic pain-reliever and a cough suppressant, similar to codeine, and a non-narcotic analgesic (pain reliever) and fever reducer used to treat moderate to severe pain.
What are the side effects of Lyrica and Norco?
- Antiepileptic medications have been associated with increased risk of suicidal thinking and behavior. Anyone considering the use of antiepileptic drugs must balance this risk of suicide with the clinical need. Patients who are started on therapy should be closely observed for clinical worsening, suicidal thoughts, or unusual changes in behavior.
The most common side effects of Lyrica are
- dry mouth (xerostomia),
- edema (accumulation of fluid),
- blurred vision,
- double vision (diplopia),
- weight gain,
- fatigue (tiredness),
- abnormal gait (ataxia),
- tremor, and
- difficulty concentrating.
Other side effects include
- increased appetite,
- myoclonus (sudden, involuntary jerking of a muscle or muscle groups),
- heart failure,
- low blood pressure,
- reduced blood platelet counts, and
- increased blood creatinine kinase levels.
Increased creatinine kinase can be a sign of muscle injury, and in clinical trials three patients experienced rhabdomyolysis (severe muscle injury). Therefore, patients should report unexplained muscle pain, tenderness or weakness to their doctors, especially if associated with fever and malaise (reduced well-being). Lyrica has rarely been associated with angioedema (swelling of the face, tongue, lips, and gums, throat and larynx).
Common side effects of hydrocodone/acetaminophen are:
- nausea, and
Other important side effects include:
- constipation, and
- spasm of the ureter, which can lead to difficulty in urinating.
Hydrocodone can impair thinking and the physical abilities required for driving or operating machinery. Hydrocodone can depress breathing, and should be used with caution in elderly, debilitated patients and in patients with serious lung disease.
Can I get addicted to Lyrica or Norco?
Addiction is not a listed side effect of Lyrica
Hydrocodone may be habit-forming. Mental and physical dependence can occur but are unlikely when used for short-term pain relief.
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What is the dosage for Lyrica vs. Norco?
- Lyrica may be taken with or without food.
- Treating diabetic peripheral neuropathy: The initial dose for neuropathic pain associated with diabetic peripheral neuropathy is 50 mg three times a day (150 mg/day). The dose may be increased to a maximum dose of 100 mg 3 times daily (300 mg/day) after one week.
- Treating postherpetic neuralgia: The recommended dose for postherpetic neuralgia is 75-150 mg twice daily or 50-100 mg three times daily. Dosing should begin at 75 mg two times a day or 50 mg three times a day (150 mg/day). The dose may be increased to 100 mg 3 times daily (300 mg/day) after one week. If pain relief is inadequate after 2-4 weeks of treatment at 300 mg/day, the dose may be increased to 300 mg twice daily or 200 mg three times daily. Doses greater than 300 mg cause more side effects.
- Treating neuropathic pain associated with spinal cord injury: The dose for treating neuropathic pain associated with spinal cord injury is 150 to 600 mg daily. Begin dosing at 75 mg two times a day an increase to 150 mg two times daily after one week if response is inadequate. May increase to 300 mg twice daily if response is inadequate after 2 to 3 weeks.
- Treating seizures: The recommended dose for treating seizures is 150-600 mg/day divided into 2 or 3 doses, starting at 150 mg daily and increasing based on response and tolerability. The maximum dose is 600 mg/day.
- Treating fibromyalgia: Fibromyalgia is treated with 300-450 mg/day in 2 or 3 divided doses.
- The usual dose for adults is 1 to 2 tablets or capsules (hydrocodone 2.5 to 10 mg; acetaminophen 300 to 750 mg) every 4 to 6 hours or 15 mL of liquid every 4 to 6 hours as needed.
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What drugs interact with Lyrica and Norco?
- Alcohol and drugs that cause sedation may increase the sedative effects of pregabalin.
- Pioglitazone (Actos) and rosiglitazone (Avandia) cause weight gain, fluid retention, and possibly heart failure. Therefore, combining pregabalin with these drugs may increase the occurrence of weight gain and fluid retention.
- Central nervous system depressants: Increased risk of additive CNS depression. Use with caution in reduced dosages.
- Anticholinergics: Additive risk of urinary retention and paralytic ileus.
- Antidepressants: May cause excessive sedation, acute hypotension and excessive anticholinergic effects. Use with caution in reduced dosages to persons receiving MAO inhibitors or tricyclic antidepressants.
- Metabolic enzymes: Concomitant use of cytochrome P-450 2D6 and 3A4 enzyme inducers or inhibitors may result in an altered response to codeine. Monitor analgesic activity and adverse drug reactions.
Are Lyrica and Norco safe to use while pregnant or breastfeeding?
- There are no adequate studies of Lyrica in pregnant women.
- It is not known whether Lyrica is excreted in breast milk.
- There are no adequate studies of hydrocodone and acetaminophen in pregnant women.
- Hydrocodone/acetaminophen is excreted in breast milk, and, therefore should be used cautiously by nursing mothers.
Medically Reviewed on 12/11/2018
FDA Prescribing Information