Is Percocet Stronger Than Norco?

Percocet is stronger than Norco, but this is a bit of an oversimplification. Though similar in many aspects, these drugs contain key differences in their formulations that make them different not just in strength, but in how they can be used.

Depending on the underlying issue being treated and other factors, you may be prescribed a larger dose of Norco than you would be given for Percocet, effectively canceling out the lower potency. In other words, it’s essential not to approach either drug with any assumptions about potency.

Ultimately, it’s better to address this question with a holistic appreciation of what each drug can do. Especially since both of these painkillers are classified as opioid medications, understanding the uses, advantages, and risks of each can help you avoid adverse effects when taking them.

What Is Percocet?

Percocet is an opioid painkiller, or analgesic, formulated with oxycodone and acetaminophen. This drug is available via prescription only. Oxycodone is the ingredient that does most of the legwork when it comes to relieving pain. However, the combination of oxycodone and acetaminophen is synergistic, meaning the pain-relieving effect it produces is stronger than that of each drug on its own.

As an opioid, oxycodone activates several types of opioid receptors in the brain, including mu, kappa, and delta receptors.[1] When these receptors are activated, a complex cell signaling chain reaction occurs. The result of this chain reaction is the reduction of chemical messengers that can communicate pain signals, including acetylcholine, substance P, and others.[2]

In other words, the oxycodone in Percocet interferes with your body’s ability to send and receive pain signals.

Common Uses of Percocet

According to official labeling information data from the Food and Drug Administration (FDA), Percocet is meant to be used for “the relief of moderate to moderately severe pain.”[3]

Many medical conditions, injuries, and other circumstances are associated with moderate to moderately severe pain. These include, but are not limited to, the following:

• Injury-related pain
• Post-surgical pain
• Chronic conditions
• Dental pain
• Pain from severe headaches or migraines

Especially when pain is on the less severe end of the spectrum, and/or when certain risk factors are present, opioid analgesics like Percocet are often treated as a second or third choice after other therapies have proven insufficient. This is because Percocet carries with it a significant risk of abuse, which comes with potentially severe consequences.

Potential Risks and Side Effects

Percocet is a potentially addictive medication. At high enough doses, it can cause feelings of euphoria and relaxation. Oxycodone is among the several prescription opioids involved in the growing opioid overdose epidemic.

According to a CDC Overdose Prevention report, of the approximately 105,000 people who died from a drug overdose in 2023, almost 80,000 of them (76%) involved opioids.[4]

Oxycodone is classified as a semi-synthetic opioid and is generally less dangerous than illegally manufactured fentanyl and fentanyl-like drugs, but is still addictive.

When used as directed, Percocet is less likely to elicit harmful side effects. However, side effects are still possible, and include:[5]

• Respiratory depression: Percocet may cause your breathing rate to slow down. Elderly patients and those with asthma, chronic obstructive pulmonary disorder (COPD), or other respiratory conditions should exercise great caution with Percocet.
• Low blood pressure: Oxycodone can dilate the blood vessels, which can significantly lower blood pressure for individuals with pre-existing blood pressure issues.
• Liver toxicity: Percocet may cause liver damage and/or exacerbate liver disease, sometimes to the extent of liver failure, even when used in therapeutic doses.

What Is Norco?

Where Percocet combines acetaminophen with oxycodone, Norco combines acetaminophen with hydrocodone. Like Percocet, Norco is a semi-synthetic opioid analgesic that the FDA approves for pain management.[6]

Norco is approved for pain management. While hydrocodone alone has antitussive properties and is used in some formulations to treat cough, Norco is not specifically FDA-approved for treating cough or cold symptoms.

With a few minor technical discrepancies, the hydrocodone in Norco follows the same “route” or mechanism that Percocet does when interfering with pain in the body. Hydrocodone is particularly fond of the mu type of opioid receptor, but it can also interact with kappa and delta receptors as dosage increases.

Hydrocodone’s interaction with the “cough center” in the medulla also allows it to have cough-suppressant effects.[7]

Common Uses of Norco

The FDA labeling information data for Norco describes it as a treatment for “pain severe enough to require an opioid analgesic and for which alternative treatments are inadequate.”[8]

Once again, this encompasses a wide range of conditions and situations, including:

• Musculoskeletal injuries
• Post-surgical pain
• Dental pain
• Chronic conditions like arthritis

When cold symptoms are severe, Norco may be used in combination with decongestants and antihistamines to relieve pain.

Potential Risks and Side Effects

The most common side effects associated with hydrocodone include constipation and nausea. However, both at therapeutic and larger doses, hydrocodone may also cause respiratory depression, headache, sedation, vomiting, abdominal pain, dizziness, and other symptoms.[9]

As with Percocet, Norco can also cause severe symptoms like liver toxicity, a sharp drop in blood pressure, and, in some cases, anaphylaxis.[10]

As a Schedule II controlled substance carrying a similar risk of addiction as Percocet, Norco is included in many of the same statistics detailing opioid-related hospitalization and death.

Side-by-Side Comparison: Is Percocet Better Than Norco?

Strength

Percocet is stronger than Norco. Quantifying exactly how much more powerful it is can be difficult, given the subjective factors. Every patient is unique in how they experience a drug’s effects.

One finding, however, neatly expressed the potency difference between these two medications by comparing them to morphine.[11] Hydrocodone is two-thirds as potent as morphine, whereas oxycodone is one and a half times as potent.

Speed of Onset

Both drugs are fast-acting and can be difficult to parse apart when it comes to speed. Immediate-release oxycodone formulations start working within 10 to 30 minutes.[12] Similarly, most reputable sources claim that hydrocodone begins to take its effects within the same window.[13]

As long as the administration routes being compared are the same (oral vs injection, etc.), then both of these drugs should deliver relief at roughly the same time.

Duration

Ignoring extended-release formulations, hydrocodone may edge past oxycodone slightly when it comes to duration. The former typically has an effect duration of four to six hours, while the latter works for three to four hours.[14]

Risk of Abuse

Both Percocet and Norco share the same legal classification as Schedule II drugs. However, given its stronger opioid component, Percocet is typically labeled the more addictive drug.

Due to oxycodone’s higher potency compared to hydrocodone, Percocet may have a higher potential for euphoria and misuse in some individuals, but both drugs carry significant risk for addiction. “Percocet is more likely to produce a powerful sense of euphoria, which is a key element in fostering addictive tendencies.”

The Bottom Line

Both Percocet and Norco are powerful, effective, but potentially addictive opiate pain relievers. Percocet may be more appropriate for more severe pain, while Norco may be more appropriate for more moderate pain and cold symptoms. Whichever you rely on, always make sure to follow your healthcare provider’s instructions and monitor your body’s response to the drug.

Don’t Battle Opioid Addiction Alone

If you believe you’ve developed an addiction to opioid pain medications like Percocet and Norco, or if you’re simply looking for a safe way to discontinue use, know that you have options.

Professional detox and rehabilitation services are available to help you through this transition with a patient and compassionate approach. Recover in confidence with the help of professional detox and rehab services.