Opioid Equivalence and Dosing Considerations

Introduction to Opioid Equivalence

• 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, 2

Opioid Equivalence Rationale

• Hydrocodone is approximately equipotent with oral morphine, though equivalence data are not fully substantiated 1, 3
• 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 2, 3
• Both medications contain the same amount of acetaminophen (325 mg) per tablet 2

Dosing Considerations

• The every-4-hours dosing schedule should remain the same when converting between these medications 2

Important Precautions

• Monitor acetaminophen total daily dose, which should not exceed 3000-4000 mg/day to avoid potential hepatic toxicity 4, 5
• Both medications are Schedule II controlled substances with similar risk profiles for dependence and abuse 2
• When converting between opioids, start with the calculated equivalent dose but be prepared to adjust based on individual patient response 4

Adverse Effects Considerations

• Both medications carry risks of respiratory depression, particularly at higher doses or when used in opioid-naïve patients 1, 4