Hi Mikey and welcome to the pain management community!
Sorry to hear about the issues you are having with your lumbar spine. I have severe issues with my lumbar spine as well.
Based on the info you provided you are taking Norco 10/325 and Vicodin ES 7.5/750. In case you don't understand the numbers, the first number is the amount of opioid that is in the pill. Norco has 10 mg of hydrocodone and Vicodin ES has 7.5 mg of hydrocodone. The second number is the amount of tylenol (acetaminophen) that is in the pill. Norco has 325 mg of tylenol and Vicodin ES has 750 mg of tylenol.
The Vicodin ES has more tylenol, which is not good for you at all. The max amount of tylenol that can taken safely every 4-6 hours is 1,000 mg. So you should not take more than 1,000 mg of tylenol in a 4 hour period. The Vicodin ES is actually lower in strength than the Norco because it contains less opioid, which is the component that is really helping with the pain. And no, it isn't safe to take 2 Vicodin ES at one time nor is it safe to take one of each (1 Vicodin ES and 1 Norco) at the same time because in both cases you will exceed the tylenol limit of 1,000 mg. Exceeding 1,000 mg of tylenol in less than 4 hours can cause liver damage and even liver failure if exceedances are repeated over the long term.
The norco supplies up to 30 mg of hydrocodone every 4 hours through adminstration of 3 norco tablets. 3 norco tablets adds up to 975 mg of tylenol - this amount of tylenol is SAFE.
The Vicodin ES supplies only 7.5 mg of hydrocodone every 4 hours through administration of 1 Vicodin ES tablet. 1 Vicodin ES tablet provides 750 mg of tylenol - this amount of tylenol is also SAFE.
I used to take opioid combination products that contained tylenol but I am very happy to say that my doctor finally eliminated all the tylenol containing products. I take pure oxycodone IR for breakthrough and no longer take tylenol on a daily basis.
Tylenol taken every day over the long term is not good for the liver. The opioid combination products that contain tylenol are used to limit the opioid (the true pain reliever component) that can be taken per day as exceeding the tylenol limit to get more opioid medication can damage the liver.
I highly recommend that you talk with your doctor about eliminating (at the very least) the Vicodin ES. You are getting more pain relief from the Norco than from the Vicodin. The vicodin is giving you more toxic tylenol and less hydrocodone than the Norco. Eventually, you should consider switching to a pain reliever that doesn't have tylenol in it especially if you will be needing pain medication over the long term. Lastly, be sure that your total daily dose of tylenol doesn't exceed 4,000 mg as exceeding this total daily limit also can cause liver damage and/or failure. New guidelines are pointing to 2,600 mg as the total daily limit and my doctor likes the total daily limit to stay at or below 2,000 mg.
Always take your Norco and Vicodin ES as prescribed by your physician. Keep track of your tylenol intake to make sure you don't exceed the safe limits. And, DO NOT take additional over the counter tylenol containing products while being treating with the Norco and Vicodin. If you feel you need to take an over the counter tylenol containing product, contact your physician or pharmacist for guidance on how to take it safely.
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