Lortab and Norco contain the same two active ingredients: hydrocodone (an opioid painkiller) and acetaminophen (the active ingredient in Tylenol). They are different brand names for the same combination drug, and when prescribed at the same strength, they work identically in your body.
Same Drug, Different Labels
Both Lortab and Norco are brand names that pharmaceutical companies gave to their versions of hydrocodone/acetaminophen tablets. The Indian Health Service, the FDA, and pharmacy references list them interchangeably alongside other brand names like Vicodin and Zydone. If your doctor switches you from one to the other at the same dose, you’re getting the same medication.
The active ingredients do the same jobs regardless of which brand name is on the bottle. Hydrocodone is the opioid component that blocks pain signals, while acetaminophen boosts the painkilling effect and helps reduce fever. Together, they’re one of the most commonly prescribed combinations for moderate to moderately severe pain.
Where the Differences Used to Matter
Historically, Lortab and Norco did differ in one important way: how much acetaminophen each tablet contained. Lortab was available in formulations with 500 mg of acetaminophen per tablet, while Norco was formulated with only 325 mg. That distinction made Norco the lower-acetaminophen option, which some doctors preferred because it reduced the risk of liver damage in patients taking multiple doses per day.
That gap closed in 2011, when the FDA determined that prescription combination products containing more than 325 mg of acetaminophen per tablet did not provide “a sufficient margin of safety to protect the public against the serious risk of acetaminophen-induced liver injury.” The agency gave manufacturers until January 2014 to reformulate or pull their higher-dose products from the market. As a result, all hydrocodone/acetaminophen tablets sold today, regardless of brand name, contain no more than 325 mg of acetaminophen per dose.
Available Strengths Today
Current hydrocodone/acetaminophen tablets come in three strengths, all with 325 mg of acetaminophen paired with different amounts of hydrocodone:
- 5/325: 5 mg hydrocodone, 325 mg acetaminophen
- 7.5/325: 7.5 mg hydrocodone, 325 mg acetaminophen
- 10/325: 10 mg hydrocodone, 325 mg acetaminophen
The first number is the hydrocodone dose, which determines how strong the painkilling effect is. The second number is the acetaminophen dose, which is now the same across the board. Whether the label says Lortab, Norco, or simply “hydrocodone/acetaminophen” (the generic), the formulations are functionally identical at the same strength.
In practice, most prescriptions today are filled with a generic version rather than either brand name. Your pharmacist may dispense whichever generic manufacturer they stock, and the pill’s shape, color, and markings can vary. The active medication inside is the same.
Scheduling and Prescription Rules
Both Lortab and Norco are classified as Schedule II controlled substances under federal law. The DEA moved all hydrocodone combination products into this more restrictive category in 2014, up from Schedule III. This means your prescription cannot include refills. Each time you need more, your doctor must write a new prescription. In most states, the prescription must also be filled within a specific window, typically 90 days.
Acetaminophen Limits to Keep in Mind
Because every tablet contains 325 mg of acetaminophen, the total amount adds up quickly if you’re taking multiple doses throughout the day. The FDA’s recommended ceiling for adults is 4,000 mg of acetaminophen in a 24-hour period, though many doctors suggest staying under 3,000 mg as a safer target, especially for older adults or anyone who drinks alcohol regularly.
The risk with acetaminophen isn’t the opioid component. It’s liver toxicity. People sometimes forget that over-the-counter cold medicines, headache remedies, and sleep aids also contain acetaminophen. Combining those with a hydrocodone/acetaminophen prescription can push you past safe limits without realizing it. If you’re taking this medication, check the labels of any other products you use to make sure you’re not doubling up.
Why Your Pharmacy Might Use One Name Over Another
If you’ve seen both names on your prescription records, it likely reflects nothing more than a change in which manufacturer your pharmacy was stocking at the time. Brand-name Lortab has largely been discontinued in favor of generics, and Norco, while still a recognized brand, is also most commonly dispensed in generic form. The name on the bottle may change from one fill to the next, but as long as the strength printed on the label matches your prescription, the medication is the same.