Norco- Drug Interactions that you should ask your doctor about

Using Norco safely is essential and to know about how to use the drug safely, you should consult your doctor for the right dosage information and also for the possible drug interactions of Norco with other drugs. If you are also using some other drugs other than Norco, then knowing about drug interactions can certainly help you use the drug safely and keep a check on the side effects that can result as a result of drug interactions

Your doctor can guide you on whether you can take Norco with other drugs or if you need a change in dose etc., let us learn about some drug interactions that you need to know about before you use Norco.

Norco can interact with

Opioid Analgesics/Naltrexone

The effect of using Opioid Analgesics/Naltrexone can be severe. These medicines interact to cause harmful effects and therefore these medicines are not used together. When these medicines are used together naltrexone can reduce the effects of opioid analgesics.

These interactions can result in withdrawal symptoms due to opioid analgesic while using naltrexone. Contact your health care provider if you experience withdrawal symptoms.

Cimetidine/Narcotic Analgesics

There are chances of moderate effects. These medicines when taken together with Norco can lead to some risks. Discuss with your doctor to know about the effects. Your body might not process the medicine effectively.

You might experience sluggishness, drowsiness, or disorientation. You may experience breathlessness or breathing problems.


Nalupine when taken together with Norco can cause some risks. Nalbuphine might stop the other pain medicine from showing results. If you have taken any opioid for quite some time now, Nalbuphine can lead to withdrawal symptoms. If you have any opioid medicine for a short duration, Nalbuphine can reduce the side effects of the medicine like shallow breathing, itching and opioid might not be successful in controlling your pain.


The effects are moderate and combination of these medicines can lead to some risks. Butorphanol can stop your pain medicine from working. Taking large doses of opioids or taking opioids for longer time, butorphanol can lead to withdrawal symptoms. If you have used any opioid medicine for a short duration, Butorphano can reduce the side effects of the medicine like shallow breathing, itching and opioid might not be successful in controlling your pain.


These medicines when used together can cause some risks. Acetaminophen can slow down the speed of your body and its mechanism to eliminate busulfan. So it will take more time for your body to flush out buslfan.

Some other medicines that can interact with Norco are

  • Anileridine
  • Boceprevir
  • Anileridine
  • Bromazepam
  • Carbinoxamine
  • Clobazam
  • Diacetylmorphine
  • Difenoxin
  • Doxylamine
  • Enflurane
  • Fospropofol

Other Interactions

Certain medicines should be avoided when eating food or certain food types as food interactions can happen. Using tobacco or alcohol can lead to severe interactions. The other foods and possible Norco interactions are

  • tobacco
  • ethanol
  • grapefruit juice
  • cabbage

Norco- Dosage Information and over dosage treatment

Norco is a combination of two medications acetaminophen which is a pain reliever and a non-narcotic medication and other one is hydrocodone which is a narcotic pain reliever. Before you start taking Norco, speak to your doctor and make sure you understand how to use Norco safely. In case you have any concerns or doubts, you should ask your doctor.

Take Norco orally as prescribed by your health care provider. You can take this medication with/without food. In case of nausea take this drug with food. You can also discuss with your pharmacist or doctor to know the best way to reduce nausea.

If you are taking the liquid form of this drug, use a measuring device available for measuring medicines to make sure you measure the exact prescribed dose. Avoid using household spoon as you will not get the exact dose.

The dosage is solely based on your medical condition and how your body responds to the treatment. In children the dosage prescribed is based on weight. Avoid increasing your dose, using the drug frequently, and using it for a prolonged period. Stop taking the medication safely as prescribed by your physician.

Pain medications are more effective when used in initial stages of pain. If you wait for a long time until the pain becomes severe then medication might not work effectively.


The dosage of hyrdocodone/acetaminophen is normally 1 tablet after every 6 hours (regardless of medication strength) or as required. The maximum tablets taken should not exceed 6 tablets a day.

If you feel the medication isn’t working well or has stopped working, speak to your doctor and do not adjust the dosage on your own.

Norco should be recommended cautiously especially in elderly people as there are higher chances of breathing problems that can arise in this section. Elderly people tend to develop kidney or liver problems due to consumption of hydrocodone/acetaminophen.

What If I missed a dose?

As Norco is used as and when required, you may not have a dosing schedule. If you are using the medication on a regular basis, take the dose you missed as soon as you recollect. Skip the dose you missed if it is time for your next dose. Avoid taking extra dose to make up for the dose you missed.

What If I overdose?

Call poison help centre in case of over dose. The initial signs of acetaminophen overdose are stomach pain, nausea, vomiting, weakness, confusion or sweating.  Later the symptoms can be dark urine, pain in upper stomach, yellow skin, and whites of eyes.

Over dosage and treatment

Norco over dosage occurs due to hydrocodone and acetaminophen toxicity. To treat overdose, you should call poison help immediately. Immediate treatment starts with measures to decrease drug absorption and aid cardio respiratory function. Intravenous fluids, oxygen, vasopressors and other necessary measures should be established as indicated. Controlled or assisted ventilation should be considered along with other measures.

It is important to seek emergency medical help immediately so that symptoms of overdose can be treated immediately and patient’s life can be saved.

Trimipramine drug interactions that can lead to severe side effects

Drug interactions can completely change how your medicine works, so make sure you check with your doctor about possible drug interactions before taking any antidepressant. Also let your doctor know about other medicines that you are using. Your doctor can guide you on which medications can interact with Trimipramine and result in severe side effects


It has been proved that cimetidine hinders the elimination of antidepressants that belong to tricyclic group. In case cimetidine therapy is started, Trimipramine dosage should be reduced and should be increased when cimetidine therapy is stopped.


According to the studies Trimipramine can increase the power of catecholamines. Therefore extra caution should be taken while using Trimipramine with local decongestants, sympathomimetic amines, local anesthetics which contain atropine, epinephrine or medications with anticholinergic effects.

MAOIs and Trimipramine

Before starting with Trimipramine maleate capsules therapy, MAOI should be stopped at least 14 days before Trimipramine therapy is given. Similarly MAOIs should be allowed to use again after 14 days of halting Trimipramine maleate capsules.

Trimipramine with Methylene blue or Linezolid

Do not use the combination of Linezolid/methylene blue(intravenous) as it can result in a serious medical condition known as serotonin syndrome. In case a patient needs urgent treatment for a psychiatric condition, one can try other interventions along with hospitalization.

In some cases patient need treatment of  Methylene blue or Linezolid with Trimipramine therapy and since there are no alternative available for Methylene blue or Linezolid, the doctors are advised to judge the risks of serotonin syndrome in a particular patient and Trimipramine maleate capsules should be halted promptly and only Methylene blue or Linezolid can be continued.

Do not drink alcohol while you are on Trimipramine as it can be dangerous. Grapefruit juice or grapefruit can also interact with Trimipramine resulting in serious side effects. Speak to your doctor about grapefruit products.

There are many other drugs that can interact with Trimipramine and effect heart rhythm like dronedarone, disopyramide etc., so if you are using these medications, let your doctor know about it.

Also tell your doctor if you are taking certain drugs that lead to drowsiness like some anthistamines, medicine for anxiety, sleep, anti-seizure drugs, muscle relaxer, psychiatric medicines, pain relievers(narcotic) etc.,

Also discuss with your doctor if you are using other drugs that can interact with Trimipramine and increase the risk of seizures like INH, theophylline, phenothiazines, tramadol and tricyclic antidepressants.

The effects of drug interactions can range from mild to severe, but you need to make sure that the medicines you are using currently apart from Trimipramine are safe as they can interact with the medication to yield harmful effects. Let your doctor check the ingredients present in other medications and possibilities of various drug interactions. You can consult your doctor to know which medications can interact with Trimipramine so that your doctor can check the medications you can take along with Trimipramine and use Trimipramine safely. Drug interactions can be quite severe and if the side effects if left untreated can lead to serious problems.

Trimipramine dosage information to get maximum benefits

Trimipramine should be taken as directed by your doctor. Do not change your Trimipramine dose on your own. Do not discontinue the medicine without your doctor’s consent. To get maximum benefits, it is necessary to take the recommended dosage. This article will help you learn about the right Trimipramine dosage information. Consult your health care provider for the right dosage as each case is different and depending upon your medical condition, the doctor can prescribe you the right dose.

Dosage should be started at low doses, which can be increased slowly as required, depending on the patient’s tolerance to the medicine and clinical response. Lower dosages are prescribed for adolescents and elderly patients. Lower dosages are also given to patients who are not being hospitalized as compared to the doses given to a patient who is hospitalized. It is not possible to prescribe a general single dose of Trimipramine maleate(capsules) that can act as an effective treatment method in all patients. Therefore the right dosage depends on various factors like patient’s age, severity and chronicity of the disease, level of psychotherapeutic support and medical condition of a particular patient.

Most antidepressants take a period of minimum 10days to 4 weeks to show positive results. Dosage increment can cut down this period, but would result in adverse reactions too.

Normal Adult Dose

Office patients/Outpatients

Initial Dose: 75mg/day in split doses, which can be increased to 150mg/day.

Dosages should not exceed 200mg/day

Maintenance therapy: 50-150mg/day

Hospitalized patients

Initial dose: 100mg/day in split doses. This can increase to 200/mg/day slowly in a couple of days, depending upon individual’s tolerance and response to the medication

If there is no improvement seen in patient in 2-3 weeks, the dose can be increased to maximum dose of 250-300mg/day

Geriatric and Adolescents patients

Initial Dose: 50mg/day is ideal, which can be increased gradually to 100mg/day depending upon individual’s tolerance and response to the medication

Trimipramine over dosage and treatment

Over dosages of this class of medications can even lead to death. Multiple drug ingestion is very common with antidepressant overdose. The overdose management is changing every day and is quite challenging. Keeping this factor in mind, one should call medical help or poison control centre immediately in case of Trimipramine over dose. Symptoms and signs of toxicity accelerate after overdose of Trimipramine and thus hospitalization is must for a patient.

Signs of Trimipramine overdose include:

  • vomiting
  • drowsiness
  • stupor
  • agitation
  • hypothermia
  • hyperactive reflexes
  • hyperpyrexia
  • dilated pupils
  • disturbed concentration
  • muscle rigidity
  • hallucinations


To treat Trimipramine overdose, an ECG is obtained immediately followed by cardiac monitoring. Patient’s airway is secured, gastric decontamination is started and an intravenous line is established. The patient is kept under medical observation for at least 6 hours wherein cardiac monitoring is conducted to check for signs of hypotension, respiratory or CNS depression, seizures and cardiac dysrhythmias. If the toxicity signs continue during this period, the monitoring is extended for some more time.

Trimipramine can treat depression safely

Trimipramine is used to treat depression and some other health ailments as suggested by the doctor. It is a tricyclic antidepressant, which increases the action of chemicals present in the brain that helps boost your mood. The generic name is Trimipramine and brand name is Surmontil.

Avoid using Trimipramine if

  • You are allergic to the ingredients present in Trimipramine or to some similar drugs.
  • you have used linezolid, furazolidone or MAOI in past 14 days
  • you are regaining health after a heart attack

Contact your health care provider if any of the above conditions are applicable to you.

Some medical conditions can interact with Trimipramine. Tell your health care provider if you are suffering from any health ailments especially

  1. If you are planning to conceive, if you are pregnant or a nursing mother.
  2. if you are allergic to certain substances food or medicines
  3. If you consume alcohol based beverages daily or have a history of alcohol addiction.
  4. If your thyroid gland is overactive, you have glaucoma, irregular heartbeat, liver or kidney problems, heart problems, diabetes, enlarged prostate, porphyria or difficulty in urinating.
  5. if you are using any prescription/non prescription medications, dietary supplement or herbal preparation
  6. If you have a history of suicidal behaviour/ thoughts, seizures, mental disorder or bipolar disorder.
  7. If any surgery is scheduled or undergoing electroshock therapy.
  8. If you are using any medicine that consists of methylene blue.

Important Information

You can take Trimipramine at bedtime as it helps reducing the side effects like drowsiness that occurs during daytime. You can discuss about this possibility with your doctor.

Take Trimipramine orally with/without food. Read the instructions given on the label carefully. To get the effect of the medication, it will take nearly 1-3 weeks, so continue taking Trimipramine even if you think you are feeling well. Try not to miss any doses.

If you miss a Trimipramine dose, take it as soon as you recollect and if it’s almost the time for your next dose then skip the missed dose. Do not take extra dose to make up the missed dose and get back to your normal dosing schedule.

Do not consume alcohol with Trimipramine as it can increase drowsiness. Speak to your doctor about which other medications can lead to drowsiness. In diabetes patients, Trimipramine can change their blood sugar levels, so check your blood sugar levels regularly. Also discuss with your doctor before changing the dose of your diabetes medication.

Teenagers, children and young adults who use Trimipramine are at higher risk of suicidal actions or thoughts. Monitor patients who use Trimipramine closely. Get in touch with your doctor if worsened, sudden or new symptoms like restlessness, panic attacks, irritable behaviour, and unusual change in mood/behaviour occur. Contact your doctor immediately if you notice any signs of suicidal actions or thoughts.

Some people who use Trimipramine also develop eye problems. Your doctor can suggest you an eye exam if you face eye problems. Inform your doctor if you experience vision changes, eye pain, redness or swelling around eyes or in eyes.


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