Narcotic needs Rx. This combination includes a narcotic. You cannot get a narcotic over-the-counter. Better still you may not need the narcotic. A lot of nsaids are just as efficient as this narcotic combination. It is better to avoid the narcotic. Cardiologist told us use narcotics and not nsaids in older people to prevent NSAID cardiovascular side effects and then the elderly had more narcotic complications -falls.