oxycodone and acetaminophen, Percocet, Roxicet, Tylox, Endocet (discontinued), Oxycet,

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Medical and Pharmacy Editor:

GENERIC NAME: oxycodone and acetaminophen

BRAND NAMES: Percocet, Roxicet, Tylox, Endocet (discontinued), Oxycet, Roxilox

DRUG CLASS AND MECHANISM: Oxycodone is a strong narcotic pain-reliever and cough suppressant similar to morphine, codeine, and hydrocodone. The precise mechanism of action is not known but may involve stimulation of opioid (narcotic) receptors in the brain. Oxycodone does not eliminate the sensation of pain but decreases discomfort by increasing tolerance to pain. In addition to tolerance to pain, oxycodone also causes sedation and respiratory depression. Acetaminophen is a non-narcotic pain-reliever and antipyretic (fever reducer). Acetaminophen relieves pain by elevating the threshold to sensing pain. It reduces fever through its action on the heat-regulating center of the brain. The combination of oxycodone and acetaminophen achieves greater pain relief than either taken separately. The FDA approved oxycodone/acetaminophen combinations in February 1980.

PRESCRIPTION: Yes

GENERIC AVAILABLE: Yes

PREPARATIONS: Tablets: 2.5/325, 5/325, 7.5/500, 10/650 mg (oxycodone/acetaminophen); Capsules: 5/500 mg; Solution: 5/325 mg per teaspoonful.

STORAGE: Oxycodone/acetaminophen should be stored at room temperature in a sealed, light- resistant container.

PRESCRIBED FOR: Oxycodone/acetaminophen is prescribed for the relief of moderate to moderately-severe pain.

DOSING: The dose of oxycodone/acetaminophen is variable and depends on the needs of the patient and specific circumstances. The usual dose is one tablet every six hours as needed. The maximum oxycodone/acetaminophen dose is 60 mg/4 g per day.

DRUG INTERACTIONS: Oxycodone, like other narcotic pain-relievers, increases the effect of drugs that slow brain function, such as alcohol, barbiturates, skeletal muscle relaxants, for example, carisoprodol (Soma), cyclobenzaprine (Flexeril), and benzodiazepines such as diazepam (Valium) and lorazepam (Ativan). Combined use of muscle relaxants or benzodiazepines and oxycodone may lead to increased respiratory depression.

Since oxycodone causes constipation, the use of antidiarrheals, for example, diphenoxylate (Lomotil) and loperamide (Imodium), in persons taking oxycodone, can lead to severe constipation.

Drugs which stimulate and also block opioid receptors, for example, pentazocine, nalbuphine (Nubain), butorphanol (Stadol), and buprenorphine (Subutex) may reduce the effect of oxycodone and may precipitate withdrawal symptoms.

A fatty meal may increase the absorption of oxycodone by 27%.

PREGNANCY: Safety of oxycodone/acetaminophen during pregnancy has not been established. Newborns of mothers who were taking oxycodone for a prolonged period may exhibit respiratory depression or withdrawal symptoms.

NURSING MOTHERS: Small amounts of oxycodone are secreted in breast milk and may cause side effects in the newborn.

SIDE EFFECTS: The most frequent adverse reactions of oxycodone/acetaminophen include lightheadedness, dizziness, sedation, nausea, and vomiting. Other side effects include drowsiness, constipation, and spasm of the ureter, which can lead to difficulty in urinating.

Oxycodone can depress breathing and, therefore, is used with caution in elderly, debilitated patients and in patients with serious lung disease. Oxycodone can impair thinking and the physical abilities required for driving or operating machinery. Oxycodone can be habit-forming. Mental and physical dependence can occur but are unlikely when used for short-term pain relief.

Reference: FDA Prescribing Information


Last Editorial Review: 7/12/2010




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