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- Does Percocet (oxycodone/acetaminophen) cause side effects?
- What are the important side effects of Percocet (oxycodone/acetaminophen)?
- Percocet (oxycodone/acetaminophen) side effects list for healthcare professionals
- Does Percocet (oxycodone/acetaminophen) cause addiction or withdrawal symptoms?
- What drugs interact with Percocet (oxycodone/acetaminophen)?
Does Percocet (oxycodone/acetaminophen) cause side effects?
Common side effects of Percocet include
- feeling uneasy,
- constipation, and
- difficulty urinating.
Serious side effects of Percocet include
- a severe reduction in blood pressure (hypotension),
- paralytic ileus,
- serious allergic reactions,
- severe skin reactions,
- depressed breathing, and
- impaired thinking and 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.
Drug interactions of Percocet include alcohol, barbiturates, skeletal muscle relaxants, and benzodiazepines, because oxycodone, like other narcotic pain relievers, increases the effect of drugs that slow brain function and may also lead to increased respiratory depression.
Drugs which stimulate and also block opioid receptors may reduce the effect of oxycodone and may precipitate withdrawal symptoms.
A fatty meal may increase the absorption of oxycodone by 27%.
What are the important side effects of Percocet (oxycodone/acetaminophen)?
The most frequent adverse reactions of Percocet (oxycodone/acetaminophen) include:
Other important side effects include:
- Spasm of the ureter, which can lead to difficulty in urinating
Possible serious side effects include:
- Severe reduction in blood pressure (hypotension)
- Paralytic ileus
- Serious allergic reactions
- Severe skin reactions
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.
Percocet (oxycodone/acetaminophen) side effects list for healthcare professionals
Serious adverse reactions that may be associated with Percocet tablet use include
The most frequently observed non-serious adverse reactions include
- drowsiness or sedation,
- nausea, and
These effects seem to be more prominent in ambulatory than in nonambulatory patients, and some of these adverse reactions may be alleviated if the patient lies down.
Other adverse reactions include
- constipation, and
Hypersensitivity reactions may include:
- skin eruptions,
- erythematous skin reactions.
Hematologic reactions may include:
Rare cases of agranulocytosis has likewise been associated with acetaminophen use. In high doses, the most serious adverse effect is a dose-dependent, potentially fatal hepatic necrosis. Renal tubular necrosis and hypoglycemic coma also may occur.
Other adverse reactions obtained from postmarketing experiences with Percocet tablets are listed by organ system and in decreasing order of severity and/or frequency as follows:
Body as a Whole
Central and Peripheral Nervous System
Fluid and Electrolyte
Dyspepsia, taste disturbances, abdominal pain, abdominal distention, sweating increased, diarrhea, dry mouth, flatulence, gastro-intestinal disorder, nausea, vomiting, pancreatitis, intestinal obstruction, ileus
Hearing and Vestibular
Metabolic and Nutritional
Miosis, visual disturbances, red eye
Bronchospasm, dyspnea, hyperpnea, pulmonary edema, tachypnea, aspiration, hypoventilation, laryngeal edema
Skin and Appendages
Erythema, urticaria, rash, flushing
Does Percocet (oxycodone/acetaminophen) cause addiction or withdrawal symptoms?
Drug Abuse And Dependence
Percocet tablets are a Schedule II controlled substance. Oxycodone is a mu-agonist opioid with an abuse liability similar to morphine. Oxycodone, like morphine and other opioids used in analgesia, can be abused and is subject to criminal diversion.
- Drug addiction is defined as an abnormal, compulsive use, use for non-medical purposes of a substance despite physical, psychological, occupational or interpersonal difficulties resulting from such use, and continued use despite harm or risk of harm.
- Drug addiction is a treatable disease, utilizing a multi-disciplinary approach, but relapse is common. Opioid addiction is relatively rare in patients with chronic pain but may be more common in individuals who have a past history of alcohol or substance abuse or dependence.
- Pseudoaddiction refers to pain relief seeking behavior of patients whose pain is poorly managed. It is considered an iatrogenic effect of ineffective pain management. The health care provider must assess continuously the psychological and clinical condition of a pain patient in order to distinguish addiction from pseudoaddiction and thus, be able to treat the pain adequately.
- Physical dependence on a prescribed medication does not signify addiction. Physical dependence involves the occurrence of a withdrawal syndrome when there is sudden reduction or cessation in drug use or if an opiate antagonist is administered. Physical dependence can be detected after a few days of opioid therapy.
- However, clinically significant physical dependence is only seen after several weeks of relatively high dosage therapy. In this case, abrupt discontinuation of the opioid may result in a withdrawal syndrome. If the discontinuation of opioids is therapeutically indicated, gradual tapering of the drug over a 2-week period will prevent withdrawal symptoms. The severity of the withdrawal syndrome depends primarily on the daily dosage of the opioid, the duration of therapy and medical status of the individual.
- The withdrawal syndrome of oxycodone is similar to that of morphine. This syndrome is characterized by yawning, anxiety, increased heart rate and blood pressure, restlessness, nervousness, muscle aches, tremor, irritability, chills alternating with hot flashes, salivation, anorexia, severe sneezing, lacrimation, rhinorrhea, dilated pupils, diaphoresis, piloerection, nausea, vomiting, abdominal cramps, diarrhea and insomnia, and pronounced weakness and depression.
- "Drug-seeking" behavior is very common in addicts and drug abusers. Drug-seeking tactics include emergency calls or visits near the end of office hours, refusal to undergo appropriate examination, testing or referral, repeated "loss" of prescriptions, tampering with prescriptions and reluctance to provide prior medical records or contact information for other treating physician(s). "Doctor Shopping" to obtain additional prescriptions is common among drug abusers and people suffering from untreated addiction.
- Abuse and addiction are separate and distinct from physical dependence and tolerance. Physicians should be aware that addiction may not be accompanied by concurrent tolerance and symptoms of physical dependence in all addicts. In addition, abuse of opioids can occur in the absence of true addiction and is characterized by misuse for non-medical purposes, often in combination with other psychoactive substances. Oxycodone, like other opioids, has been diverted for non-medical use. Careful record-keeping of prescribing information, including quantity, frequency, and renewal requests is strongly advised.
- Proper assessment of the patient, proper prescribing practices, periodic re-evaluation of therapy, and proper dispensing and storage are appropriate measures that help to limit abuse of opioid drugs.
- Like other opioid medications, Percocet tablets are subject to the Federal Controlled Substances Act. After chronic use, Percocet tablets should not be discontinued abruptly when it is thought that the patient has become physically dependent on oxycodone.
Interactions with Alcohol and Drugs of Abuse
Oxycodone may be expected to have additive effects when used in conjunction with alcohol, other opioids, or illicit drugs that cause central nervous system depression.
What drugs interact with Percocet (oxycodone/acetaminophen)?
Drug/Drug Interactions with Oxycodone
Opioid analgesics may enhance the neuromuscular-blocking action of skeletal muscle relaxants and produce an increase in the degree of respiratory depression.
Patients receiving CNS depressants such as other opioid analgesics, general anesthetics, phenothiazines, other tranquilizers, centrally-acting anti-emetics, sedative-hypnotics or other CNS depressants (including alcohol) concomitantly with Percocet tablets may exhibit an additive CNS depression. When such combined therapy is contemplated, the dose of one or both agents should be reduced. The concurrent use of anticholinergics with opioids may produce paralytic ileus.
Agonist/antagonist analgesics (i.e., pentazocine, nalbuphine, naltrexone, and butorphanol) should be administered with caution to a patient who has received or is receiving a pure opioid agonist such as oxycodone. These agonist/antagonist analgesics may reduce the analgesic effect of oxycodone or may precipitate withdrawal symptoms.
Drug/Drug Interactions with Acetaminophen
Alcohol, ethyl: Hepatotoxicity has occurred in chronic alcoholics following various dose levels (moderate to excessive) of acetaminophen.
Anticholinergics: The onset of acetaminophen effect may be delayed or decreased slightly, but the ultimate pharmacological effect is not significantly affected by anticholinergics.
Oral Contraceptives: Increase in glucuronidation resulting in increased plasma clearance and a decreased half-life of acetaminophen.
Charcoal (activated): Reduces acetaminophen absorption when administered as soon as possible after overdose.
Beta Blockers (Propanolol): Propanolol appears to inhibit the enzyme systems responsible for the glucuronidation and oxidation of acetaminophen. Therefore, the pharmacologic effects of acetaminophen may be increased.
Loop diuretics: The effects of the loop diuretic may be decreased because acetaminophen may decrease renal prostaglandin excretion and decrease plasma renin activity.
Lamotrigine: Serum lamotrigine concentrations may be reduced, producing a decrease in therapeutic effects.
Probenecid: Probenecid may increase the therapeutic effectiveness of acetaminophen slightly.
Zidovudine: The pharmacologic effects of zidovudine may be decreased because of enhanced non-hepatic or renal clearance of zidovudine.
Drug/Laboratory Test Interactions
Depending on the sensitivity/specificity and the test methodology, the individual components of Percocet (Oxycodone and Acetaminophen Tablets, USP) may cross-react with assays used in the preliminary detection of cocaine (primary urinary metabolite, benzoylecgonine) or marijuana (cannabinoids) in human urine.
A more specific alternate chemical method must be used in order to obtain a confirmed analytical result. The preferred confirmatory method is gas chromatography/mass spectrometry (GC/MS). Moreover, clinical considerations and professional judgment should be applied to any drug-of-abuse test result, particularly when preliminary positive results are used.
Acetaminophen may interfere with home blood glucose measurement systems; decreases of >20% in mean glucose values may be noted. This effect appears to be drug, concentration and system dependent.
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Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.
Professional side effects, drug interactions, and addiction sections courtesy of the U.S. Food and Drug Administration.