Acetaminophen and Oxycodone

Acetaminophen and Oxycodone Brand Names

Endocet | Magnacet | Nalocet | Narvox | Percocet | Perloxx | Primalev | Primlev | Prolate | Roxicet | Tylox | XARTEMIS XR | Xolox

What is Acetaminophen and Oxycodone

Acetaminophen and oxycodone are used together to treat moderate to severe pain due to cancer, dental procedures, headache, back pain, arthralgias, and myalgias.

Acetaminophen is a non-salicylate analgesic with similar analgesic potency as NSAIDs. Oxycodone is an oral semisynthetic opiate agonist derived from the opioid alkaloid, thebaine.

The combination of acetaminophen and oxycodone produces additive analgesia as compared to the same doses of either agent alone. Combinations containing higher doses of one or both components give progressively increasing analgesia.

However, dosage escalation of this combination is limited by the maximum dose and ‘ceiling effect’ of acetaminophen. The combination of acetaminophen and opioid analgesics may achieve a ‘dose-sparing’ effect such that lower doses of the both agents produce pain relief with fewer side effects.

The acetaminophen-oxycodone combination is available as tablets, capsules, and liquid dosage forms.

The FDA approved the first acetaminophen and oxycodone preparation (Percocet(R)) in August 1976.

Indications

• moderate pain
• severe pain

Side Effects

1. abdominal pain
2. acute generalized exanthematous pustulosis (AGEP)
3. adrenocortical insufficiency
4. agitation
5. agranulocytosis
6. amenorrhea
7. anaphylactic shock
8. anaphylactoid reactions
9. angioedema
10. anorexia
11. anxiety
12. apnea
13. arthralgia
14. asthenia
15. blurred vision
16. bradycardia
17. cardiac arrest
18. cerebral edema
19. chest pain (unspecified)
20. chills
21. confusion
22. constipation
23. contact dermatitis
24. cough
25. dehydration
26. depression
27. diaphoresis
28. diarrhea
29. dizziness
30. drowsiness
31. dysgeusia
32. dyspepsia
33. dysphoria
34. dyspnea
35. dysuria
36. ecchymosis
37. edema
38. elevated hepatic enzymes
39. encephalopathy
40. erythema
41. euphoria
42. fatigue
43. flatulence
44. flushing
45. GI obstruction
46. gonadal suppression
47. hallucinations
48. headache
49. hearing loss
50. hemolytic anemia
51. hepatic failure
52. hepatic necrosis
53. hepatitis
54. hepatotoxicity
55. hiccups
56. hyperbilirubinemia
57. hyperemia
58. hyperglycemia
59. hyperhidrosis
60. hyperkalemia
61. hypertension
62. hypoesthesia
63. hypoglycemia
64. hypoprothrombinemia
65. hypotension
66. hypothermia
67. hypoventilation
68. ileus
69. impotence (erectile dysfunction)
70. infertility
71. insomnia
72. interstitial nephritis
73. jaundice
74. laryngeal edema
75. lethargy
76. libido decrease
77. malaise
78. memory impairment
79. metabolic acidosis
80. migraine
81. miosis
82. myalgia
83. myoclonia
84. nausea
85. neonatal opioid withdrawal syndrome
86. neutropenia
87. oliguria
88. orthostatic hypotension
89. palpitations
90. pancreatitis
91. pancytopenia
92. paresthesias
93. peripheral edema
94. physiological dependence
95. polydipsia
96. proteinuria
97. pruritus
98. psychological dependence
99. pulmonary edema
100. purpura
101. rash
102. renal failure (unspecified)
103. renal papillary necrosis
104. renal tubular necrosis
105. respiratory arrest
106. respiratory depression
107. rhabdomyolysis
108. seizures
109. serotonin syndrome
110. sinus tachycardia
111. Stevens-Johnson syndrome
112. suicidal ideation
113. syncope
114. tachypnea
115. throat irritation
116. thrombocytopenia
117. tinnitus
118. tolerance
119. toxic epidermal necrolysis
120. tremor
121. urinary retention
122. urticaria
123. visual impairment
124. vomiting
125. withdrawal
126. xerostomia

Monitoring Parameters

• LFTs
• serum creatinine/BUN: in chronic use or acute toxicity

Contraindications

• abrupt discontinuation
• accidental exposure
• acetaminophen hypersensitivity
• acute abdomen
• adrenal insufficiency
• alcoholism
• asthma
• biliary tract disease
• bladder obstruction
• bone marrow suppression
• breast-feeding
• cardiac arrhythmias
• cardiac disease
• children
• chronic obstructive pulmonary disease (COPD)
• CNS depression
• coadministration with other CNS depressants
• constipation
• cor pulmonale
• driving or operating machinery
• dysphagia
• esophageal stricture
• G6PD deficiency
• geriatric
• GI disease
• GI obstruction
• head trauma
• hepatic disease
• hepatitis
• hepatotoxicity
• hypotension
• hypothyroidism
• hypovolemia
• hypoxemia
• ileus
• immunosuppression
• increased intracranial pressure
• infants
• infection
• inflammatory bowel disease
• intracranial mass
• labor
• myxedema
• neonatal opioid withdrawal syndrome
• neonates
• obesity
• obstetric delivery
• oliguria
• opiate agonist hypersensitivity
• orthostatic hypotension
• pancreatitis
• potential for overdose or poisoning
• pregnancy
• prostatic hypertrophy
• psychosis
• pulmonary disease
• renal disease
• renal impairment
• respiratory depression
• respiratory insufficiency
• scoliosis
• sleep apnea
• status asthmaticus
• substance abuse
• sulfite hypersensitivity
• ulcerative colitis
• urethral stricture
• urinary retention

Interactions

• Abacavir; Lamivudine, 3TC; Zidovudine, ZDV
• Acetaminophen; Aspirin, ASA; Caffeine
• Acetaminophen; Butalbital
• Acetaminophen; Butalbital; Caffeine
• Acetaminophen; Butalbital; Caffeine; Codeine
• Acetaminophen; Caffeine; Dihydrocodeine
• Acetaminophen; Caffeine; Magnesium Salicylate; Phenyltoloxamine
• Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine
• Acetaminophen; Chlorpheniramine; Dextromethorphan; Pseudoephedrine
• Acetaminophen; Chlorpheniramine; Phenylephrine; Phenyltoloxamine
• Acetaminophen; Codeine
• Acetaminophen; Dextromethorphan; Doxylamine
• Acetaminophen; Diphenhydramine
• Acetaminophen; Hydrocodone
• Acetaminophen; Pentazocine
• Acetaminophen; Propoxyphene
• Acetaminophen; Tramadol
• Acrivastine; Pseudoephedrine
• Aldesleukin, IL-2
• Alfentanil
• Aliskiren; Amlodipine
• Aliskiren; Amlodipine; Hydrochlorothiazide, HCTZ
• Aliskiren; Hydrochlorothiazide, HCTZ
• Almotriptan
• Alosetron
• Alprazolam
• Alvimopan
• Amide local anesthetics
• Amifampridine
• Amiloride
• Amiloride; Hydrochlorothiazide, HCTZ
• Amiodarone
• Amitriptyline
• Amitriptyline; Chlordiazepoxide
• Amlodipine
• Amlodipine; Atorvastatin
• Amlodipine; Benazepril
• Amlodipine; Celecoxib
• Amlodipine; Hydrochlorothiazide, HCTZ; Olmesartan
• Amlodipine; Hydrochlorothiazide, HCTZ; Valsartan
• Amlodipine; Olmesartan
• Amlodipine; Telmisartan
• Amlodipine; Valsartan
• Amobarbital
• Amoxapine
• Amoxicillin; Clarithromycin; Lansoprazole
• Amoxicillin; Clarithromycin; Omeprazole
• Antacids
• Anticholinergics
• Apalutamide
• Apomorphine
• Apraclonidine
• Aprepitant, Fosaprepitant
• Aripiprazole
• Armodafinil
• Articaine; Epinephrine
• Asenapine
• Aspirin, ASA
• Aspirin, ASA; Butalbital; Caffeine
• Aspirin, ASA; Butalbital; Caffeine; Codeine
• Aspirin, ASA; Caffeine; Dihydrocodeine
• Aspirin, ASA; Caffeine; Orphenadrine
• Aspirin, ASA; Carisoprodol
• Aspirin, ASA; Carisoprodol; Codeine
• Aspirin, ASA; Citric Acid; Sodium Bicarbonate
• Aspirin, ASA; Dipyridamole
• Aspirin, ASA; Omeprazole
• Aspirin, ASA; Oxycodone
• Aspirin, ASA; Pravastatin
• Atazanavir
• Atazanavir; Cobicistat
• Atenolol; Chlorthalidone
• Atomoxetine
• Atropine; Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
• Atropine; Difenoxin
• Atropine; Diphenoxylate
• Atropine; Hyoscyamine; Phenobarbital; Scopolamine
• Azelastine
• Azelastine; Fluticasone
• Azilsartan; Chlorthalidone
• Baclofen
• Barbiturates
• Belladonna Alkaloids; Ergotamine; Phenobarbital
• Belladonna; Opium
• Benazepril; Hydrochlorothiazide, HCTZ
• Bendroflumethiazide; Nadolol
• Benzhydrocodone; Acetaminophen
• Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
• Benzonatate
• Bethanechol
• Bexarotene
• Bicalutamide
• Bismuth Subcitrate Potassium; Metronidazole; Tetracycline
• Bismuth Subsalicylate
• Bismuth Subsalicylate; Metronidazole; Tetracycline
• Bisoprolol; Hydrochlorothiazide, HCTZ
• Boceprevir
• Bosentan
• Brexpiprazole
• Brigatinib
• Brimonidine
• Brimonidine; Brinzolamide
• Brimonidine; Timolol
• Brompheniramine
• Brompheniramine; Carbetapentane; Phenylephrine
• Brompheniramine; Dextromethorphan; Guaifenesin
• Brompheniramine; Guaifenesin; Hydrocodone
• Brompheniramine; Hydrocodone; Pseudoephedrine
• Brompheniramine; Pseudoephedrine
• Bumetanide
• Bupivacaine
• Bupivacaine Liposomal
• Bupivacaine; Lidocaine
• Buprenorphine
• Buprenorphine; Naloxone
• Bupropion
• Bupropion; Naltrexone
• Buspirone
• Busulfan
• Butabarbital
• Butorphanol
• Candesartan; Hydrochlorothiazide, HCTZ
• Cannabidiol
• Capsaicin; Metaxalone
• Captopril; Hydrochlorothiazide, HCTZ
• Carbamazepine
• Carbetapentane; Chlorpheniramine
• Carbetapentane; Chlorpheniramine; Phenylephrine
• Carbetapentane; Diphenhydramine; Phenylephrine
• Carbetapentane; Guaifenesin
• Carbetapentane; Guaifenesin; Phenylephrine
• Carbetapentane; Phenylephrine
• Carbetapentane; Phenylephrine; Pyrilamine
• Carbetapentane; Pseudoephedrine
• Carbetapentane; Pyrilamine
• Carbinoxamine
• Carbinoxamine; Dextromethorphan; Pseudoephedrine
• Carbinoxamine; Hydrocodone; Phenylephrine
• Carbinoxamine; Hydrocodone; Pseudoephedrine
• Carbinoxamine; Phenylephrine
• Carbinoxamine; Pseudoephedrine
• Cariprazine
• Carisoprodol
• Cenobamate
• Ceritinib
• Cetirizine
• Cetirizine; Pseudoephedrine
• Charcoal
• Chlophedianol; Dexbrompheniramine
• Chlophedianol; Dexchlorpheniramine; Pseudoephedrine
• Chloral Hydrate
• Chloramphenicol
• Chlorcyclizine
• Chlordiazepoxide
• Chlordiazepoxide; Clidinium
• Chloroprocaine
• Chlorothiazide
• Chlorpheniramine
• Chlorpheniramine; Codeine
• Chlorpheniramine; Dextromethorphan
• Chlorpheniramine; Dextromethorphan; Phenylephrine
• Chlorpheniramine; Dihydrocodeine; Phenylephrine
• Chlorpheniramine; Dihydrocodeine; Pseudoephedrine
• Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine
• Chlorpheniramine; Hydrocodone
• Chlorpheniramine; Hydrocodone; Phenylephrine
• Chlorpheniramine; Hydrocodone; Pseudoephedrine
• Chlorpheniramine; Phenylephrine
• Chlorpheniramine; Pseudoephedrine
• Chlorpromazine
• Chlorthalidone
• Chlorthalidone; Clonidine
• Chlorzoxazone
• Cholestyramine
• Choline Salicylate; Magnesium Salicylate
• Cimetidine
• Ciprofloxacin
• Citalopram
• Clarithromycin
• Clemastine
• Clobazam
• Clomipramine
• Clonazepam
• Clonidine
• Clopidogrel
• Clorazepate
• Clozapine
• Cobicistat
• Codeine
• Codeine; Guaifenesin
• Codeine; Phenylephrine; Promethazine
• Codeine; Promethazine
• COMT inhibitors
• Conivaptan
• Crizotinib
• Crofelemer
• Cyclizine
• Cyclobenzaprine
• Cyclosporine
• Cyproheptadine
• Dabrafenib
• Dalfopristin; Quinupristin
• Danazol
• Dantrolene
• Dapsone
• Darifenacin
• Darunavir
• Darunavir; Cobicistat
• Darunavir; Cobicistat; Emtricitabine; Tenofovir alafenamide
• Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir
• Deferasirox
• Delavirdine
• Desflurane
• Desipramine
• Desmopressin
• Deutetrabenazine
• Dexamethasone
• Dexchlorpheniramine
• Dexchlorpheniramine; Dextromethorphan; Pseudoephedrine
• Dexmedetomidine
• Dexpanthenol
• Dextromethorphan; Diphenhydramine; Phenylephrine
• Dextromethorphan; Promethazine
• Dextromethorphan; Quinidine
• Diazepam
• Diflunisal
• Dihydrocodeine; Guaifenesin; Pseudoephedrine
• Diltiazem
• Dimenhydrinate
• Diphenhydramine
• Diphenhydramine; Hydrocodone; Phenylephrine
• Diphenhydramine; Ibuprofen
• Diphenhydramine; Naproxen
• Diphenhydramine; Phenylephrine
• Dolasetron
• Doxepin
• Doxylamine
• Doxylamine; Pyridoxine
• Dronabinol
• Dronedarone
• Droperidol
• Drospirenone; Ethinyl Estradiol
• Drospirenone; Ethinyl Estradiol; Levomefolate
• Duvelisib
• Efavirenz
• Efavirenz; Emtricitabine; Tenofovir
• Efavirenz; Lamivudine; Tenofovir Disoproxil Fumarate
• Elagolix
• Elagolix; Estradiol; Norethindrone acetate
• Elbasvir; Grazoprevir
• Eletriptan
• Elexacaftor; tezacaftor; ivacaftor
• Eliglustat
• Eltrombopag
• Eluxadoline
• Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Alafenamide
• Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate
• Enalapril; Hydrochlorothiazide, HCTZ
• Enflurane
• Enzalutamide
• Eprosartan; Hydrochlorothiazide, HCTZ
• Erythromycin
• Erythromycin; Sulfisoxazole
• Escitalopram
• Esketamine
• Eslicarbazepine
• Estazolam
• Eszopiclone
• Ethacrynic Acid
• Ethanol
• Ethinyl Estradiol
• Ethinyl Estradiol; Desogestrel
• Ethinyl Estradiol; Ethynodiol Diacetate
• Ethinyl Estradiol; Etonogestrel
• Ethinyl Estradiol; Levonorgestrel
• Ethinyl Estradiol; Levonorgestrel; Ferrous bisglycinate
• Ethinyl Estradiol; Levonorgestrel; Folic Acid; Levomefolate
• Ethinyl Estradiol; Norelgestromin
• Ethinyl Estradiol; Norethindrone
• Ethinyl Estradiol; Norethindrone Acetate
• Ethinyl Estradiol; Norethindrone Acetate; Ferrous fumarate
• Ethinyl Estradiol; Norethindrone; Ferrous fumarate
• Ethinyl Estradiol; Norgestimate
• Ethinyl Estradiol; Norgestrel
• Etomidate
• Etravirine
• Everolimus
• Exenatide
• Fedratinib
• Fentanyl
• Fesoterodine
• Flibanserin
• Fluconazole
• Fluoxetine
• Fluoxetine; Olanzapine
• Fluphenazine
• Flurazepam
• Fluvoxamine
• Fosamprenavir
• Fosinopril; Hydrochlorothiazide, HCTZ
• Fosphenytoin
• Fospropofol
• Fostamatinib
• Frovatriptan
• Furosemide
• Gabapentin
• Gefitinib
• General anesthetics
• Granisetron
• grapefruit juice
• Guaifenesin; Hydrocodone
• Guaifenesin; Hydrocodone; Pseudoephedrine
• Guanabenz
• Guanfacine
• Haloperidol
• Halothane
• Homatropine; Hydrocodone
• Hydantoins
• Hydralazine; Hydrochlorothiazide, HCTZ
• Hydrochlorothiazide, HCTZ
• Hydrochlorothiazide, HCTZ; Irbesartan
• Hydrochlorothiazide, HCTZ; Lisinopril
• Hydrochlorothiazide, HCTZ; Losartan
• Hydrochlorothiazide, HCTZ; Methyldopa
• Hydrochlorothiazide, HCTZ; Metoprolol
• Hydrochlorothiazide, HCTZ; Moexipril
• Hydrochlorothiazide, HCTZ; Olmesartan
• Hydrochlorothiazide, HCTZ; Propranolol
• Hydrochlorothiazide, HCTZ; Quinapril
• Hydrochlorothiazide, HCTZ; Spironolactone
• Hydrochlorothiazide, HCTZ; Telmisartan
• Hydrochlorothiazide, HCTZ; Triamterene
• Hydrochlorothiazide, HCTZ; Valsartan
• Hydrocodone
• Hydrocodone; Ibuprofen
• Hydrocodone; Phenylephrine
• Hydrocodone; Potassium Guaiacolsulfonate
• Hydrocodone; Potassium Guaiacolsulfonate; Pseudoephedrine
• Hydrocodone; Pseudoephedrine
• Hydromorphone
• Hydroxyprogesterone
• Hydroxyzine
• Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate; Sodium Biphosphate
• Idelalisib
• Iloperidone
• Imatinib
• Imipramine
• Indapamide
• Indinavir
• Insulin Glargine; Lixisenatide
• Isavuconazonium
• Isoflurane
• Isoniazid, INH
• Isoniazid, INH; Pyrazinamide, PZA; Rifampin
• Isoniazid, INH; Rifampin
• Istradefylline
• Itraconazole
• Ivacaftor
• Ketamine
• Ketoconazole
• Lamivudine, 3TC; Zidovudine, ZDV
• Lamotrigine
• Lanthanum Carbonate
• Lapatinib
• Larotrectinib
• Lasmiditan
• Lefamulin
• Lemborexant
• Lesinurad
• Lesinurad; Allopurinol
• Letermovir
• Levobupivacaine
• Levocetirizine
• Levorphanol
• Lidocaine
• Lidocaine; Prilocaine
• Lincosamides
• Linezolid
• Lixisenatide
• Lofexidine
• Lomitapide
• Loop diuretics
• Loperamide
• Loperamide; Simethicone
• Lopinavir; Ritonavir
• Lorazepam
• Lorlatinib
• Loxapine
• Lumacaftor; Ivacaftor
• Lumacaftor; Ivacaftor
• Lumateperone
• Lurasidone
• Magnesium Salicylate
• Magnesium Salts
• Maprotiline
• Melatonin
• Meperidine
• Meperidine; Promethazine
• Mephobarbital
• Mepivacaine
• Mepivacaine; Levonordefrin
• Meprobamate
• Mesoridazine
• Metaxalone
• Methadone
• Methenamine; Sodium Acid Phosphate; Methylene Blue; Hyoscyamine
• Methocarbamol
• Methohexital
• Methyclothiazide
• Methyldopa
• Methylene Blue
• Metoclopramide
• Metolazone
• Metyrapone
• Metyrosine
• Midazolam
• Mifepristone
• Minocycline
• Mipomersen
• Mirabegron
• Mirtazapine
• Mitotane
• Modafinil
• Molindone
• Monoamine oxidase inhibitors
• Morphine
• Morphine; Naltrexone
• Nabilone
• Nafcillin
• Nalbuphine
• Naloxone
• Naltrexone
• Naproxen; Sumatriptan
• Naratriptan
• Nefazodone
• Nelfinavir
• Nesiritide, BNP
• Netupitant, Fosnetupitant; Palonosetron
• Nevirapine
• Nicardipine
• Nilotinib
• Nitroglycerin
• Nortriptyline
• Octreotide
• Olanzapine
• Ombitasvir; Paritaprevir; Ritonavir
• Omeprazole; Amoxicillin; Rifabutin
• Omeprazole; Sodium Bicarbonate
• Ondansetron
• Oritavancin
• Orphenadrine
• Osilodrostat
• Oxazepam
• Oxcarbazepine
• Oxymorphone
• Ozanimod
• Palbociclib
• Paliperidone
• Palonosetron
• Papaverine
• Paroxetine
• Pazopanib
• Peginterferon Alfa-2b
• Pegvisomant
• Penicillin G Benzathine; Penicillin G Procaine
• Penicillin G Procaine
• Pentazocine
• Pentazocine; Naloxone
• Pentobarbital
• Perampanel
• Perindopril; Amlodipine
• Perphenazine
• Perphenazine; Amitriptyline
• Phenobarbital
• Phenothiazines
• Phentermine; Topiramate
• Phenylephrine; Promethazine
• Phenytoin
• Pimozide
• Pneumococcal Vaccine, Polyvalent
• Posaconazole
• Pramipexole
• Pramlintide
• Prasugrel
• Pregabalin
• Prilocaine
• Prilocaine; Epinephrine
• Primidone
• Procaine
• Procarbazine
• Prochlorperazine
• Promethazine
• Propafenone
• Propofol
• Propoxyphene
• Protriptyline
• Quazepam
• Quetiapine
• Quinidine
• Quinine
• Ramelteon
• Ranolazine
• Rasagiline
• Remifentanil
• Ribociclib
• Ribociclib; Letrozole
• Rifabutin
• Rifampin
• Rifapentine
• Rifaximin
• Risperidone
• Ritonavir
• Rizatriptan
• Rolapitant
• Ropinirole
• Ropivacaine
• Rotigotine
• Rucaparib
• Salsalate
• Saquinavir
• Secobarbital
• Segesterone Acetate; Ethinyl Estradiol
• Selective norepinephrine reuptake inhibitors
• Selpercatinib
• Serotonin-Receptor Agonists
• Serotonin-Receptor Antagonists
• Sertraline
• Sevoflurane
• Sildenafil
• Simeprevir
• Skeletal Muscle Relaxants
• Sodium Bicarbonate
• Sodium Oxybate
• Solifenacin
• Spironolactone
• St. John’s Wort, Hypericum perforatum
• Streptogramins
• Sulfinpyrazone
• Sumatriptan
• Suvorexant
• Tapentadol
• Tasimelteon
• Telaprevir
• Telithromycin
• Telotristat Ethyl
• Temazepam
• Terbinafine
• Tetrabenazine
• Tetracaine
• Tezacaftor; Ivacaftor
• Thalidomide
• Thiazide diuretics
• Thiethylperazine
• Thiopental
• Thioridazine
• Thiothixene
• Ticagrelor
• Tipranavir
• Tizanidine
• tobacco
• Tolterodine
• Topiramate
• Torsemide
• Tramadol
• Trandolapril; Verapamil
• Trazodone
• Triamterene
• Triazolam
• Tricyclic antidepressants
• Trifluoperazine
• Trimethobenzamide
• Trimetrexate
• Trimipramine
• Triprolidine
• Trospium
• Tucatinib
• Valerian, Valeriana officinalis
• Valproic Acid, Divalproex Sodium
• Vemurafenib
• Verapamil
• Vigabatrin
• Vilazodone
• Voriconazole
• Vortioxetine
• Voxelotor
• Warfarin
• Zafirlukast
• Zaleplon
• Ziconotide
• Zidovudine, ZDV
• Ziprasidone
• Zolmitriptan
• Zolpidem