Combunox

Generic Name: ibuprofen and oxycodone (eye byoo PROE fen and ox i KOE done)
Brand Names: Combunox

What is Combunox?

Combunox contains a combination of oxycodone and ibuprofen. Oxycodone is in a group of drugs called opioid pain relievers. An opioid is sometimes called a narcotic.

Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID). Ibuprofen works by reducing hormones that cause inflammation and pain in the body.

Combunox is used short-term to relieve moderate to severe pain.

Combunox may also be used for purposes not listed in this medication guide.

Important information about Combunox

Combunox may cause life-threatening heart or circulation problems such as heart attack or stroke, especially if you use it long term. Do not use Combunox just before or after heart bypass surgery (coronary artery bypass graft, or CABG). Get emergency medical help if you have chest pain, weakness, shortness of breath, slurred speech, or problems with vision or balance.

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Combunox may also cause serious effects on the stomach or intestines, including bleeding or perforation (forming of a hole). These conditions can be fatal and can occur without warning while you are taking Combunox, especially in older adults. Call your doctor at once if you have symptoms of stomach bleeding such as black, bloody, or tarry stools, or coughing up blood or vomit that looks like coffee grounds.

Oxycodone may be habit-forming and should be used only by the person it was prescribed for. Keep Combunox in a secure place where others cannot get to it. Avoid drinking alcohol. It may increase your risk of stomach bleeding.

Tell your doctor if the medicine seems to stop working as well in relieving your pain.

Before taking Combunox

You should not use Combunox if you have severe or uncontrolled asthma, or a stomach condition called paralytic ileus. Do not use Combunox just before or after heart bypass surgery (coronary artery bypass graft, or CABG). Oxycodone may be habit forming and should be used only by the person it was prescribed for. Never share Combunox with another person, especially someone with a history of drug abuse or addiction. Keep the medication in a place where others cannot get to it. Ibuprofen may cause life-threatening heart or circulation problems such as heart attack or stroke, especially if you use it long term.

Combunox may also cause serious effects on the stomach or intestines, including bleeding or perforation (forming of a hole). These conditions can be fatal and can occur without warning while you are taking Combunox, especially in older adults.

Do not use Combunox if you are allergic to oxycodone or ibuprofen (Advil, Motrin), or other NSAIDs such as aspirin, Aleve, Celebrex, Orudis, Indocin, Lodine, Voltaren, Toradol, Mobic, Relafen, Feldene, and others.

To make sure you can safely take Combunox, tell your doctor if you have any of these other conditions:

• heart disease, congestive heart failure, high blood pressure, or a history of heart attack, stroke, or blood clot;

• asthma or other breathing disorders;

• liver or kidney disease;

• a history of head injury or brain tumor;

• epilepsy or other seizure disorder;

• stomach or intestinal disorder, history of stomach ulcer or bleeding;

• underactive thyroid, a pancreas disorder, or Addison's disease or other adrenal gland disorder;

• curvature of the spine;

• an enlarged prostate or problems with urination; or

• mental illness or a history of drug or alcohol addiction.

FDA pregnancy category D. Oxycodone may cause breathing problems and addiction or withdrawal symptoms in a newborn if the mother takes the medication during pregnancy. Taking ibuprofen during the last 3 months of pregnancy may harm the unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using Combunox. Ibuprofen and oxycodone may pass into breast milk and could harm a nursing baby. Do not use Combunox without telling your doctor if you are breast-feeding a baby.

See also: Combunox pregnancy and breastfeeding warnings (in more detail)

Older adults may be more sensitive to the effects of this medicine.

How should I take Combunox?

Take Combunox exactly as prescribed. Never take Combunox in larger amounts, or for longer than recommended by your doctor. Follow the directions on your prescription label. Tell your doctor if the medicine seems to stop working as well in relieving your pain.

Drink 6 to 8 full glasses of water daily to help prevent constipation while you are taking Combunox. Ask your doctor about ways to increase the fiber in your diet. Do not use a stool softener (laxative) without first asking your doctor. If you need surgery, tell the surgeon ahead of time that you are using Combunox.

Store Combunox at room temperature away from moisture and heat.

Keep track of the amount of medicine used from each new bottle. Oxycodone is a drug of abuse and you should be aware if anyone is using your medicine improperly or without a prescription.

See also: Combunox dosage (in more detail)

What happens if I miss a dose?

Since Combunox is taken as needed, you may not be on a dosing schedule. If you are taking the medication regularly, take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose of Combunox can be fatal.

Overdose symptoms may include extreme drowsiness, nausea, vomiting, dark urine, jaundice (yellowing of the skin or eyes), black or bloody stools, coughing up blood, urinating less than usual or not at all, confusion, ringing in your ears, pinpoint pupils, weak pulse, slow heart rate, fainting, blue lips, shallow breathing.

What should I avoid while taking Combunox?

Combunox may impair your thinking or reactions. Avoid driving or operating machinery until you know how Combunox will affect you. Ask a doctor or pharmacist before using any other cold, allergy, or pain medicine. Ibuprofen is contained in many combination medicines. Taking certain products together can cause you to get too much ibuprofen. Check the label to see if a medicine contains ibuprofen. Avoid drinking alcohol. It may increase your risk of stomach bleeding.

Combunox side effects

Get emergency medical help if you have any of these signs of an allergic reaction to Combunox: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Stop using Combunox and call your doctor at once if you have a serious side effect such as:

• chest pain, weakness, shortness of breath, slurred speech, problems with vision or balance;

• black, bloody, or tarry stools, coughing up blood or vomit that looks like coffee ground;

• swelling or rapid weight gain;

• shallow breathing, slow heartbeat;

• confusion, feeling light-headed, fainting;

• easy bruising or bleeding;

• nausea, upper stomach pain, itching, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);

• severe blistering, peeling, and red skin rash; or

• fever, headache, neck stiffness, chills, increased sensitivity to light, purple spots on the skin, and/or seizure (convulsions).

Less serious Combunox side effects include:

• headache, dizziness, drowsiness;

• mild nausea, vomiting, upset stomach, bloating, gas, constipation, diarrhea;

• blurred vision; or

• dry mouth.

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect. You may report side effects to FDA at 1-800-FDA-1088.

See also: Combunox side effects (in more detail)

What other drugs will affect Combunox?

Before using Combunox, tell your doctor if you regularly use other medicines that make you sleepy (such as cold or allergy medicine, sedatives, other narcotic pain medicine, sleeping pills, muscle relaxers, and medicine for seizures, depression, or anxiety). They can add to sleepiness caused by oxycodone.

Also tell your doctor if you are using any of the following drugs:

• a blood thinner such as warfarin (Coumadin, Jantoven);

• a diuretic (water pill);

• an MAO inhibitor such as furazolidone (Furoxone), isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam, Zelapar), or tranylcypromine (Parnate);

• aspirin or other NSAIDs such as ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn, Naprelan, Treximet), celecoxib (Celebrex), diclofenac (Arthrotec, Cambia, Cataflam, Voltaren, Flector Patch, Pennsaid, Solareze), indomethacin (Indocin), meloxicam (Mobic), and others;

• heart or blood pressure medication such as benazepril (Lotensin), enalapril (Vasotec), lisinopril (Prinivil, Zestril), quinapril (Accupril), ramipril (Altace), and others;

• lithium (Eskalith, Lithobid);

• a bronchodilator (such as Atrovent, Spiriva), diuretics (water pills), steroid medicines, or blood thinners;

• methotrexate (Rheumatrex, Trexall);

• an injected narcotic medicine such as pentazocine (Talwin), butorphanol (Stadol), or nalbuphine Nubain);

• atropine (Donnatal), dimenhydrinate (Dramamine), or scopolamine (Transderm-Scop); or

• bowel or bladder medications such as dicyclomine (Bentyl), hyoscyamine (Anaspaz, Cystospaz, Levsin), tolterodine (Detrol) and others;

This list is not complete and other drugs may interact with Combunox. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

Where can I get more information?

• Your pharmacist can provide more information about Combunox.