Acetaminophen / Oxycodone Dosage

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Usual Adult Dose for:

Usual Geriatric Dose for:

Usual Pediatric Dose for:

Additional dosage information:

Usual Adult Dose for Pain

Initial dose:
One tablet or capsule (acetaminophen/oxycodone 325 mg-5 mg), (acetaminophen/oxycodone 500 mg-5 mg), or (acetaminophen/oxycodone 500 mg-10 mg) orally every 6 hours as needed, or 5 mL (acetaminophen/oxycodone 325 mg-5 mg) oral elixir every 6 hours as needed.

Alternatively, the following dosage combinations may be used:
one or two tablets of acetaminophen-oxycodone 300 mg-2.5 mg every six hours (maximal daily dose is 12 tablets), or
one tablet of acetaminophen-oxycodone 300 mg-5 mg every six hours (maximal daily dose is 12 tablets), or
one tablet of acetaminophen-oxycodone 300 mg-7.5 mg every six hours (maximal daily dose is 8 tablets), or
one tablet of acetaminophen-oxycodone 300 mg-10 mg every six hours (maximal daily dose is 6 tablets), or
one or two tablets of acetaminophen-oxycodone 400 mg-2.5 mg every six hours (maximal daily dose is 10 tablets), or
one tablet of acetaminophen-oxycodone 400 mg-5 mg every six hours (maximal daily dose is 10 tablets), or
one tablet of acetaminophen-oxycodone 400 mg-7.5 mg every six hours (maximal daily dose is 8 tablets), or
one tablet of acetaminophen-oxycodone 400 mg-10 mg every six hours (maximal daily dose is 6 tablets) as needed.

Usual Geriatric Dose for Pain

Initial dose: 1/2 tablet (acetaminophen/oxycodone 163-250 mg-2.5 mg) orally every 6 hours as needed or
2.5 mL (acetaminophen/oxycodone 163 mg-2.5 mg) oral elixir every 6 hours as needed.

Usual Pediatric Dose for Pain

Dosage calculations are based on oxycodone: 0.05 - 0.15 mg/kg/dose, given every 4 to 6 hours as needed. Severe pain dosage up to 0.2 mg/kg/dose, given every 3 to 4 hours.

Renal Dose Adjustments

Dosage adjustments in patients with kidney dysfunction should be done cautiously.

Liver Dose Adjustments

Dosage adjustments in patients with liver dysfunction should be done cautiously.

Dose Adjustments

Do not exceed 4 g of acetaminophen in a 24 hour period. Dosage of oxycodone can be titrated to achieve desired effect.

In neonates, infants and children, the acetaminophen dosage should be based on patient's weight.

Precautions

Oxycodone, particularly in large doses, may cause life-threatening respiratory depression. Treatment includes maintenance of the airway, artificial ventilation if necessary, and the opiate antagonist, naloxone. (The usual adult dose of naloxone is 1 to 2 mg every 5 minutes as necessary. The dose is usually administered intravenously, but in an emergency it may be given intramuscularly, subcutaneously, or sublingually.)

Oxycodone, like other narcotic analgesics, should be administered with caution to elderly patients, patients with head injuries, increased intracranial pressure, acute undiagnosed abdominal pain, hypothyroidism, severe renal disease, severe liver disease, Addison's disease, prostatic hypertrophy, urethral stricture, and general debilitation.

Dialysis

Dosage adjustments in dialysis patients should be done cautiously.

Other Comments

The FDA has asked manufacturers to limit the maximum amount of acetaminophen in prescription products to 325 mg per dosage unit. There are no data that indicate that taking more than 325 mg of acetaminophen per dosage unit provides more pain relief. The goal of the FDA is to reduce the risk of severe liver injury from acetaminophen overdose, which can lead to liver failure, liver transplant, and even death. The total number of units that may be prescribed and the time intervals for dosing will not change. Drug companies will have until January 14, 2014 to comply with FDA requirements.

Doses of oxycodone up to 120 mg every 4 hours have been used for treatment of cancer pain.

Usual acetaminophen maximum dosage is 4 g per day.

Oxycodone is available as a single ingredient product and should be considered when the acetaminophen dose reaches 4 g per day.

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