Oxycodone / Acetaminophen

Pronunciation

Pronunciation: OX-i-KOE-done/a-SEET-a-MIN-oh-fen
Class: Opioid analgesic combination

Trade Names

Endocet
- Tablets oxycodone hydrochloride 5 mg/acetaminophen 325 mg
- Tablets oxycodone hydrochloride 7.5 mg/acetaminophen 325 mg
- Tablets oxycodone hydrochloride 7.5 mg/acetaminophen 500 mg
- Tablets oxycodone hydrochloride 10 mg/acetaminophen 325 mg
- Tablets oxycodone hydrochloride 10 mg/acetaminophen 650 mg

Magnacet
- Tablets oxycodone hydrochloride 5 mg/acetaminophen 400 mg
- Tablets oxycodone hydrochloride 7.5 mg/acetaminophen 400 mg
- Tablets oxycodone hydrochloride 10 mg/acetaminophen 400 mg

Percocet
- Tablets oxycodone hydrochloride 2.5 mg/acetaminophen 325 mg
- Tablets oxycodone hydrochloride 5 mg/acetaminophen 325 mg
- Tablets oxycodone hydrochloride 7.5 mg/acetaminophen 325 mg
- Tablets oxycodone hydrochloride 7.5 mg/acetaminophen 500 mg
- Tablets oxycodone hydrochloride 10 mg/acetaminophen 325 mg
- Tablets oxycodone hydrochloride 10 mg/acetaminophen 650 mg

Primlev
- Tablets oxycodone hydrochloride 5 mg/acetaminophen 300 mg
- Tablets oxycodone hydrochloride 7.5 mg/acetaminophen 300 mg
- Tablets oxycodone hydrochloride 10 mg/acetaminophen 300 mg

Roxicet
- Tablets oxycodone hydrochloride 5 mg/acetaminophen 325 mg
- Solution, oral oxycodone hydrochloride 5 mg/acetaminophen 325 mg

Roxicet 5/500
- Caplets oxycodone hydrochloride 5 mg/acetaminophen 500 mg

Roxilox
- Capsules oxycodone hydrochloride 5 mg/acetaminophen 500 mg

Tylox
- Capsules oxycodone hydrochloride 5 mg/acetaminophen 500 mg

Xolox
- Tablets oxycodone hydrochloride 10 mg/acetaminophen 500 mg

Percocet-Demi (Canada)
PMS-Oxycodone-Acetaminophen (Canada)
ratio-Oxycocet (Canada)

Pharmacology

Acetaminophen inhibits synthesis of prostaglandins and peripherally blocks pain impulse generation, whereas oxycodone binds to opiate receptors in CNS. Combination has a synergistic effect on alleviating pain.

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Indications and Usage

Relief of moderate to moderately severe pain.

Contraindications

Hypersensitivity to acetaminophen, oxycodone, or similar compounds.

Dosage and Administration

Adults

PO 2.5 to 10 mg of oxycodone every 6 h as needed. Max dose is oxycodone 60 mg/acetaminophen 4 g/day.

Moderate pain (off-label)
Adults

PO Initial dose of oxycodone 5 mg per dose.

Children

PO Initial dose is oxycodone 0.1 to 0.2 mg/kg per dose (up to 5 mg per dose) every 4 to 6 h as needed. Max is 90 mg/kg/day based on acetaminophen component in children less than 45 kg, and 4 g/day based on the acetaminophen component in children more than 45 kg.

Severe pain (off-label)
Adults

PO Initial dose of oxycodone 10 to 20 mg per dose.

Children

PO Initial dose is oxycodone 0.2 mg/kg per dose (up to 5 mg per dose) every 4 to 6 h as needed. Max is 90 mg/kg/day based on acetaminophen component in children less than 45 kg, and 4 g/day based on the acetaminophen component in children more than 45 kg.

Moderate to severe pain (off-label)
Elderly

PO Consider an initial dose of 25% to 50% less than the initial adult dose. Titrate dose as needed for adequate pain relief. Do not exceed acetaminophen 4 g/day.

General Advice

  • Taper dose gradually to prevent signs and symptoms of withdrawal in the physically dependent patient.

Storage/Stability

Store at 59° to 86°F.

Drug Interactions

Anesthetics

Additive CNS depression.

Carbamazepine, hydantoins, sulfinpyrazone

Increased risk of hepatotoxicity.

CNS depressants (eg, alcohol, barbiturates, hypnotics, phenothiazines, sedatives, tricyclic antidepressants, other narcotics)

Additive CNS depression.

Laboratory Test Interactions

May cause false decrease in mean glucose values with Chemstrip bG , Dextrostix , and Visidex II home blood glucose systems.

Adverse Reactions

Cardiovascular

Bradycardia; hypotension; tachycardia.

CNS

Confusion; dizziness; dysphoria; euphoria; fatigue; headache; light-headedness; nervousness; sedation; weakness.

Dermatologic

Pruritus; rash.

GI

Abdominal pain; anorexia; biliary spasm; constipation; dry mouth; nausea; vomiting.

Genitourinary

Urinary retention or hesitancy.

Respiratory

Dyspnea; respiratory depression.

Miscellaneous

Malaise; psychological and physical dependence with long-term use; tolerance.

Precautions

Warnings

These products contain acetaminophen. Acetaminophen has been associated with cases of acute liver failure, at times resulting in liver transplant and death. Most of the cases of liver injury are associated with the use of acetaminophen at doses that exceed 4,000 milligrams per day, and often involve more than one acetaminophen-containing product.


Pregnancy

Category C .

Lactation

Undetermined.

Children

Safety and efficacy not established.

Elderly

Use with caution.

Hepatic Function

Chronic alcoholics should limit acetaminophen intake to less than 2 g/day.

Special Risk Patients

Use with caution in elderly, debilitated patients and those with hepatic or kidney failure or conditions accompanied by hypoxia or hypercapnia; monitor carefully to avoid decrease in pulmonary ventilation. Also use cautiously in patients sensitive to CNS depressants, postoperatively, and in patients with pulmonary disease.

Sulfite Sensitivity

Use with caution in patients known to be sensitive, as some products contain bisulfites.

Acute abdominal conditions

Diagnosis may be obscured; use with caution.

Dependence

Can produce drug dependence; has abuse potential.

Head injury

Respiratory depression and elevation of CSF pressure may be exacerbated.

Overdosage

Symptoms

Cardiopulmonary arrest, CNS depression (somnolence progressing to stupor or coma), circulatory collapse, death, hepatic damage, miosis, respiratory depression.

Patient Information

  • Instruct patient to take medication before pain becomes severe for greatest effectiveness.
  • Teach patient methods to prevent constipation.
  • Instruct patient to make position changes slowly if light-headedness or sedation occurs.
  • Advise patient to avoid intake of alcoholic beverages or products containing alcohol while using this medication.
  • Advise patient that drug may cause drowsiness, and to use caution while driving or performing other tasks requiring mental alertness.
  • Caution patient that physical dependency and withdrawal symptoms may occur following discontinuation of long-term therapy.

Copyright © 2009 Wolters Kluwer Health.

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