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Combunox

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

Medically reviewed by Philip Thornton, DipPharm. Last updated on Jan 12, 2020.

What is Combunox?

Combunox contains a combination of oxycodone and ibuprofen. Oxycodone is an opioid pain medication, sometimes called a narcotic. Ibuprofen is a nonsteroidal anti inflammatory drug (NSAID). This medicine works by reducing substances in the body that cause pain, fever, and inflammation.

Combunox is used short-term to relieve severe pain.

Combunox is not for treating arthritis pain.

Important Information

Oxycodone can slow or stop your breathing, and may be habit-forming. MISUSE OF NARCOTIC MEDICINE CAN CAUSE ADDICTION, OVERDOSE, OR DEATH, especially in a child or other person using the medicine without a prescription. Keep the medication in a place where others cannot get to it.

Taking Combunox during pregnancy may cause life-threatening withdrawal symptoms in the newborn.

Fatal side effects can occur if you use Combunox with alcohol, or with other drugs that cause drowsiness or slow your breathing.

Before taking this medicine

Ibuprofen can increase your risk of fatal heart attack or stroke, even if you don't have any risk factors. Do not use Combunox just before or after heart bypass surgery (coronary artery bypass graft, or CABG).

Ibuprofen may also cause stomach or intestinal bleeding, which can be fatal. These conditions can occur without warning while you are using Combunox, especially in older adults.

You should not use Combunox if you are allergic to oxycodone or ibuprofen (Advil, Motrin), or if you have:

To make sure Combunox is safe for you, tell your doctor if you have ever had:

Be sure your doctor knows if you also take stimulant medicine, opioid medicine, herbal products, or medicine for depression, mental illness, Parkinson's disease, migraine headaches, serious infections, or prevention of nausea and vomiting. These medicines may interact with hydrocodone and cause a serious condition called serotonin syndrome.

Taking ibuprofen during the last 3 months of pregnancy may harm the unborn baby. If you use oxycodone while you are pregnant, your baby could become dependent on the drug. This can cause life-threatening withdrawal symptoms in the baby after it is born. Babies born dependent on habit-forming medicine may need medical treatment for several weeks.

If you are breastfeeding while taking Combunox, tell your doctor if your baby has severe drowsiness or breathing problems.

How should I take Combunox?

Take Combunox exactly as prescribed. Follow the directions on your prescription label and read all medication guides. Never use Combunox in larger amounts, or for longer than prescribed. Use the lowest dose that is effective in treating your condition. Tell your doctor if you feel an increased urge to take more of this medicine.

Never share opioid medicine with another person, especially someone with a history of drug abuse or addiction. MISUSE CAN CAUSE ADDICTION, OVERDOSE, OR DEATH. Keep the medication in a place where others cannot get to it. Selling or giving away opioid medicine is against the law.

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.

Do not keep leftover opioid medication. Just one dose can cause death in someone using Combunox accidentally or improperly. Ask your pharmacist where to locate a drug take-back disposal program. If there is no take-back program, flush the unused medicine down the toilet.

Combunox dosing information

Usual Adult Dose for Pain:

Initial dose: 1 tablet (oxycodone 5 mg/ibuprofen 400 mg) orally every 6 hours as needed for pain
Maximum dose: 4 tablets in 24 hours
Duration of therapy: Not to exceed 7 days

Comments:
-Because of the risks of addiction, abuse and misuse, the lowest effective dose for the shortest duration consistent with individual patient treatment goals should be used.
-Monitor patients closely for respiratory depression within the first 24 to 72 hours of initiating therapy and following any increase in dose.

Use: For the short term management of acute to moderate pain severe enough to require an opioid analgesic for which alternative treatments are inadequate.

Usual Pediatric Dose for Pain:

14 or older:
Initial dose: 1 tablet (oxycodone 5 mg/ibuprofen 400 mg) orally every 6 hours as needed for pain
Maximum dose: 4 tablets in 24 hours
Duration of therapy: Not to exceed 7 days

Comments:
-Because of the risks of addiction, abuse and misuse, the lowest effective dose for the shortest duration consistent with individual patient treatment goals should be used.
-Monitor patients closely for respiratory depression within the first 24 to 72 hours of initiating therapy and following any increase in dose.

Use: For the short term management of acute to moderate pain severe enough to require an opioid analgesic for which alternative treatments are inadequate.

What happens if I miss a dose?

Since Combunox is used for pain, you are not likely to miss a dose. Skip any missed dose if it is almost time for your next scheduled dose. Do not use 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. A oxycodone overdose can be fatal, especially in a child or other person using the medicine without a prescription. Overdose symptoms may include black or bloody stools, coughing up blood, confusion, weakness, cold and clammy skin, very slow breathing, or coma.

What should I avoid while taking Combunox?

Avoid driving or hazardous activity until you know how Combunox will affect you. Dizziness or drowsiness can cause falls, accidents, or severe injuries.

Do not drink alcohol. Dangerous side effects or death could occur.

Ask a doctor or pharmacist before using other medicines for pain, fever, swelling, or cold/flu symptoms. They may contain ingredients similar to ibuprofen (such as aspirin, ketoprofen, or naproxen).

Combunox side effects

Get emergency medical help if you have signs of an allergic reaction to Combunox (hives, difficult breathing, swelling in your face or throat) or a severe skin reaction (fever, sore throat, burning in your eyes, skin pain, red or purple skin rash that spreads and causes blistering and peeling).

Get emergency medical help if you have signs of a heart attack or stroke: chest pain spreading to your jaw or shoulder, sudden numbness or weakness on one side of the body, slurred speech, leg, swelling, feeling short of breath.

Stop using Combunox and call your doctor at once if you have:

  • weak or shallow breathing, sighing, slow heartbeats, breathing that stops during sleep;

  • swelling or rapid weight gain;

  • a skin rash, no matter how mild;

  • pale skin, feeling light-headed;

  • signs of stomach bleeding - bloody or tarry stools, coughing up blood or vomit that looks like coffee grounds;

  • kidney problems - little or no urination, swelling in your feet or ankles, feeling tired or short of breath; or

  • liver problems - loss of appetite, diarrhea, upper stomach pain, tiredness, flu-like symptoms, dark urine, jaundice (yellowing of the skin or eyes).

Seek medical attention right away if you have symptoms of serotonin syndrome, such as: agitation, hallucinations, fever, sweating, shivering, fast heart rate, muscle stiffness, twitching, loss of coordination, nausea, vomiting, or diarrhea.

Serious side effects may be more likely in older adults and those who are overweight, malnourished, or debilitated.

Common Combunox side effects may include:

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect Combunox?

You may have breathing problems or withdrawal symptoms if you start or stop taking certain other medicines. Tell your doctor if you also use an antibiotic, antifungal medication, heart or blood pressure medication, seizure medication, or medicine to treat HIV or hepatitis C.

Opioid medication can interact with many other drugs and cause dangerous side effects or death. Be sure your doctor knows if you also use:

  • cold or allergy medicines, bronchodilator asthma/COPD medication, or a diuretic ("water pill");

  • medicines for motion sickness, irritable bowel syndrome, or overactive bladder;

  • other narcotic medications - opioid pain medicine or prescription cough medicine;

  • a sedative like Valium - diazepam, alprazolam, lorazepam, Xanax, Klonopin, Ativan, and others;

  • drugs that make you sleepy or slow your breathing - a sleeping pill, muscle relaxer, medicine to treat mood disorders or mental illness; or

  • drugs that affect serotonin levels in your body - a stimulant, or medicine for depression, Parkinson's disease, migraine headaches, serious infections, or nausea and vomiting.

This list is not complete. Other drugs may interact with ibuprofen and oxycodone, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed here.

Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Combunox only for the indication prescribed.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.