Ibuprofen / oxycodone Side Effects
Medically reviewed by Drugs.com. Last updated on Mar 9, 2022.
Summary
More frequently reported side effects include: drowsiness. See below for a comprehensive list of adverse effects.
For the Consumer
Applies to ibuprofen / oxycodone: oral tablet
Warning
Oral route (Tablet)
Oxycodone hydrochloride/ibuprofen has the potential for addiction, abuse, and misuse, which can lead to overdose and death. Assess each patient's risk before prescribing, and monitor for development of these behaviors or conditions. Serious, life-threatening, or fatal respiratory depression may occur. Monitor closely, especially upon initiation or following a dose increase. Accidental ingestion of oxycodone hydrochloride/ibuprofen, especially in children, can result in fatal overdose of oxycodone hydrochloride and ibuprofen. Prolonged use of oxycodone hydrochloride/ibuprofen during pregnancy can result in neonatal opioid withdrawal syndrome, which may be life-threatening if not recognized and treated. If opioid use is required for a prolonged period in a pregnant woman, advise the patient of the risk of neonatal opioid withdrawal syndrome and ensure that appropriate treatment will be available. Concomitant use of cytochrome P450 3A4 inhibitors or discontinuation of concomitantly used cytochrome P450 3A4 inducers may affect the plasma levels of oxycodone and lead to increased adverse reactions and fatal respiratory depression. Monitor patients carefully when oxycodone hydrochloride/ibuprofen and cytochrome P450 3A4 inhibitors and inducers are concurrently used. Concomitant use of benzodiazepines and opioids may result in profound sedation, respiratory depression, coma, and death. Reserve concomitant prescribing for patients with inadequate alternative treatment options. Limit dosages and durations to the minimum required and follow patients for signs and symptoms of respiratory depression and sedation. NSAIDs may cause an increased risk of serious cardiovascular thrombotic events, myocardial infarction, and stroke, which can be fatal. This risk may be increased in patients with cardiovascular disease or risk factors for cardiovascular disease. Oxycodone hydrochloride/ibuprofen is contraindicated for use in the setting of coronary artery bypass graft (CABG) surgery. NSAIDs can also increase the risk of serious gastrointestinal (GI) adverse events (eg, bleeding, ulceration, and perforation of the stomach or intestines) especially in the elderly and patients with a prior history of ulcer disease and/or GI bleeding, which can be fatal.
Side effects requiring immediate medical attention
Along with its needed effects, ibuprofen / oxycodone may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur while taking ibuprofen / oxycodone:
Less common
- Feeling faint, dizzy, or lightheaded
- feeling of warmth or heat
- flushing or redness of the skin, especially on the face and neck
- headache
- sweating
Rare
- Abdominal or stomach pain
- blurred vision
- changes in skin color
- chest pain
- confusion
- convulsions
- decrease in frequency of urination
- decreased urine
- difficulty in passing urine (dribbling)
- difficulty with breathing
- dizziness
- dizziness, faintness, or lightheadedness when getting up from a lying position
- dry mouth
- excessive muscle tone
- fainting
- fast, pounding, or irregular heartbeat or pulse
- increased need to urinate
- increased thirst
- loss of appetite
- mood changes
- muscle pain or cramps
- muscle stiffness
- muscle tension or tightness
- nausea or vomiting
- numbness or tingling in the hands, feet, or lips
- pain, tenderness, or swelling of the foot or leg
- painful urination
- pale skin
- passing urine more often
- severe constipation
- severe vomiting
- troubled breathing with exertion
- unusual bleeding or bruising
- unusual tiredness or weakness
Get emergency help immediately if any of the following symptoms of overdose occur while taking ibuprofen / oxycodone:
Symptoms of overdose
- Change in consciousness
- chest pain or discomfort
- cold and clammy skin
- constricted pupils
- continuing ringing or buzzing or other unexplained noise in the ears
- decreased awareness or responsiveness
- difficult or troubled breathing
- difficulty with sleeping
- disorientation
- drowsiness to profound coma
- fainting
- hearing loss
- irregular, fast or slow, or shallow breathing
- lethargy
- loss of bladder control
- loss of consciousness
- muscle spasm or jerking of all extremities
- pale or blue lips, fingernails, or skin
- seeing, hearing, or feeling things that are not there
- severe sleepiness
- skeletal muscle flaccidity
- sleepiness or unusual drowsiness
- sudden fainting
- sudden loss of consciousness
Side effects not requiring immediate medical attention
Some side effects of ibuprofen / oxycodone may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.
Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
Less common
- Acid or sour stomach
- belching
- bloated or full feeling
- diarrhea
- difficulty having a bowel movement (stool)
- excess air or gas in the stomach or intestines
- fever
- heartburn
- indigestion
- lack or loss of strength
- passing gas
- stomach discomfort, upset, or pain
Rare
- Back pain
- body aches or pain
- bruising, large, flat, blue or purplish patches in the skin
- changes in vision
- chills
- congestion
- cough or hoarseness
- delusions
- dementia
- difficult urination
- difficulty with moving
- dryness or soreness of the throat
- enlarged abdomen or stomach
- false or unusual sense of well-being
- fear
- hoarseness
- impaired vision
- increase in body movements
- lower back or side pain
- nervousness
- pain, swelling, or redness in the joints
- rash
- runny nose
- swelling
- taste perversion
- tender, swollen glands in the neck
- trouble with sleeping
- trouble with swallowing
- voice changes
For Healthcare Professionals
Applies to ibuprofen / oxycodone: oral tablet
General
The most commonly reported adverse events have included nausea, vomiting, flatulence, somnolence, and dizziness.[Ref]
Gastrointestinal
Abdominal pain, enlarged abdomen, dry mouth, dyspepsia, eructation, and ileus, have been reported in less than 1% of patients.[Ref]
Common (1% to 10%): Nausea, vomiting, flatulence, constipation, diarrhea, dyspepsia
Frequency not reported: Abdominal pain, enlarged abdomen, dry mouth, eructation, ileus
Postmarketing reports:[Ref]
Cardiovascular
Hypotension, syncope, tachycardia, edema, and chest pain have been reported in less than 1% of patients.[Ref]
Common (1% to 10%): Vasodilation, thrombophlebitis
Frequency not reported: Hypotension, syncope, tachycardia, vasodilation, edema, chest pain[Ref]
Nervous system
Very common (10% or more): Dizziness (19.2%), somnolence (17.4%), headache (10.2%)
Common (1% to 10%): Hyperkinesia, hypertonia
Frequency not reported: Taste perversion
Postmarketing reports: Serotonin syndrome[Ref]
Respiratory
Frequency not reported: Respiratory depression[Ref]
Dermatologic
Common (1% to 10%): Sweat, rash[Ref]
Metabolic
Frequency not reported: Hypokalemia[Ref]
Hypersensitivity
Postmarketing reports: Anaphylaxis[Ref]
Hematologic
Common (1% to 10%): Ecchymosis
Frequency not reported: Anemia[Ref]
Psychiatric
Frequency not reported: Insomnia, euphoria, nervousness, abnormal thinking, anxiety[Ref]
Insomnia, euphoria, nervousness, abnormal thinking, and anxiety have been reported in less than 1% of patients.[Ref]
Endocrine
Postmarketing reports: Adrenal insufficiency, androgen deficiency
Adrenal insufficiency and androgen deficiency have been reported with opioid use, most often with chronic use.
Musculoskeletal
Frequency not reported: Arthritis, back pain[Ref]
Genitourinary
Frequency not reported: Urinary frequency[Ref]
Other
Common (1% to 10%): Fever, asthenia
Frequency not reported: Chills[Ref]
Ocular
Frequency not reported: Amblyopia[Ref]
More about ibuprofen / oxycodone
- Drug interactions
- Dosage information
- During pregnancy
- Reviews (1)
- Drug images
- Drug class: narcotic analgesic combinations
Patient resources
- Other brands
- Combunox
Professional resources
Related treatment guides
References
1. "Product Information. Ibuprofen-Oxycodone Hydrochloride (ibuprofen-oxycodone)." Actavis U.S. (Alpharma USPD) (2017):
2. Avery GS, Davies EF "Ibuprofen: a review of its pharmacological properties and therapeutic efficacy in rheumatic disorders." Drugs 2 (1971): 440-6
3. Clements D, Rhodes J, Williams GT "Colitis associated with ibuprofen." Br Med J 301 (1990): 987
4. Bergmann JF, Chassany O, Geneve J, et al. "Endoscopic evaluation of the effect of ketoprofen, ibuprofen and aspirin on the gastroduodenal mucosa." Eur J Clin Pharmacol 42 (1992): 685-8
5. "Product Information. Motrin (ibuprofen)." Pharmacia and Upjohn (2002):
6. Fries JF, Morfeld D, Ramey DR, Singh G "Comparative toxicity of non-steroidal anti-inflammatory agents." Pharmacol Ther 62 (1994): 175-91
7. Kwo PY, Tremaine WJ "Nonsteroidal anti-inflammatory drug-induced enteropathy: case discussion and review of the literature." Mayo Clin Proc 70 (1995): 55-61
8. Wolfe TR "Ibuprofen overdose." Am J Emerg Med 13 (1995): 375
9. Hayllar H, Rafi S, Bjarnason I, Wrigglesworth JM, Macpherson AJS, Somasundaram S "The biochemical basis of non-steroidal anti-inflammatory drug-induced damage to the gastrointestinal tract: a review and a hypothesis." Scand J Gastroenterol 30 (1995): 289-99
10. Ribeiro A, Loeb DS, Wolfe JT, Wolfsen HC "Colonic strictures induced by nonsteroidal anti-inflammatory drugs." South Med J 91 (1998): 568-72
11. Bruce B, Fries JF "Rates of Serious Gastrointestinal Events from Low Dose Use of Acetylsalicylic Acid, Acetaminophen, and Ibuprofen in Patients with Osteoarthritis and Rheumatoid Arthritis." J Rheumatol 30 (2003): 2226-2233
12. "Product Information. Combunox (ibuprofen-oxycodone)." Forest Pharmaceuticals (2004):
13. Seibold JR, Kim HC "Acral vasospasm complicating therapy with ibuprofen and tolmetin." J Rheumatol 9 (1982): 647-8
14. Agnholt J, Andreasen F "The effect of ibuprofen therapy on water and electrolyte balance." Acta Med Scand 212 (1982): 65-9
15. Bloomfield SS, Radack KL, Deck CC "Ibuprofen interferes with the efficacy of antihypertensive drugs: a randomized, double-blind, placebo-controlled trial of ibuprofen compared with acetaminophen." Ann Intern Med 107 (1987): 628-35
16. Day RO, Johnson AG, Nguyen TV "Do nonsteroidal anti-inflammatory drugs affect blood pressure? A meta-analysis." Ann Intern Med 121 (1994): 289-300
17. Avron J, Bohn RL, Gurwitz JH, Mogun H, Monane M, Glynn RJ "Initiation of antihypertensive treatment during nonsteroidal anti-inflammatory drug therapy." JAMA 272 (1994): 781-6
18. Gurwitz JH, Monane M, Everitt DE, et al. "The impact of ibuprofen on the efficacy of antihypertensive treatment with hydrochlorothiazide in elderly persons." J Gerontol A Biol Sci Med Sci 51 (1996): m74-9
19. Bakker A, Stricker BH, Leufkens HG, Heerdink ER, Herings RM, Ottervanger JP "NSAIDs associated with increased risk of congestive heart failure in elderly patients taking diuretics." Arch Intern Med 158 (1998): 1108-12
20. Flavin S, Zusman RM, MacDonald B, Palmer R, Weiss R, Haig A "Effects of nabumetone, celecoxib, and ibuprofen on blood pressure control in hypertensive patients on angiotensin converting enzyme inhibitors." Am J Hypertens 16 (2003): 135-9
21. Kantrowitz FG, Giansiracusa DF, Blumberg S "Aseptic meningitis associated with ibuprofen." Arch Intern Med 140 (1980): 1553
22. Peck MG, Joyner PU "Ibuprofen-associated aseptic meningitis." Clin Pharm 1 (1982): 561-5
23. Caplan LR, Weinstein RA, Quinn JP "Eosinophilic meningitis and ibuprofen therapy." Neurology 34 (1984): 108-9
24. Lawson JM, Grady MJ "Ibuprofen-induced aseptic meningitis in a previously healthy patient." West J Med 143 (1985): 386-7
25. Hegstad DR, Specht NL, Bouland DL "Ibuprofen and aseptic meningitis." Ann Intern Med 104 (1986): 731
26. Bacher T, Ersgaard H, Glud TK, Jensen S "Ibuprofen-induced meningitis in a male with systemic lupus erythematosus." Acta Med Scand 221 (1987): 509-11
27. Durback MA, Freeman J, Schumacher HR Jr "Recurrent ibuprofen-induced aseptic meningitis: third episode after only 200 mg of generic ibuprofen." Arthritis Rheum 31 (1988): 813-5
28. Eichenbaum HW, Gilbert GJ "Ibuprofen-induced meningitis in an elderly patient with systemic lupus erythematosus." South Med J 82 (1989): 514-5
29. Agus B, Kramer N, Nelson J, et al. "Acute central nervous system symptoms caused by ibuprofen in connective tissue disease." J Rheumatol 17 (1990): 1094-6
30. Cramond T, Smith MT, Leow KP, Williams B "Single-dose and steady-state pharmacokinetics and pharmacodynamics of oxycodone in patients with cancer." Clin Pharmacol Ther 52 (1992): 487-95
31. Walsh D, Glare P "Dose-ranging study of oxycodone for advanced cancer pain (meeting abstract)." Proc Annu Meet Am Soc Clin Oncol 10 (1991): a1201
32. Cramond T, Watt JA, Smith MT, Leow KP, Williams BE "Comparative oxycodone pharmacokinetics in humans after intravenous, oral, and rectal administration." Ther Drug Monit 14 (1992): 479-84
33. Glare PA, Walsh TD "Dose-ranging study of oxycodone for chronic pain in advanced cancer." J Clin Oncol 11 (1993): 973-8
34. Decastro A, Olson NZ, Zighelboim I, Sunshine A "Ketoprofen, acetaminophen plus oxycodone, and acetaminophen in the relief of postoperative pain." Clin Pharmacol Ther 54 (1993): 546-55
35. Caspi M, Katona BG, Wigley FM, Walters JK "Aseptic meningitis from over-the-counter ibuprofen." Lancet 1 (1988): 59
36. Horn AC, Jarrett SW "Ibuprofen-induced aseptic meningitis in rheumatoid arthritis." Ann Pharmacother 31 (1997): 1009-11
37. Nguyen HT, Juurlink DN "Recurrent ibuprofen-induced aseptic meningitis." Ann Pharmacother 38 (2004): 408-10
38. Mahutte CK, Ramirez MM, Chetty KG "Drug-induced pulmonary edema in a patient infected with human immunodeficiency virus." Chest 104 (1993): 967-9
39. "Product Information. OxyContin (oxycodone)." Purdue Frederick Company (2001):
40. Bar-Sela S, Zeevi D, Levo Y, et al. "A lupus-like syndrome due to ibuprofen hypersensitivity." J Rheumatol 7 (1980): 379-80
41. Shelley WB, Shelley ED "Ibuprofen urticaria." J Am Acad Dermatol 17 (1987): 1057-8
42. Laing VB, Flowres FP, Sherertz EF "Pemphigoid-like bullous eruption related to ibuprofen." J Am Acad Dermatol 19 (1988): 91-4
43. Bergner T, Przybilla B "Photosensitization caused by ibuprofen." J Am Acad Dermatol 26 (1992): 114-6
44. Halpern SM, Volans GN "Cutaneous toxicity of ibuprofen." Arch Dermatol 130 (1994): 259-60
45. Maessenvisch B, Peters F, Kho L "Leukocytoclastic vasculitis induced by a nonsteroidal antiinflammatory drug." J Rheumatol 23 (1996): 2008-9
46. Farr PM, Meggitt SJ "Pseudoporphyria and propionic acid non-steroidal anti-inflammatory drugs." Br J Dermatol 141 (1999): 591-2
47. Schwartz RA, Krasowska D, Lecewicz-Torun B "Generalized lichenoid drug eruption following Blaschko lines." Int J Dermatol 40 (2001): 774-6
48. Rault RM "Case report: hyponatremia associated with nonsteroidal antiinflammatory drugs." Am J Med Sci 305 (1993): 318-20
49. Rossi O, Timonen TT, Hakala M, et al. "Agranulocytosis in a patient with psoriatic arthritis receiving auranofin and ibuprofen." Scand J Rheumatol 16 (1987): 375-6
50. Lindblad R, Rodjer S "A case of severe pancytopenia caused by ibuprofen." J Intern Med 229 (1991): 281-3
51. Ragni MV, Miller BJ, Whalen R, Ptachcinski R "Bleeding tendency, platelet function, and pharmacokinetics of ibuprofen and zidovudine in HIV(+) hemophilic men." Am J Hematol 40 (1992): 176-82
52. Bowen RJ, Swift IA, Longenecker GL, et al. "Kinetics of ibuprofen effect on platelet and endothelial prostanoid release." Clin Pharmacol Ther 37 (1985): 343-8
53. Braden NJ, Galletta G, Scheinbaum ML, Chomilo F, Walson PD, Sawyer LA "Comparison of multidose ibuprofen and acetaminophen therapy in febrile children." Am J Dis Child 146 (1992): 626-32
54. Gardos G "Dyskinesia after discountinuation of compound analgesic containing oxycodone ." Lancet 1 (1977): 759-60
55. Goldberg M, Fishbain DA, Rosomoff H, Rosomoff RS "Atypical withdrawal syndrome (organic delusional syndrome) secondary to oxycodone detoxification ." J Clin Psychopharmacol 8 (1988): 441-2
56. Katz N, Zemishlany Z, Weizman A "Ibuprofen and Psychotic Exacerbation." Am J Psychiatry 159 (2002): 1606-1607
57. Tullio CJ "Ibuprofen-induced visual disturbance." Am J Hosp Pharm 38 (1981): 1362
58. Asherov J, Schoenberg A, Weinberger A "Diplopia following ibuprofen administration." JAMA 248 (1982): 649
59. Dayan M, Fitt A, Gillie RF "Vortex keratopathy associated with ibuprofen therapy." Eye 10 (1996): 145-6
Further information
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
Some side effects may not be reported. You may report them to the FDA.