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Look Up > Drugs > Oxycodone and Acetaminophen
Oxycodone and Acetaminophen
Pronunciation
U.S. Brand Names
Generic Available
Canadian Brand Names
Synonyms
Pharmacological Index
Use
Restrictions
Pregnancy Risk Factor
Contraindications
Warnings/Precautions
Adverse Reactions
Drug Interactions
Mechanism of Action
Pharmacodynamics/Kinetics
Usual Dosage
Dietary Considerations
Dental Health: Local Anesthetic/Vasoconstrictor Precautions
Dental Health: Effects on Dental Treatment
Patient Information
Nursing Implications
Dosage Forms
References

Pronunciation
(oks i KOE done & a seet a MIN oh fen)

U.S. Brand Names
Endocet®; Percocet® 2.5/325; Percocet® 5/325; Percocet® 7.5/500; Percocet® 10/650; Roxicet® 5/500; Roxilox™; Tylox®

Generic Available

Yes


Canadian Brand Names
Endocet®; Oxycocet; Percocet®-Demi

Synonyms
Acetaminophen and Oxycodone

Pharmacological Index

Analgesic, Narcotic


Use

Dental: Treatment of postoperative pain

Medical: Management of moderate to severe pain


Restrictions

C-II


Pregnancy Risk Factor

C


Contraindications

Hypersensitivity to oxycodone, acetaminophen or any component; severe respiratory depression, severe renal or liver insufficiency


Warnings/Precautions

Use with caution in patients with hypersensitivity reactions to other phenanthrene derivative opioid agonists (morphine, codeine, hydrocodone, hydromorphone, levorphanol, oxymorphone); respiratory diseases including asthma, emphysema, COPD, or severe liver or renal insufficiency; some preparations contain sulfites which may cause allergic reactions; may be habit-forming


Adverse Reactions

>10%:

Cardiovascular: Hypotension

Central nervous system: Fatigue, drowsiness, dizziness

Gastrointestinal: Nausea, vomiting

Neuromuscular & skeletal: Weakness

1% to 10%:

Central nervous system: Nervousness, headache, restlessness, malaise, confusion

Gastrointestinal: Anorexia, stomach cramps, xerostomia, constipation, biliary spasm

Genitourinary: Ureteral spasms, decreased urination

Local: Pain at injection site

Respiratory: Dyspnea, shortness of breath

<1%: Mental depression, hallucinations, paradoxical CNS stimulation, increased intracranial pressure, rash, urticaria, paralytic ileus, blood dyscrasias (neutropenia, pancytopenia, leukopenia), hepatic necrosis with overdosage, renal injury with chronic use, physical and psychological dependence, hypersensitivity reactions (rare), histamine release


Drug Interactions

Decreased effect: Phenothiazines may antagonize the analgesic effect of opiate agonists

Increased toxicity: CNS depressants, tricyclic antidepressants may potentiate the effects of opiate agonists; dextroamphetamine may enhance the analgesic effect of opiate agonists


Mechanism of Action

Oxycodone, as with other narcotic (opiate) analgesics, blocks pain perception in the cerebral cortex by binding to specific receptor molecules (opiate receptors) within the neuronal membranes of synapses. This binding results in a decreased synaptic chemical transmission throughout the CNS thus inhibiting the flow of pain sensations into the higher centers. Mu and kappa are the two subtypes of the opiate receptor which oxycodone binds to cause analgesia.

Acetaminophen inhibits the synthesis of prostaglandins in the CNS and peripherally blocks pain impulse generation; produces antipyresis from inhibition of hypothalamic heat-regulating center


Pharmacodynamics/Kinetics

Onset of effect: Narcotic analgesia: 0.5-1 hour

Duration of effect: 4-6 hours

Serum half-life: Oxycodone: 2-3 hours


Usual Dosage

Oral (doses should be titrated to appropriate analgesic effects):

Adults: 1-2 tablets every 4-6 hours as needed for pain

Maximum daily dose of acetaminophen: 4 g/day

Dosing adjustment in hepatic impairment: Dose should be reduced in patients with severe liver disease


Dietary Considerations

No data reported


Dental Health: Local Anesthetic/Vasoconstrictor Precautions

No information available to require special precautions


Dental Health: Effects on Dental Treatment

1% to 10% of patients experience dry mouth


Patient Information

See individual agents. Pregnancy/breast-feeding precautions: Inform prescriber if you are or intend to get pregnant. Consult prescriber if breast-feeding.


Nursing Implications

Monitor for pain relief, respiratory and mental status, blood pressure, constipation


Dosage Forms

Caplet: Oxycodone hydrochloride 5 mg and acetaminophen 500 mg

Capsule: Oxycodone hydrochloride 5 mg and acetaminophen 500 mg

Solution, oral: Oxycodone hydrochloride 5 mg and acetaminophen 325 mg per 5 mL (5 mL, 500 mL)

Tablet: Oxycodone hydrochloride 2.5 mg and acetaminophen 325 mg; oxycodone hydrochloride 5 mg and acetaminophen 325 mg; oxycodone hydrochloride 7.5 mg and acetaminophen 500 mg; oxycodone hydrochloride 10 mg and acetaminophen 650 mg


References

Cooper SA, Precheur H, Rauch D, et al, "Evaluation of Oxycodone and Acetaminophen in Treatment of Postoperative Pain," Oral Surg Oral Med Oral Pathol, 1980, 50(6):496-501.

Dionne RA, "New Approaches to Preventing and Treating Postoperative Pain," J Am Dent Assoc, 1992, 123(6):26-34.

Gobetti JP, "Controlling Dental Pain," J Am Dent Assoc, 1992, 123(6):47-52.

Olkkola KT, Hamunen K, and Maunuksela EL, "Clinical Pharmacokinetics and Pharmacodynamics of Opioid Analgesics in Infants and Children," Clin Pharmacokinet, 1995, 28(5):385-404.

Sinatra RS and Harrison DM, "Oxymorphone in Patient-Controlled Analgesia," Clin Pharm, 1989, 8(8):541, 544.


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