Yes

Analgesic, Narcotic

Dental: Treatment of postoperative pain

Medical: Management of moderate to severe pain

C-II

D

Known hypersensitivity to oxycodone or aspirin; severe respiratory depression

Use with caution in patients with hypersensitivity to other phenanthrene derivative opioid agonists (morphine, codeine, hydrocodone, hydromorphone, oxymorphone, levorphanol); children and teenagers should not be given aspirin products if chickenpox or flu symptoms are present; aspirin use has been associated with Reye's syndrome; severe liver or renal insufficiency, pre-existing CNS and depression

>10%:

Cardiovascular: Hypotension

Central nervous system: Fatigue, drowsiness, dizziness

Gastrointestinal: Nausea, vomiting, heartburn, stomach pains, dyspepsia

Neuromuscular & skeletal: Weakness

1% to 10%:

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

Dermatologic: Rash

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

Genitourinary: Ureteral spasms, decreased urination

Hematologic: Hemolytic anemia

Local: Pain at injection site

Respiratory: Dyspnea, shortness of breath

Miscellaneous: Anaphylactic shock

<1%: Mental depression, hallucinations, paradoxical CNS stimulation, increased intracranial pressure, insomnia, jitters, rash, urticaria, paralytic ileus, occult bleeding, prolongation of bleeding time, leukopenia, thrombocytopenia, iron deficiency anemia, hepatotoxicity, impaired renal function, bronchospasm, physical and psychological dependence, histamine release

Decreased effect with phenothiazines

Increased effect/toxicity with CNS depressants, TCAs, dextroamphetamine

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.

Aspirin inhibits prostaglandin synthesis by decreasing the activity of the enzyme, cyclo-oxygenase, which results in decreased formation of prostaglandin precursors, acts on the hypothalamic heat-regulating center to reduce fever, blocks thromboxane synthetase action which prevents formation of the platelet-aggregating substance thromboxane A₂

Onset of effect: Narcotic analgesia: 0.5-1 hour

Duration of effect 4-6 hours

Serum half-life: Oxycodone: 2-3 hours

Oral (based on oxycodone combined salts):

Adults: Percodan®: 1 tablet every 6 hours as needed for pain or Percodan®-Demi: 1-2 tablets every 6 hours as needed for pain

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

May be taken with food or water

No information available to require special precautions

1% to 10% of patients experience dry mouth; use with caution in patients with platelet and bleeding disorders, renal dysfunction, erosive gastritis, or peptic ulcer disease, previous nonreaction does not guarantee future safe taking of medication; use with caution in impaired hepatic function; do not use aspirin in children <16 years of age for chickenpox or flu symptoms due to the association with Reye's syndrome

Elderly are a high-risk population for adverse effects from nonsteroidal anti-inflammatory agents. As much as 60% of elderly with GI complications to NSAIDs can develop peptic ulceration and/or hemorrhage asymptomatically. Also, concomitant disease and drug use contribute to the risk for GI adverse effects. Use lowest effective dose for shortest period possible. Consider renal function decline with age. Use with caution in patients with history of asthma.

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

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

Tablet:

Percodan®-Demi: Oxycodone hydrochloride 2.25 mg, oxycodone terephthalate 0.19 mg, and aspirin 325 mg

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.