oxycodone - acetaminophen
In this drug factsheet:
What side effects are possible with this medication?
Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent. The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.
The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.
Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.
- lightheadedness or feeling faint
- mood changes
Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not check with your doctor or seek medical attention.
Check with your doctor as soon as possible if any of the following side effects occur:
- blurred or double vision or other changes in vision
- difficulty sleeping
- dizziness when rising from a lying down or sitting position
- dry mouth
- false sense of well-being
- general feeling of discomfort or illness
- loss of appetite
- muscle twitching
- nightmares or unusual dreams
- pain in lower back or side
- redness or flushing of face
- signs of allergic reaction (e.g., hives, itching, or skin rash)
- signs of liver problems (e.g., nausea, vomiting, diarrhea, loss of appetite, weight loss, yellowing of the skin or whites of the eyes, dark urine, pale stools)
- sore throat and fever
- symptoms of urinary retention (e.g., decrease in amount of urine, or difficult or painful urination)
- unusual excitement (especially in children)
Stop taking the medication and seek immediate medical attention if any of the following occur:
- convulsions (seizures)
- signs of a serious allergic reaction (e.g., abdominal cramps, difficulty breathing, nausea and vomiting, or swelling of the face and throat)
- signs of breathing problems (e.g., shallow, irregular breathing, or slow or troubled breathing)
- symptoms of overdose (e.g., cold, clammy skin, abnormally slow or weak breathing, severe dizziness, confusion, slow heartbeat, or extreme drowsiness)
Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.
Are there any other precautions or warnings for this medication?
Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.
HEALTH CANADA ADVISORY
July 9, 2015
Health Canada has issued new restrictions concerning the use of acetaminophen. To read the full Health Canada Advisory, visit Health Canada's web site at www.hc-sc.gc.ca.
Abdominal conditions: Oxycodone may make the diagnosis of abdominal conditions more difficult or it may worsen these conditions. People with abdominal conditions such as inflammatory or obstructive bowel disease, acute cholecystitis, or pancreatitis should discuss with their doctor how this medication may affect their medical condition, how their medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
Breathing: Oxycodone can suppress breathing. People at risk for breathing difficulties, such as asthma, should discuss with their doctor how this medication may affect their medical condition, how their medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
Dependence and withdrawal: This medication contains oxycodone. Physical dependence, psychological dependence, and abuse have occurred with the use of oxycodone. People with a history of past or current substance use problems may be at greater risk of developing abuse or addiction while taking this medication. Abuse is not a problem with people who require this medication for pain relief. If this medication is stopped suddenly, you may experience withdrawal symptoms such as anxiety, sweating, trouble sleeping, shaking, pain, nausea, tremors, diarrhea, and hallucinations. If you have been taking this medication for a while, it should be stopped gradually as directed by your doctor.
Drowsiness/reduced alertness: This medication may cause drowsiness. Do not drive, operate machinery, or perform other potentially hazardous tasks until you have determined how this medication affects you.
Head injury: People with head injuries or increased pressure in the head may have a higher risk of experiencing side effects (breathing problems) or worsening of their condition while taking this medication. These people should discuss with their doctor how this medication may affect their medical condition, how their medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
Kidney function: People with kidney disease or reduced kidney function should discuss with their doctor how this medication may affect their medical condition, how their medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
Liver function: Acetaminophen can cause decreased liver function. People with liver disease or reduced liver function should discuss with their doctor how this medication may affect their medical condition, how their medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
Other medical conditions: People about to undergo surgery of the biliary tract should use caution while taking oxycodone as it may worsen their condition. Oxycodone will worsen the effects of acute alcohol intoxication and delirium tremens.
As well, people with low thyroid (hypothyroidism), Addison's disease, benign prostatic hypertrophy (enlarged prostate), urethral stricture, decreased function of the adrenal glands, or porphyria should discuss with their doctor how this medication may affect their medical condition, how their medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
Seizures: This medication may cause seizures, especially when higher doses are used or when taken with other medications that may increase the risk of seizures such as:
- monoamine oxidase inhibitors (MAOIs; e.g., phenelzine, tranylcypromine)
- neuroleptics (e.g., haloperidol, quetiapine, olanzapine, resperidone)
- opioids (e.g., morphine, codeine, oxycodone)
- selective serotonin reuptake inhibitors (SSRIs; e.g., paroxetine, fluoxetine, citalopram)
- tricyclic antidepressants (TCAs; e.g., amitriptyline, imipramine)
The risk of seizures is also higher for people with epilepsy, a history of seizures, or who are at risk of seizures (e.g., people with head trauma).
Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.
Breast-feeding: This medication passes into breast milk. If you are a breast-feeding mother and are taking oxycodone and acetaminophen, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.
Children: The safety and effectiveness of using full-strength oxycodone - acetaminophen have not been established for children. (In the case of Percocet® Demi, the safety and effectiveness have not been established for children under 6 years old.)
Seniors: Seniors who take this medication may be more likely to experience side effects or worsening of preexisting medical conditions.
What other drugs could interact with this medication?
There may be an interaction between oxycodone - acetaminophen and any of the following:
- antihistamines (e.g., cetirizine, dimenhydrinate, diphenhydramine, hydroxyzine)
- antipsychotics (e.g., haloperidol, quetiapine, olanzapine, risperidone)
- "azole" antifungal medications (e.g., fluconazole, itraconazole, ketoconazole)
- barbiturates (e.g., butalbital, phenobarbital, secobarbital)
- benzodiazepines (e.g., alprazolam, diazepam, lorazepam)
- chloral hydrate
- macrolide antibiotics (e.g., clarithromycin, erythromycin, telithromycin)
- monoamine oxidase inhibitors (MAOIs; e.g., tranylcypromine, phenelzine, moclobemide)
- other narcotic analgesics (e.g., codeine, morphine)
- phenothiazines (e.g., perphenazine, thioridazine)
- protease inhibitors (e.g., daraunavir, indinavir, lopinavir, ritonavir saquinavir,)
- selective serotonin reuptake inhibitors (SSRIs; e.g., citalopram, fluoxetine, sertraline)
- St. John's wort
- thiazide diuretics (e.g., hydrochlorothiazide, indapamide)
- tricyclic antidepressants (e.g., amitriptyline, desipramine, imipramine)
If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:
- stop taking one of the medications,
- change one of the medications to another,
- change how you are taking one or both of the medications, or
- leave everything as is.
An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.
Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.