Oxycodone Acetaminophen 5-325 Efectos Secundarios

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What to Know About Oxycodone

Mark Gurarie is a freelance writer, editor, and adjunct lecturer of writing composition at George Washington University.

Updated on April 08, 2023

David Ozeri, MD, is a board-certified rheumatologist from Tel Aviv, Israel specializing in arthritis, autoimmune diseases, and biologic therapies.

Table of Contents
Table of Contents

Prescribed to help manage moderate to severe pain, oxycodone is an opioid analgesic drug. It acts on the central nervous system (CNS) of the brain, essentially suppressing pain signaling and stimulating the body’s own pain managing system.

Oxycodone is sold under many names, including Xtampza ER, Oxyfast, Oxaydo, Oxycontin, and others. An active ingredient in other formulations of opioids, in its pure form oxycodone is usually a tablet or capsule, though it may be prescribed in liquid form.

Though highly effective in reducing discomfort, this drug produces a range of side-effects, has very high abuse potential, and overdoses can be deadly. Illicit use of opioids like oxycodone has contributed to a drastic increase in opioid-related deaths and health problems, which is a public health crisis in the U.S.

If you or a loved one has been prescribed oxycodone, a knowledge of how this drug works, what its effects are, and how to take it safely is essential.

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Uses

Like all opioids, oxycodone is primarily a pain medication. Currently, Food and Drug Administration (FDA) guidelines for use are:

Chronic moderate to severe pain as in osteoarthritis, back pain, and some other conditions: Healthcare providers prescribe extended-release versions of oxycodone, such as Xtampza ER or Oxycontin, for cases where other approaches aren’t expected to be successful.
Acute moderate to severe pain that cannot be managed with other methods: Faster-acting forms and some derivatives of this drug may be indicated to help with comfort following surgery, some types of cancer, or following painful injury, such as bone fracture.

Before Taking

In light of the growing opioid epidemic in the U.S., healthcare providers have become more wary when prescribing oxycodone. They’ll make sure pain can’t be managed by other means, and work with patients to make sure they don’t develop drug dependency. As such, careful evaluation is an essential part of the process.

Before this drug is administered or prescribed, the Centers for Disease Control (CDC) recommends practitioners consider the following:

Abuse potential: Healthcare providers perform a careful evaluation to determine whether the patient is likely to develop opioid use disorder (OUD), which is an addiction to the drug. This will mean assessing their previous history of substance and alcohol use.
Minimal effective dose: Opioids like oxycodone are considered when 24-hour management of moderate to severe pain is needed. healthcare providers will work with you to determine a dosage that is as limited as possible and monitor you throughout the course of medication, with the goal of weaning you off this drug.
Risk factors: Since oxycodone ER has such a pervasive effect on multiple body systems, practitioners also need to factor in likely risk-factors for adverse effects. This means assessing health status as well as any prescribed or over-the-counter medications, as well as supplements, you’re taking.
Other means of pain management: For chronic pain, especially, healthcare providers will first explore alternatives to oxycodone for pain management. These include taking Tylenol (acetaminophen), non-steroidal anti-inflammatory drugs (NSAIDs) such as Advil (ibuprofen) and Aleve (naproxen), or other approaches, such as cognitive-behavioral therapy (CBT) and exercise therapy.
Urine testing: Practitioners test urine to assess levels of other drugs in the body or detect any unreported use of opioids.

Precautions and Contraindications

Healthcare providers are always very careful about prescribing oxycodone, and there are several factors that outright contraindicate its use:

Respiratory depression: Since one of the side-effects of opioid drugs is respiratory depression, in which breathing is slower and less effective. Those who already have this condition should not be given these drugs.
Unmonitored bronchial asthma: Related to the above, opioids are not safe for patients with un-managed asthma, in which airways are obstructed by inflammation in the lungs.
Gastrointestinal obstruction: Oxycodone can also affect the gastrointestinal system, so conditions that cause obstruction of the intestines, like paralytic ileus, are contraindicators. These may arise due to a range of conditions, including pancreatitis, appendicitis, gastroenteritis (stomach flu), and other conditions.
Allergy: Some patients have a hypersensitivity to oxycodone, leading to anaphylactic shock, a medical emergency characterized by difficulty breathing, skin rash, and shock.

In addition, healthcare providers will also need to consider the following, which can impact efficacy and increase risks associated with treatment:

Age: Oxycodone is primarily indicated for adults, though reduced dosages can be given to children 11 years and older, with modifications made for those over 65.
Pregnancy: Taking oxycodone or other opioids for prolonged periods during pregnancy can lead to neonatal withdrawal syndrome, in which the newborn is born addicted, and experiences withdrawal. This can be fatal and requires careful management.
Breastfeeding: Evidence suggests that opioids can be transmitted to babies during nursing, so those who breastfeed may be counseled about alternatives.
Chronic obstructive pulmonary disease (COPD): Patients with COPD, a progressive inflammation of the lungs that leads to breathing difficulties, may not be good candidates for oxycodone due to an increased risk of respiratory depression. This is particularly the case for those over 65.
Adrenal insufficiency: This rare condition is when your body doesn’t produce enough of the hormones cortisol and/or aldosterone. It can result from treatment and will therefore be considered carefully in those with this condition.
Low blood pressure (hypotension): If your blood pressure is too low—due to reduced blood volume or as a result of taking some medications—taking oxycodone can increase the risk of developing shock, reducing heart productivity to dangerous levels.
Intracranial pressure: Some brain tumor or head injury patients experience increased intracranial pressure, in which increases in cerebrospinal fluid (the fluid that surrounds the brain) put pressure on the brain, itself. Taking oxycodone can further exacerbate this issue.
Seizure disorders: Patients who experience seizures, or brain attack, may be at increased risk of developing these if prescribed.
Use of certain drugs: Though they may not outright contraindicate its use, benzodiadepines and drugs that act on CYP3A4 receptors in the brain may also cause severe reactions when taken alongside oxycodone (see below).

Make sure to let your healthcare provider know about all medications, supplements, and vitamins you’re currently taking. Though some drugs have minor interaction risks, others may outright contraindicate use or prompt careful consideration as to whether Xtampza ER is an appropriate treatment.

Other Opioids

As mentioned, oxycodone is what is considered an opioid or narcotic. There are other drugs of this class, including:

Codeine
Fentanyl
Heroin
Hydrocodone
Methadone
Morphine
Tramadol

In addition, oxycodone is also an ingredient in other commonly prescribed opioids including:

Lorcet
Roxicet
Percocet
Endocet
Endodan
Percodan
Primalev

Dosage

As noted above, oxycodone comes in both a liquid form, and as tablets or pills. Here’s a quick breakdown of how dosage works in these forms.

Extended-release tablets/capsule: Oxycontin, a tablet, and Xtampza ER, a capsule, are the extended-release versions of oxycodone. Whereas the former is round in shape, the latter is narrower and filled with yellow to light brown capsules.

Tablets and capsules will vary in strength; for instance, typical Xtampza ER tablets come in doses of 9, 13.5, 18, 27, 36 milligrams (mg). Film-coated Oxycontin tablets (controlled-release) come in doses of 10, 15, 20, 30, 40, 60, and 80 mg.

Specific instructions depend on your healthcare provider, but, according to the manufacturer, one tablet every 12 hours (twice daily) is recommended.

Solution: Liquid forms of this drug, such as Oxydose and Oxyfast, are taken orally. The solution comes in two concentrations: 1 milligram (mg)/milliliter (mL) and a much stronger 20 mg/mL solution, which is typically reserved for patients who are more tolerant of opioids.

Specific dosages vary based on the case and level of tolerance, but dosing tends to call for 5 to 15 mg every four to six hours as necessary for pain. You’ll get specific guidance on how to correctly administer this solution.

Modifications

Naturally, some health conditions and other factors may necessitate modifications to dosage of both extended-release and liquid forms of oxycodone. Roughly speaking, these are as follows:

Children 11 and older: The safety of some kinds of oxycodone, like Xtampza Z, has not been established; however, those 11 and up may receive smaller, modified doses of Oxycontin. Oxycodone, in any form, will only be attempted after a child has already developed tolerance to other opioids.
Adults above 65: It tends to take longer for the bodies of people over 65 to process medications and drugs. They also are more likely to suffer from conditions that impact this process, so dosages typically begin at about one-half to one-third of what a healthy adult gets. If necessary, this can be slightly increased.
Liver impairment: Though not an outright contraindicator, those with liver conditions may also have more trouble clearing oxycodone from the bloodstream. In these cases, standard dosages may be cut by as much as one half.
CNS depressants: Patients taking sedatives or anti-anxiety medications like Ambien (zolpidem), Valium (diazepam), and others should start with a dosage that is 50% to 75% reduced.

How to Take and Store

You’ll get specific instructions from your practitioner about taking oxycodone. However, the typical guidelines are as follows:

Extended-release capsules, such as Xtempza ER, must be taken with food; try to be consistent with regards to the size of the meal taken with the drug. For those who have difficulty swallowing, the contents of these capsules can be sprinkled onto soft foods.
Extended-release tablets, like Oxycontin, should also be taken with food. These tablets, however, should be taken whole, and not licked or made wet before administration. Never crush, break, or attempt to dissolve them.
Liquid oxycodone should be kept refrigerated. You’ll be provided a measuring cup; always use that to measure the dosages, and don’t use teaspoons or tablespoons. Make sure to swallow what you’ve measured out right away, and don’t pour any back for future use.

And what do you do if you miss a dose? The recommendation is that you take the medication as soon as you remember, and try to return to your normal schedule of doses as soon as possible.

If so much time has elapsed that you’re almost to your next scheduled dose, you can go ahead and skip one. Don’t double-up on medications if you missed them.

It’s also important not to stop taking this drug suddenly as this can lead to withdrawal, which can lead to a range of symptoms, including irritability, nausea, restlessness, runny nose, anxiety, cramps, and many others.

Once it’s been determined that there’s no need to continue treatment, healthcare providers will need to taper your intake. This typically means reductions of 25% to 50% of dosage every two to four days, alongside careful monitoring.

It’s important that you keep your medications safe and out of reach of children. Finally, it’s absolutely essential that you dispose of any leftover medicine safely. These drugs can be habit-forming, and they should never be shared. Excess medication should be taken to a pharmacy, police station, or other safe disposal location.

Side Effects

Among the reasons that excessive opioid use can become problematic is the propensity for users to experience both major and minor side-effects. Though these may be challenging, they can be managed. Throughout the course of treatment, stay vigilant of how you’re feeling and keep your healthcare provider informed on your progress.

Common

Not usually warranting emergency care, the most common side-effects of oxycodone are:

Constipation
Headache
Nausea
Sleepiness
Dizziness
Abdominal pain
Dry mouth
Sweatiness

If these persist or become severe, let your healthcare provider know.

Severe

Rarer, more severe adverse reactions, occurring in between 1% and 5% of cases, require immediate medical attention. These include:

Opioid dependency/addiction
Circulatory issues (rapid or irregular heartbeat).
Psychiatric issues like anxiety, confusion, and nervousness.
Chills, sweating, and/or fever.
Muscle twitching
Enlarged lymph nodes
Tinnitus (ringing in the ears)
Decreased fertility
Impotence
Menstruation problems
Neurological disorders (tremors, speech problems, vertigo, abnormal walk, and others)
Anaphylactic shock (swelling in the face, throat, tongue, lips, and extremities)

Overdose of oxycodone can lead to coma and even death. In these cases, the primary danger is respiratory depression, which leads to insufficient oxygen circulating the body.

If your loved one is taking this kind of medication, it’s essential to know the signs, so you can get help as soon as possible. These include:

Very small, “pinpoint” pupils
Loss of consciousness
Slow, shallow breathing
Choking and gurgling sounds
Unresponsive body
Pale, blue, and/or cold skin

If you find a loved one in this condition, there are several steps to take:

Call 911 immediately.
Administer naloxone (a drug that counters the effect of opioids) if available.
Try to keep the person awake and breathing.
Lay the person on their side.
Stay nearby until help arrives.

Warnings and Interactions

As noted earlier, some medications and drugs can severely increase the complications and may be contraindicators for oxycodone. In addition, a number of other prescribed and over-the-counter medications, herbs, supplements, and other substances can also affect the way opioids like this work. These include:

Alcohol: When alcohol is mixed with opioid drugs, they become much stronger. This severely increases the chance for overdose and can be deadly.
Benzodiazepines: When used alongside benzodiadepines, such as Valium (diazepam), Xanax (alprazolam), and Klonopin (clonazepam), oxycodone can lead to severe side-effects up to and including death. Certain muscle-relaxers, tranquilizers, and even other types of opioids can have this effect.
CYP3A4 inhibitors: Drugs that act on CYP3AG receptors like erythromycin, ketoconazole, or ritonavir may also cause severe reactions when taken alongside oxycodone. In some cases, respiratory depression can result.
Serotonergic drugs: Typically prescribed for depression, these include selective serotonin reuptake inhibitors (SSRIs), tricyclic antidepressants, triptans, 5-HT3 receptor antagonists, and others. Concomitant use has lead to serotonin syndrome, in which an excess of this brain chemical causes shivering or diarrhea in mild cases, or fever, seizures, and muscle-stiffness in severe ones.
Monoamine oxidase inhibitors (MAOIs): Interactions between this class of anti-depressant drugs like phenelzine, tranylcypromine, and linezolid may also lead to serotonin syndrome or respiratory depression.
Partial-agonist opioids: Use of this class of opioids alongside oxycodone may significantly reduce the efficacy of the drug, or even start to cause withdrawal symptoms.
Muscle relaxers: Those that take muscle-relaxers like baclofen, carisoprodol, metaxalone, and others may also have an increased risk of respiratory arrest.
Diuretics: Drugs that promote urination, such as thiazides like metolazone, hydrochlorothiazide, and others may interact poorly with oxycodone, limiting their effect.
Anticholinergic drugs: Users of this class of drug, which acts on the brain chemical acetylcholine, may experience severe constipation and even develop paralytic ileus when taking oxycodone.

This is only a partial list; make sure to have a clear sense of what you can and can’t take alongside oxycodone, and let your healthcare provider know if you’re making any changes.

When an opioid overdose is suspected, Narcan (naloxone hydrochloride) should be administered as soon as possible. The FDA approved Narcan Nasal Spray in March 2023 as an over-the-counter (OTC) emergency treatment for opioid overdose.

A Word From Verywell

There is always a fine-line with opioid drugs like oxycodone; for as well as it works in managing pain, this medication is not without its disadvantages and outright dangers. There certainly is an extent to which prescription opioids have contributed to the overall opioid epidemic, and there’s no doubt that any responsible use involves being mindful of potential dependency.

However, in the face of this crisis, healthcare providers and medical professionals have become better-versed at educating patients about these drugs. They’ve revised their prescription approaches to minimize risk and have developed better protocols for managing issues that arise. So long as its used safely and as directed, there’s no doubt that oxycodone has an important place in medicine.

Oxycodone

Generic name: oxycodone [ ox-i-KOE-done ]
Brand names: Oxaydo, OxyContin, Oxyfast, Roxicodone, RoxyBond, . show all 16 brands Xtampza ER; oxycodone is also present in the following combination drugs: Combunox, Endocet, Endodan, Moxduo, Oxycodan, Percocet, Percodan, Primlev, Roxicet, Xartemis XR, and others
Drug class: Opioids (narcotic analgesics)

Medically reviewed by Kaci Durbin, MD. Last updated on Feb 20, 2023.

What is oxycodone?

Oxycodone is an opioid pain medication sometimes called a narcotic.

Oxycodone is used to treat moderate to severe pain.

The extended-release form of oxycodone is for around-the-clock treatment of pain and should not be used on an as-needed basis for pain.

Warnings

You should not use oxycodone if you have severe asthma or breathing problems, or a blockage in your stomach or intestines.

MISUSE OF OPIOID MEDICINE CAN CAUSE ADDICTION, OVERDOSE, OR DEATH. Keep the medication in a place where others cannot get to it.

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

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

Oxycodone can slow or stop your breathing. This is more likely in elderly or ill patients, but can occur in anyone taking this medicine.

Before taking this medicine

You should not use oxycodone if you are allergic to it, or if you have:

severe asthma or breathing problems; or
a blockage in your stomach or intestines.

You should not use this medicine if you are already using a similar opioid medicine and are tolerant to it. Do not use this medicine if you have used a MAO inhibitor in the past 14 days, such as isocarboxazid, linezolid, phenelzine, rasagiline, selegiline, or tranylcypromine or have received a methylene blue injection.

Most brands of oxycodone are not approved for use in people under the age of 18. OxyContin should not be given to a child younger than 11 years old.

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

breathing problems, sleep apnea;
a head injury, brain tumor, or seizures;
drug or alcohol addiction, or mental illness;
lung disease;
liver or kidney disease;
thyroid disorder;
adrenal disease (such as Addison’s disease;
urination problems; or
problems with your gallbladder or pancreas.

If you use opioid medicine 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 opioids may need medical treatment for several weeks. Tell your doctor if you are pregnant before using oxycodone. If you become pregnant while taking oxycodone, do not stop your medication suddenly without talking to your doctor. You may need to decrease your medicine gradually.

Ask a doctor before using oxycodone if you are breastfeeding. Tell your doctor if you notice severe drowsiness or slow breathing in the nursing baby.

How should I use oxycodone?

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

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.

Stop taking all other around-the-clock opioid pain medicines when you start taking extended-release oxycodone.

Swallow the capsule or tablet whole to avoid exposure to a potentially fatal overdose. Do not crush, chew, break, open, or dissolve.

If you cannot swallow a capsule whole, open it and sprinkle the medicine into a spoonful of pudding or applesauce. Swallow the mixture right away without chewing. Do not save it for later use.

Never crush or break an oxycodone pill to inhale the powder or mix it into a liquid to inject the drug into your vein. This can cause in death.

Measure liquid medicine carefully. Use the dosing syringe provided, or use a medicine dose-measuring device (not a kitchen spoon).

You should not stop using oxycodone suddenly. Follow your doctor’s instructions about gradually decreasing your dose.

Store at room temperature, away from heat, moisture, and light. Keep track of your medicine. Oxycodone is a drug of abuse and you should be aware if anyone is using your medicine improperly or without a prescription.

Do not keep leftover opioid medication. Just one dose can cause death in someone using this medicine 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.

What happens if I miss a dose?

Since oxycodone is used for pain, you are not likely to miss a dose. Skip any missed dose if it is almost time for your next dose. Do not use two doses at one time.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An oxycodone overdose can be fatal, especially in a child or other person using the medicine without a prescription. Overdose symptoms may include severe drowsiness, pinpoint pupils, slow breathing, or no breathing.

Your doctor may recommend you get naloxone (a medicine to reverse an opioid overdose) and keep it with you at all times. A person caring for you can give the naloxone if you stop breathing or don’t wake up. Your caregiver must still get emergency medical help and may need to perform CPR (cardiopulmonary resuscitation) on you while waiting for help to arrive.

Anyone can buy naloxone from a pharmacy or local health department. Make sure any person caring for you knows where you keep naloxone and how to use it.

What should I avoid while using oxycodone?

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

Avoid driving or operating machinery until you know how this medicine will affect you. Dizziness or severe drowsiness can cause falls or other accidents.

Avoid medication errors. Always check the brand and strength of oxycodone you get from the pharmacy.

Oxycodone side effects

Get emergency medical help if you have signs of an allergic reaction to oxycodone: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Opioid medicine, including oxycodone, can slow or stop your breathing, and death may occur. A person caring for you should give naloxone and/or seek emergency medical attention if you have slow breathing with long pauses, blue colored lips, or if you are hard to wake up.

Call your doctor at once if you have:

noisy breathing, sighing, shallow breathing, breathing that stops during sleep;
a slow heart rate or weak pulse;
cold, clammy skin;
a light-headed feeling, like you might pass out;
confusion, unusual thoughts or behavior;
seizure (convulsions);
low cortisol levels – nausea, vomiting, loss of appetite, dizziness, worsening tiredness or weakness; or
high levels of serotonin in the body – agitation, hallucinations, fever, sweating, shivering, fast heart rate, muscle stiffness, twitching, loss of coordination, nausea, vomiting, diarrhea.

Serious breathing problems may be more likely in older adults and in those who are debilitated or have wasting syndrome or chronic breathing disorders.

Long-term use of opioid medication, such as oxycodone, may affect fertility (ability to have children) in men or women. It is not known whether opioid effects on fertility are permanent.

Common oxycodone side effects may include:

drowsiness, dizziness, tiredness;
headache;
constipation, stomach pain, nausea, vomiting; or
itching, red eyes, or flushing.

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 oxycodone?

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:

other opioids – opioid pain medicine or prescription cough medicine;
sedative medications including alprazolam or Xanax, clonazepam or Klonopin, diazepam or Valium, lorazepam or Ativan, temazepam or Restoril and others;
sleeping pills;
muscle relaxants or tranquilizers;
medicine for depression, anxiety, or other mental illness;
medicine for Parkinson’s disease;
migraine headache treatment; or
medications used for the prevention of nausea and vomiting.
cold or allergy medicines, bronchodilator asthma/COPD medication, or a diuretic (“water pill”);
medicines for motion sickness, irritable bowel syndrome, or overactive bladder;

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

Popular FAQ

Percocet is a combination of acetaminophen and immediate-release oxycodone taken as a tablet for pain. In general, oxycodone (an opioid) stays in the urine for 4 days, saliva for 2 days, and hair for up to 90 days. It can take about 1 day to get a dose of Percocet out of your bloodstream, but it still may be detectable on a drug test. Continue reading

Immediate-release oxycodone has a half-life of just under 4 hours which means the pain-relieving effects of one dose will be gone within 6 to 24 hours, but it can remain detectable in saliva, urine, and hair for much longer. In saliva, oxycodone is detectable within minutes of taking it and lasts for up to 48 hours (2 days). Oxycodone is detectable in urine within 1 to 3 hours and will stay detectable for 1 to 4 days. Like most other opioids, oxycodone is detectable in hair for up to 90 days. Continue reading

How long opioid withdrawal lasts depends on the opioid you have been taking and whether it is a short-acting or long acting opioid.

If you have been using a short-acting opioid, acute opioid withdrawal lasts 4 to 10 days, with withdrawal symptoms starting 8 to 24 hours after last use.

If you have been using a long-acting opioid, acute opioid withdrawal lasts 10 to 20 days, with withdrawal symptoms starting 12 to 48 hours after last use. Continue reading

Immediate-release oxycodone starts to work quickly, within 10 to 30 minutes, but it may take up to 1 hour for it to be fully absorbed, and the full effects reached. Food can delay how quickly oxycodone takes to work, but not how much is absorbed. Continue reading

More FAQ

Which painkiller should you use?
Oxycodone vs Hydrocodone – How do they compare?
What is hydrochloride?

References

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Oxycodone Acetaminophen 5-325 Efectos Secundarios

What to Know About Oxycodone

Uses