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Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated. Acetaminophen-Oxycodone mg Endocet mg mg slide 6 of 16, Endocet mg mg,.
Endocet mg slide 7 of 16, Endocet mg,. Endocet 7. Oxycodone-APAP 7. Percocet mg slide 12 of 16, Percocet mg,. Percocet 2. Percocet mg slide 14 of 16, Percocet mg,. Percocet 7. Roxicet slide 16 of 16, Roxicet,. What is the most important information I should know about acetaminophen and oxycodone? What is acetaminophen and oxycodone? Acetaminophen and oxycodone is a combination medicine used to relieve moderate to severe pain. Acetaminophen and oxycodone may also be used for purposes not listed in this medication guide.
What should I discuss with my healthcare provider before taking acetaminophen and oxycodone? How should I take acetaminophen and oxycodone? What happens if I miss a dose? What happens if I overdose? What should I avoid while taking acetaminophen and oxycodone? Do not drink alcohol. Dangerous side effects or death could occur. What are the possible side effects of acetaminophen and oxycodone? What other drugs will affect acetaminophen and oxycodone?
Where can I get more information? Your pharmacist can provide more information about acetaminophen and oxycodone. Copyright Cerner Multum, Inc. Version: Your use of the content provided in this service indicates that you have read, understood and agree to the End-User License Agreement, which can be accessed by clicking on this link.
Top of Page. You should not use this medicine if you are allergic to acetaminophen Tylenol or oxycodone, or if: you have severe asthma or breathing problems; you have a blockage in your stomach or intestines, including paralytic ileus; or you have recently used alcohol, sedatives, tranquilizers, or other narcotic medications. To make sure this medicine is safe for you, tell your doctor if you have: any type of breathing problem or lung disease; liver disease, cirrhosis, or if you drink alcohol daily; a history of drug abuse, alcohol addiction, or mental illness; kidney disease, urination problems; problems with your gallbladder, pancreas, thyroid, or adrenal gland; a history of head injury, brain tumor, or seizures; or if you use a sedative like Valium diazepam, alprazolam, lorazepam, Ativan, Klonopin, Restoril, Tranxene, Versed, Xanax, and others.
Call your doctor at once if you have: shallow breathing, slow heartbeat; a light-headed feeling, like you might pass out; confusion, unusual thoughts or behavior; seizure convulsions ; problems with urination; infertility, missed menstrual periods; impotence, sexual problems, loss of interest in sex; liver problems --nausea, upper stomach pain, itching, loss of appetite, dark urine, clay-colored stools, jaundice yellowing of the skin or eyes ; or low cortisol levels --nausea, vomiting, loss of appetite, dizziness, worsening tiredness or weakness.
Certain over-the-counter pain medications can be used alongside antibiotics and other self care options to help alleviate the pain caused by a UTI. CBD cannabidiol is a chemical found in the Cannabis sativa plant, which is being investigated for its potential health benefits.
Studies in animals suggest that CBD cannabidiol has a role to play in the treatment of pain, but clinical trial evidence in people is lacking. The metabolism of oxycodone to oxymorphone is catalyzed by CYP2D6. Free and conjugated noroxycodone, free and conjugated oxycodone, and oxymorphone are excreted in human urine following a single oral dose of oxycodone.
Acetaminophen is metabolized in the liver via cytochrome P microsomal enzyme. High doses of acetaminophen may deplete the glutathione stores so that inactivation of the toxic metabolite is decreased. At high doses, the capacity of metabolic pathways for conjugation with glucuronic acid and sulfuric acid may be exceeded, resulting in increased metabolism of acetaminophen by alternate pathways.
Oxycodone and acetaminophen tablets USP are indicated for the relief of moderate to moderately severe pain. Oxycodone and acetaminophen tablets should not be administered to patients with known hypersensitivity to oxycodone, acetaminophen, or any other component of this product.
Oxycodone is contraindicated in any situation where opioids are contraindicated including patients with significant respiratory depression in unmonitored settings or the absence of resuscitative equipment and patients with acute or severe bronchial asthma or hypercarbia.
Oxycodone is contraindicated in the setting of suspected or known paralytic ileus. The excessive intake of acetaminophen may be intentional to cause self-harm or unintentional as patients attempt to obtain more pain relief or unknowingly take other acetaminophen-containing products.
The risk of acute liver failure is higher in individuals with underlying liver disease and in individuals who ingest alcohol while taking acetaminophen. Instruct patients to look for acetaminophen or APAP on package labels and not to use more than one product that contains acetaminophen.
Instruct patients to seek medical attention immediately upon ingestion of more than milligrams of acetaminophen per day, even if they feel well. There have been post-marketing reports of hypersensitivity and anaphylaxis associated with use of acetaminophen.
Clinical signs included swelling of the face, mouth, and throat, respiratory distress, urticaria, rash, pruritus, and vomiting. There were infrequent reports of life-threatening anaphylaxis requiring emergency medical attention. Instruct patients to discontinue oxycodone and acetaminophen tablets USP immediately and seek medical care if they experience these symptoms. Do not prescribe oxycodone and acetaminophen tablets USP for patients with acetaminophen allergy. Oxycodone is an opioid agonist of the morphine-type.
Such drugs are sought by drug abusers and people with addiction disorders and are subject to criminal diversion. Oxycodone can be abused in a manner similar to other opioid agonists, legal or illicit. This should be considered when prescribing or dispensing oxycodone and acetaminophen tablets in situations where the physician or pharmacist is concerned about an increased risk of misuse, abuse, or diversion. Concerns about misuse, addiction, and diversion should not prevent the proper management of pain.
Healthcare professionals should contact their State Professional Licensing Board or State Controlled Substances Authority for information on how to prevent and detect abuse or diversion of this product. Administration of oxycodone and acetaminophen tablets should be closely monitored for the following potentially serious adverse reactions and complications:.
Respiratory depression is a hazard with the use of oxycodone, one of the active ingredients in oxycodone and acetaminophen tablets, as with all opioid agonists. Elderly and debilitated patients are at particular risk for respiratory depression as are non-tolerant patients given large initial doses of oxycodone or when oxycodone is given in conjunction with other agents that depress respiration. Oxycodone should be used with extreme caution in patients with acute asthma, chronic obstructive pulmonary disorder COPD , cor pulmonale, or preexisting respiratory impairment.
In such patients, even usual therapeutic doses of oxycodone may decrease respiratory drive to the point of apnea. In these patients alternative non-opioid analgesics should be considered, and opioids should be employed only under careful medical supervision at the lowest effective dose. The respiratory depressant effects of opioids include carbon dioxide retention and secondary elevation of cerebrospinal fluid pressure, and may be markedly exaggerated in the presence of head injury, other intracranial lesions or a preexisting increase in intracranial pressure.
Oxycodone produces effects on pupillary response and consciousness which may obscure neurologic signs of worsening in patients with head injuries. Oxycodone may cause severe hypotension particularly in individuals whose ability to maintain blood pressure has been compromised by a depleted blood volume, or after concurrent administration with drugs which compromise vasomotor tone such as phenothiazines. Oxycodone, like all opioid analgesics of the morphine-type, should be administered with caution to patients in circulatory shock, since vasodilation produced by the drug may further reduce cardiac output and blood pressure.
Oxycodone may produce orthostatic hypotension in ambulatory patients. Opioid analgesics should be used with caution when combined with CNS depressant drugs, and should be reserved for cases where the benefits of opioid analgesia outweigh the known risks of respiratory depression, altered mental state, and postural hypotension.
Acute Abdominal Conditions — The administration of oxycodone and acetaminophen tablets or other opioids may obscure the diagnosis or clinical course in patients with acute abdominal conditions. Oxycodone and acetaminophen tablets should be given with caution to patients with CNS depression, elderly or debilitated patients, patients with severe impairment of hepatic, pulmonary, or renal function, hypothyroidism, Addison's disease, prostatic hypertrophy, urethral stricture, acute alcoholism, delirium tremens, kyphoscoliosis with respiratory depression, myxedema, and toxic psychosis.
Oxycodone and acetaminophen tablets may obscure the diagnosis or clinical course in patients with acute abdominal conditions. Oxycodone may aggravate convulsions in patients with convulsive disorders, and all opioids may induce or aggravate seizures in some clinical settings. Following administration of oxycodone and acetaminophen tablets, anaphylactic reactions have been reported in patients with a known hypersensitivity to codeine, a compound with a structure similar to morphine and oxycodone.
The frequency of this possible cross-sensitivity is unknown. Patients receiving other opioid analgesics, general anesthetics, phenothiazines, other tranquilizers, centrally-acting anti-emetics, sedative-hypnotics or other CNS depressants including alcohol concomitantly with oxycodone and acetaminophen tablets may exhibit an additive CNS depression. When such combined therapy is contemplated, the dose of one or both agents should be reduced. Oxycodone and other morphine-like opioids have been shown to decrease bowel motility.
Ileus is a common postoperative complication, especially after intra-abdominal surgery with use of opioid analgesia. Caution should be taken to monitor for decreased bowel motility in postoperative patients receiving opioids. Standard supportive therapy should be implemented. Oxycodone may cause spasm of the Sphincter of Oddi and should be used with caution in patients with biliary tract disease, including acute pancreatitis.
Opioids like oxycodone may cause increases in the serum amylase level. Tolerance is the need for increasing doses of opioids to maintain a defined effect such as analgesia in the absence of disease progression or other external factors. Physical dependence is manifested by withdrawal symptoms after abrupt discontinuation of a drug or upon administration of an antagonist.
Physical dependence and tolerance are not unusual during chronic opioid therapy. The opioid abstinence or withdrawal syndrome is characterized by some or all of the following: restlessness, lacrimation, rhinorrhea, yawning, perspiration, chills, myalgia, and mydriasis. Other symptoms also may develop, including: irritability, anxiety, backache, joint pain, weakness, abdominal cramps, insomnia, nausea, anorexia, vomiting, diarrhea, or increased blood pressure, respiratory rate, or heart rate.
The following information should be provided to patients receiving oxycodone and acetaminophen tablets by their physician, nurse, pharmacist, or caregiver:. Although oxycodone may cross-react with some drug urine tests, no available studies were found which determined the duration of detectability of oxycodone in urine drug screens.
However, based on pharmacokinetic data, the approximate duration of detectability for a single dose of oxycodone is roughly estimated to be one to two days following drug exposure.
Urine testing for opiates may be performed to determine illicit drug use and for medical reasons such as evaluation of patients with altered states of consciousness or monitoring efficacy of drug rehabilitation efforts. The preliminary identification of opiates in urine involves the use of an immunoassay screening and thin-layer chromatography TLC.
The identities of 6-keto opiates e. Opioid analgesics may enhance the neuromuscular-blocking action of skeletal muscle relaxants and produce an increase in the degree of respiratory depression. Patients receiving CNS depressants such as other opioid analgesics, general anesthetics, phenothiazines, other tranquilizers, centrally-acting anti-emetics, sedative-hypnotics or other CNS depressants including alcohol concomitantly with oxycodone and acetaminophen tablets may exhibit an additive CNS depression.
The concurrent use of anticholinergics with opioids may produce paralytic ileus. Alcohol, ethyl — Hepatotoxicity has occurred in chronic alcoholics following various dose levels moderate to excessive of acetaminophen.
Anticholinergics — The onset of acetaminophen effect may be delayed or decreased slightly, but the ultimate pharmacological effect is not significantly affected by anticholinergics.
Oral Contraceptives — Increase in glucuronidation resulting in increased plasma clearance and a decreased half-life of acetaminophen. Charcoal activated — Reduces acetaminophen absorption when administered as soon as possible after overdose. Beta Blockers Propanolol — Propanolol appears to inhibit the enzyme systems responsible for the glucuronidation and oxidation of acetaminophen.
Therefore, the pharmacologic effects of acetaminophen may be increased. Loop Diuretics — The effects of the loop diuretic may be decreased because acetaminophen may decrease renal prostaglandin excretion and decrease plasma renin activity.
Lamotrigine — Serum lamotrigine concentrations may be reduced, producing a decrease in therapeutic effects. Probenecid — Probenecid may increase the therapeutic effectiveness of acetaminophen slightly. Zidovudine — The pharmacologic effects of zidovudine may be decreased because of enhanced nonhepatic or renal clearance of zidovudine.
A more specific alternate chemical method must be used in order to obtain a confirmed analytical result. Moreover, clinical considerations and professional judgment should be applied to any drug-of-abuse test result, particularly when preliminary positive results are used. This effect appears to be drug, concentration and system dependent.
Carcinogenesis — Animal studies to evaluate the carcinogenic potential of oxycodone and acetaminophen have not been performed. Mutagenesis — The combination of oxycodone and acetaminophen has not been evaluated for mutagenicity. Oxycodone alone was negative in a bacterial reverse mutation assay Ames , an in vitro chromosome aberration assay with human lymphocytes without metabolic activation and an in vivo mouse micronucleus assay.
Oxycodone was clastogenic in the human lymphocyte chromosomal assay in the presence of metabolic activation and in the mouse lymphoma assay with or without metabolic activation.
Fertility — Animal studies to evaluate the effects of oxycodone on fertility have not been performed.
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