Acetaminophen Oxycodone: Side Effects, Interactions

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For the past couple of decades, the United States has been gripped by the opioid overdose epidemic. In a bit of positive news, drug overdose deaths decreased by four percent from 2017 to 2018, but according to the U.S. Centers For Disease Control and Prevention (CDC), overdose deaths are still four times higher in 2018 than in 1999. Of the 67,367 deaths in 2018, an estimated 70 percent of them involved opioids. 

From 2017 to 2018, opioid-involved death rates decreased by two percent, while prescription opioid-involved death rates decreased by 13.5 percent. Heroin-involved death rates decreased by four percent, although synthetic opioid-involved death rates like fentanyl increased by ten percent. The government has implemented strict restrictions on prescribing opioids, but in some cases, they’re still given to chronic pain patients or those receiving major surgery. 

From 1999 to 2019, nearly 450,000 people have lost their lives to opioids. Despite their usefulness in medicine, they are extremely dangerous. Drugs like oxycodone with acetaminophen, often referred to as Percocet, Endocet, or Roxicet, are drugs that have contributed to the nightmare we’ve faced. 

The opioid crisis came in three waves – the first is when pharmaceutical companies assured the medical community opioids were not addictive. Unfortunately, this wasn’t true, and it led physicians to prescribe at much greater rates. Once the government took control in 2010 and put stricter restrictions on opioids, it pushed users to heroin. The third wave, which has so far been the worst, is when fentanyl was introduced into the black market. 

Oxycodone and Acetaminophen

Today, oxycodone and acetaminophen are still widely used in the medical community. If you’re using the drugs or have discussed it with your primary care physician, it’s important to understand the side effects and interactions with other drugs to prevent adverse reactions or death. 

Oxycodone and acetaminophen are used to relieve pain severe enough to warrant treatment when other pain medications have failed to work. Acetaminophen is used to relieve pain and reduce fever, but it isn’t considered habit-forming when used for prolonged periods. However, acetaminophen can cause unwanted effects in large doses, such as liver or kidney damage. 

Oxycodone belongs to a class of medications known as narcotic analgesics or pain medicine. It works on the central nervous system (CNS) to relieve pain. When the drug is used for an extended period, it can lead to mental or physical dependence. However, those who have ongoing pain shouldn’t let the fear of using narcotics prevent them from relieving their pain. Mental dependence, or addiction, isn’t likely to happen when narcotics are used for this purpose.

However, physical dependence can lead to withdrawal side effects if treatment is stopped abruptly. Severe withdrawal side effects can be prevented by gradually reducing the person’s dosage over a prolonged period before treatment is halted completely. 

Oxycodone and acetaminophen are only available with a prescription by prescription from a licensed physician. 

What Should I Discuss With My Doctor Before Taking Acetaminophen and Oxycodone?

If you have a history of dependence or addiction, you should not use oxycodone and acetaminophen. You should also avoid these drugs if you’re allergic or if you have the following:

  • Breathing problems or severe asthma
  • Blockage in your intestines or stomach

You should also share with your doctor if you’ve experienced the following:

  • Liver disease
  • Sleep apnea or other breathing problems
  • Kidney disease
  • Drug or alcohol addiction
  • Urination problems
  • Brain tumor
  • Crohn’s disease, ulcerative colitis, or inflammatory bowel disease
  • If you drink alcohol
  • Heart or circulation problems
  • Liver disease
  • Seizures or a head injury
  • Problems with your pancreas, thyroid, or gallbladder

You should never use opioid medication while pregnant. Your baby could be born dependent on oxycodone, which may lead to life-threatening withdrawal symptoms during birth. Babies born dependent on oxycodone could require medical treatment for several weeks and face issues in their life. 

You should also avoid breastfeeding if you’re using oxycodone and acetaminophen as the medication can be passed through breast milk. This can cause breathing problems, drowsiness, or death in a nursing baby. 

acetaminophen-oxycodone-side-effects

How Should Acetaminophen and Oxycodone Be Taken?

You should always follow your doctor’s instructions when prescribed this medication. You should never use this medication in larger amounts or for longer than it’s prescribed. An overdose can lead to lasting liver damage or death. You should speak with your doctor if you feel an increased urge to use more of the drug.

Never share this medication with others, especially with a person who has a history of addiction or drug abuse. Misuse can lead to addiction, overdose, or death. Keep the medication where others can’t find it. Selling or giving away oxycodone and acetaminophen is strictly forbidden by the law. 

If the medication is given in liquid form, measure it carefully by using a dosing syringe or a medicine dose-measuring device – never a kitchen spoon. If you require surgery or other medical tests, let your doctor know you’re using this medication. 

Do not stop using oxycodone and acetaminophen abruptly – it can lead to unpleasant withdrawal symptoms. Talk to your doctor about tapering your dose for a more comfortable experience. 

What Interacts with Oxycodone and Acetaminophen?

Oxycodone is a depressant drug, and using it in conjunction with other depressants can slow breathing enough to the point of losing consciousness. In 2019, an estimated 16 percent of opioid overdoses also involved benzodiazepines, which are prescription sedatives used to treat anxiety or insomnia. 

Other drugs that interact with oxycodone and acetaminophen include:

  • Atropine
  • Alcohol
  • Antihistamines for cough, cold, or allergy
  • Antiviral medications for HIV or AIDS
  • Certain medications for sleep or anxiety
  • Certain medications for bladder problems, such as tolterodine or oxybutynin
  • Certain antibiotics like erythromycin, clarithromycin, rifampin, and linezolid
  • Certain depression medications, such as fluoxetine, sertraline, or amitriptyline
  • Certain medications for fungal infections, such as itraconazole, ketoconazole, or voriconazole
  • Certain medications for migraine headaches, such as eletriptan, almotriptan, frovatriptan, naratriptan, sumatriptan, rizatriptan, or zolmitriptan
  • Certain medication for nausea and vomiting, such as ondansetron, dolasetron, or palonosetron
  • Certain medications for Parkinson’s disease, such as benztropine or trihexyphenidyl
  • Certain medications for seizures, such as phenytoin, phenobarbital, or primidone
  • Certain medications for stomach issues, such as hyoscyamine or dicyclomine. 
  • Certain medications for travel sickness like scopolamine
  • Diuretics
  • Ipratropium
  • General anesthetics, such as isoflurane, halothane, propofol, or methoxyflurane
  • Local anesthetics, such as pramoxine, lidocaine, or tetracaine
  • MAOIs like Eldepryl, Carbex, Marplan, Parnate, or Nardil
  • Medications that relax muscles before surgery
  • Nilotinib
  • Methylene blue
  • Other medications that contain acetaminophen
  • Other narcotic medications for cough or pain
  • Phenothiazines like mesoridazine, chlorpromazine, thioridazine, or prochlorperazine

The above-listed medications may not contain all potential interactions. You should always provide your doctor with a list of herbs, medications, and non-prescription drugs that you use. You should also mention if you drink alcohol, smoke, or use illegal drugs. Some of these may interact with oxycodone and acetaminophen. 

What Side Effects Can Occur From Oxycodone and Acetaminophen?

All side effects should be reported to your physician immediately. If you believe your life is in danger, you should contact 911 immediately. Potential side effects that could occur from oxycodone and acetaminophen use include:

  • Confusion
  • Breathing issues
  • Allergic reactions that include itching, skin rashes, hives, or swelling of the lips, face, or tongue
  • Blistering, redness, peeling, or loosening of the skin, including inside your mouth
  • Signs and symptoms of liver injury like dark yellow or brown urine
  • Ill feelings, such as flu-like symptoms
  • Light-colored stools
  • Nausea
  • Loss of appetite
  • Right upper belly pain
  • Unusually tired or weak
  • Yellowing of the skin or eyes
  • Signs of low blood pressure that includes dizziness, feeling faint or lightheaded, falling, or feeling unusually weak or tired
  • Troubling urinating or change in the amount of urine produced

Side effects that don’t require immediate medical attention but should still be told to your doctor if they’re bothersome include:

  • Tiredness
  • Dry mouth
  • Nausea or vomiting
  • Constipation

Speak to your doctor for a full list of side effects. Oxycodone and acetaminophen can be a useful medication when you follow the directions. However, dependence can occur despite taking precautions, and if you feel you’ve become dependent on the drug, it might be necessary to reach out and get help. If you experience withdrawal symptoms if you miss a dose, it could indicate a growing dependency on oxycodone. 

You should always avoid this medication, if possible. Talk to your doctor about alternatives to treat your pain. 

Sources

Cleveland Clinic (February 2021) Acetaminophen; Oxycodone Tablets. from https://my.clevelandclinic.org/health/drugs/19670-acetaminophen-oxycodone-tablets

DEA (February 2021) Benzodiazepines. from https://www.dea.gov/factsheets/benzodiazepines

NIDA (February 2021) Benzodiazepines and Opioids. from https://www.drugabuse.gov/drug-topics/opioids/benzodiazepines-opioids

CDC (February 2021) Understanding the Epidemic. from https://www.cdc.gov/drugoverdose/epidemic/index.html

CDC (February 2021) Data Analysis and Resources. from https://www.cdc.gov/drugoverdose/data/analysis.html

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