Percocet

Pain Relief

Percocet is a combination medicine used to relieve moderate to moderately severe pain. It is typically prescribed for short-term use when other pain relief options, such as non-opioid medications, are not effective or cannot be used.

Common uses for this medication include:

• Managing pain after surgical procedures.
• Treating acute pain resulting from physical injuries.
• Addressing severe pain that requires an opioid component for relief.

The medication works through two different mechanisms. Oxycodone, an opioid, changes the way the brain and nervous system perceive pain. Acetaminophen works as a non-opioid pain reliever and can also help lower a fever. Because of the potential for serious risks, including addiction and misuse, it is used only when necessary for pain management.

How Percocet Relieves Pain

Percocet is a combination medication containing oxycodone and acetaminophen. These two ingredients work together to provide pain relief through different mechanisms in the body.

Oxycodone is an opioid analgesic. It works by binding to specific proteins called opioid receptors located in the brain and spinal cord. This interaction changes the way the central nervous system sends and receives pain signals, effectively altering how the body perceives and reacts to pain.

Acetaminophen is a non-opioid pain reliever and fever reducer. It works by changing the way the body senses pain and by cooling the body to reduce fever. While the exact way it works is not completely understood, it is thought to increase the body's overall pain threshold.

The combination of these two medications allows them to address pain through multiple pathways, which is often more effective for managing moderate to moderately severe pain than using either medication alone.

Common Side Effects

Percocet may cause several common side effects. If these symptoms are severe or do not go away, consult a healthcare provider:

• Nausea and vomiting
• Constipation
• Dizziness or lightheadedness
• Drowsiness
• Headache
• Dry mouth
• Sweating
• Blurred vision

Serious Side Effects

Some side effects can be serious. Seek emergency medical attention if you experience any of the following:

• Slowed, shallow, or difficult breathing
• Extreme sleepiness or difficulty waking up
• Seizures
• Chest pain or a fast or slow heartbeat
• Confusion or unusual changes in mood
• Difficulty urinating
• Signs of an allergic reaction, such as rash, hives, itching, or swelling of the face, lips, or tongue
• Signs of liver damage, including yellowing of the skin or eyes (jaundice), dark urine, or pain in the upper right stomach area

Withdrawal Symptoms

If you stop taking Percocet suddenly after regular use, you may experience withdrawal symptoms. These can include:

• Restlessness, anxiety, or irritability
• Muscle, back, or joint pain
• Runny nose and watery eyes
• Sweating, chills, or yawning
• Nausea, vomiting, diarrhea, or stomach cramps
• Difficulty falling or staying asleep
• Fast heartbeat or increased blood pressure

Boxed Warnings

Percocet has several boxed warnings due to the potential for serious harm:

• Addiction, Abuse, and Misuse: Use of this medication exposes individuals to the risks of opioid addiction, abuse, and misuse, which can lead to overdose and death.
• Respiratory Depression: Serious, life-threatening, or fatal breathing problems may occur. Monitoring is especially important when starting the medication or after a dose increase.
• Accidental Ingestion: Accidental ingestion of even one dose, especially by children, can result in a fatal overdose.
• Neonatal Opioid Withdrawal Syndrome: Prolonged use during pregnancy can result in withdrawal symptoms in the newborn, which may be life-threatening if not recognized and treated.
• Liver Toxicity: The acetaminophen in this medication has been linked to cases of acute liver failure, sometimes resulting in liver transplant or death. Most cases are associated with doses exceeding 4,000 milligrams per day or using more than one product containing acetaminophen.

Other Serious Precautions

Interactions with Other Drugs: Using Percocet with benzodiazepines or other central nervous system depressants, including alcohol, can cause severe sedation, respiratory depression, coma, and death.

Adrenal Insufficiency: Long-term use of opioids may lead to adrenal insufficiency, a condition where the body does not produce enough of certain hormones. Symptoms include nausea, vomiting, loss of appetite, and worsening fatigue.

Severe Hypotension: This medication may cause a serious drop in blood pressure, which can lead to dizziness or fainting.

Gastrointestinal Conditions: Percocet should not be used by individuals with known or suspected gastrointestinal obstruction, including paralytic ileus.

Contraindications

Percocet is generally not recommended for people with:

• Significant respiratory depression.
• Acute or severe bronchial asthma in unmonitored settings.
• Known hypersensitivity to oxycodone, acetaminophen, or any other components of the drug.

Safe Disposal

Because of the high risk of fatal overdose from accidental ingestion, unused Percocet should be disposed of immediately through a drug take-back program or by flushing it down the toilet if a take-back option is not available.

Pregnancy

Using Percocet during pregnancy, especially for a prolonged period, can lead to neonatal opioid withdrawal syndrome (NOWS) in the newborn. This condition can be life-threatening and requires medical management after birth. Symptoms of withdrawal in a baby may include:

• High-pitched crying or irritability
• Tremors or shaking
• Sleep problems
• Diarrhea or vomiting
• Failure to gain weight

If you are pregnant or planning to become pregnant, tell your doctor before taking this medication. They will determine if the benefits of treatment outweigh the potential risks to the fetus.

Breastfeeding

The active ingredients in Percocet pass into breast milk and can cause serious side effects in a nursing infant. These risks include extreme sleepiness, difficulty breathing, or limpness. Because of these safety concerns, breastfeeding is generally not recommended while taking this medication. Consult a healthcare professional to discuss the safest options for feeding your baby while managing your pain.

Dosage Forms

Percocet is available in the following forms to be taken by mouth:

• Tablets: This is the most common form of the medication.
• Oral Solution: A liquid version of the medication is also available for oral use.

Composition

Each dose of Percocet contains two active ingredients: oxycodone and acetaminophen. The medication is available in several different strengths, which are defined by the amount of each ingredient present in the tablet or liquid. Most formulations use a fixed amount of acetaminophen combined with varying amounts of oxycodone.

FDA Approval and Use

Percocet is approved by the U.S. Food and Drug Administration (FDA) for the management of pain severe enough to require an opioid analgesic. It is typically reserved for situations where alternative treatment options, such as non-opioid analgesics, are inadequate or not tolerated.

Boxed Warnings

The FDA requires a Boxed Warning for Percocet, which is the most serious type of warning. This warning highlights several critical risks:

• Addiction, Abuse, and Misuse: Use of this medication can lead to opioid use disorder, overdose, and death.
• Respiratory Depression: Serious, life-threatening, or fatal breathing problems may occur, particularly when starting the medication or after a dose increase.
• Accidental Ingestion: Accidental ingestion of even one dose, especially by children, can result in a fatal overdose.
• Neonatal Opioid Withdrawal Syndrome: Prolonged use during pregnancy can result in life-threatening withdrawal symptoms in the newborn.
• Hepatotoxicity: The acetaminophen component is associated with cases of acute liver failure, which may lead to liver transplant or death.
• Risks from Combined Use: Using opioids with benzodiazepines or other central nervous system depressants may result in profound sedation, respiratory depression, coma, and death.

Regulatory Oversight

Percocet is classified as a Schedule II controlled substance because it has a high potential for abuse and may lead to severe psychological or physical dependence. To manage these risks, the FDA has implemented a Risk Evaluation and Mitigation Strategy (REMS) for all opioid analgesics. This program requires that training be made available to healthcare providers and that patients receive specific information about the safe use, storage, and disposal of these medications.

Safe Disposal

The FDA includes Percocet on its Flush List. This means that if a drug take-back program is not immediately available, unused or expired Percocet should be flushed down the toilet to prevent accidental ingestion or intentional misuse by others in the household.

Risk of Addiction and Misuse

Percocet is a combination of oxycodone and acetaminophen. Oxycodone is an opioid pain medication that can be habit-forming, even when taken at recommended doses. Addiction involves a strong craving for the drug and continued use despite knowing it causes harm. Misusing the medication by taking larger amounts or using it more frequently than prescribed increases the risk of serious side effects or a fatal overdose.

Physical Dependence and Withdrawal

Using Percocet for an extended period can lead to physical dependence. This means the body has adjusted to the presence of the drug. If you stop taking it suddenly, you may experience withdrawal symptoms, such as:

• Restlessness and anxiety
• Muscle and bone pain
• Insomnia
• Diarrhea and vomiting
• Cold flashes or shivering

To avoid withdrawal, healthcare providers usually recommend tapering the dose gradually rather than stopping abruptly.

Safe Use and Disposal

To reduce the risk of addiction and accidental exposure to others, follow these safety measures:

• Never share your medication with anyone else, as it can be fatal for others, especially children.
• Store the medication in a secure, locked location.
• If you have unused Percocet, dispose of it properly. Because of its high potential for harm if taken accidentally, the FDA recommends flushing unused Percocet down the toilet if a drug take-back program is not immediately available.