What is Percocet (Oxycodone and Acetaminophen)?

From the Guidelines

Percocet should be prescribed with caution due to its significant risks, including physical dependence, addiction, and liver damage, and its use should be carefully monitored and limited to the lowest effective dose for the shortest duration necessary. When considering the use of Percocet, it is essential to weigh the potential benefits against the risks, particularly in patients with a history of substance abuse or those taking other central nervous system depressants 1. The standard dosage of Percocet ranges from 2.5/325mg to 10/325mg (oxycodone/acetaminophen), and it is typically taken every 4-6 hours as needed for pain. However, the acetaminophen component can cause liver damage if taken in excessive amounts, and patients should be advised to stay below 3000-4000mg daily.

Some key points to consider when prescribing Percocet include:

• The risk of physical dependence and addiction, particularly with long-term use 1
• The potential for liver damage due to the acetaminophen component, especially when taken in excessive amounts 1
• The increased risk of dangerous respiratory depression when combined with alcohol or other central nervous system depressants 1
• The need for careful monitoring and appropriate prescribing practices due to its high potential for misuse and addiction 1

It is also important to note that the efficacy of long-term use of opioids, including Percocet, has not been well established, and the balance between potential risks and benefits must be weighed when considering their use in patients who are surviving cancer 1. Additionally, alternative treatments, such as tapentadol, may be considered for patients with severe chronic pain, as they have shown comparable efficacy to oxycodone and other opioids, with potentially fewer adverse effects 1.

In terms of specific patient populations, it is essential to exercise caution when prescribing Percocet to patients with a history of substance abuse, as well as those taking other central nervous system depressants, due to the increased risk of dangerous respiratory depression 1. Furthermore, patients with liver disease or those taking other medications that may interact with acetaminophen should be closely monitored for signs of liver damage.

Overall, Percocet can be an effective treatment for moderate to severe pain, but its use should be carefully monitored and limited to the lowest effective dose for the shortest duration necessary to minimize the risk of adverse effects and dependence.

From the FDA Drug Label

Oxycodone hydrochloride tablets are: A strong prescription pain medicine that contains an opioid (narcotic) that is used to manage pain severe enough to require an opioid pain medicine, when other pain treatments such as non-opioid pain medicines do not treat your pain well enough or you cannot tolerate them. The answer to the question about Percocet is that Percocet is not directly mentioned in the provided drug labels, but based on the information about oxycodone, which is a component of Percocet, it can be inferred that Percocet is a strong prescription pain medicine that contains an opioid (narcotic) used to manage severe pain.

• Key points about oxycodone include:
  • It is an opioid agonist
  • It is used to manage pain severe enough to require an opioid pain medicine
  • It can cause serious side effects, including overdose and death
  • It should be taken exactly as prescribed by a healthcare provider 2
• Important information about oxycodone hydrochloride tablets includes:
  • They should not be taken with other opioid medicines, benzodiazepines, alcohol, or other central nervous system depressants
  • They should not be given to anyone else, as they could die from taking them
  • They should be stored away from children and in a safe place to prevent stealing or abuse 2

From the Research

Overview of Percocet

• Percocet is a combination medication containing oxycodone and acetaminophen, used to treat moderate to severe pain 3, 4, 5.
• Oxycodone is a semi-synthetic opioid with an agonist activity on mu, kappa, and delta receptors, while acetaminophen is a non-opioid analgesic 4.

Pharmacology and Clinical Use

• The efficacy of oxycodone is similar to that of morphine, with a ratio of 1/1.5-2 for the treatment of cancer pain 4.
• Oxycodone has a more predictable metabolism than morphine, making titration easier 4.
• A study comparing oxycodone/acetaminophen to acetaminophen alone for emergency department patients with musculoskeletal pain refractory to ibuprofen found that oxycodone/acetaminophen resulted in slightly greater pain relief, but with more medication-related adverse events 5.

Abuse and Dependence

• Oxycodone has been identified as a drug with significant abuse potential, similar to heroin and morphine 6.
• Both animal and human abuse liability studies have confirmed the abuse potential of oxycodone 6.
• The use of oxycodone has been linked to an increased risk of injury, particularly when combined with skeletal muscle relaxants 7.

Safety and Adverse Events

• Common side effects of oxycodone include nausea, constipation, and drowsiness, with vomiting, pruritus, and dizziness being less common 4.
• The combination of oxycodone with skeletal muscle relaxants has been associated with an increased risk of injury, with varying injury rates depending on the specific opioid and muscle relaxant used 7.