What are the doses of Percocet (oxycodone and acetaminophen)?

From the Guidelines

Percocet should be prescribed in doses ranging from 2.5/325 mg to 10/325 mg, with the first number representing oxycodone and the second representing acetaminophen, and used at the lowest effective dose for the shortest duration possible due to risks of dependence, addiction, and respiratory depression, as recommended by the CDC clinical practice guideline for prescribing opioids for pain - United States, 2022 1.

Key Considerations for Percocet Dosing

• For adults with moderate to severe pain, the usual starting dose is 5/325 mg or 7.5/325 mg taken every 4-6 hours as needed, with a maximum daily limit of 4000 mg of acetaminophen, although many clinicians recommend staying below 3000 mg 1.
• Dosing should be individualized based on pain severity, patient response, and medical history, taking into account factors such as age, liver or kidney function, and opioid tolerance 1.
• Lower doses are recommended for elderly patients, those with liver or kidney impairment, or patients who are opioid-naive, to minimize the risk of adverse effects 1.
• Patients should be advised to limit daily acetaminophen intake to a maximum of 4 g, and to avoid taking additional over-the-counter products containing acetaminophen, as recommended by the FDA and the NCCN clinical practice guidelines in oncology 1.

Important Safety Information

• Percocet should be used with caution in patients with a history of substance abuse or dependence, and in those taking other CNS depressants, such as benzodiazepines or alcohol, due to the increased risk of respiratory depression and death 1.
• Patients should be monitored closely for signs of opioid use disorder, and offered medication treatment if necessary, as recommended by the CDC clinical practice guideline for prescribing opioids for pain - United States, 2022 1.
• Patients should be advised to store Percocet in a secure and preferably locked location, and to dispose of unused medication safely, to prevent accidental ingestion or diversion 1.

From the Research

Doses of Percocet (Oxycodone and Acetaminophen)

• The doses of Percocet (oxycodone and acetaminophen) can vary, but according to a study published in 2003 2, the initial dose is 2.5/325 mg three times a day (TID), with a maximum dose of 20/650 mg TID.
• Another study published in 2000 3 and its update in 2009 4 examined the efficacy of single-dose oral oxycodone, with or without paracetamol, in acute postoperative pain in adults, and found that oxycodone 10 mg plus paracetamol 650 mg provided good analgesia to half of those treated.
• The FDA has limited the dose of acetaminophen in prescription combination opioid products to 325 mg/tablet, as announced in 2011 5.
• A study published in 2010 6 discussed the potential consequences of removing opioid/acetaminophen combination prescription pain medications due to the risk of hepatotoxicity associated with their use.

Specific Doses and Combinations

• Oxycodone 7.5-mg/acetaminophen 325-mg formulation 2
• Oxycodone 10-mg/acetaminophen 325-mg formulation 2
• Oxycodone 10 mg plus paracetamol 650 mg 3, 4
• Oxycodone 15 mg alone 4

Regulation and Safety

• The FDA mandate limiting acetaminophen dosage to 325 mg/tablet in prescription acetaminophen and opioid products was associated with a statistically significant decrease in the yearly rate of hospitalizations and proportion per year of acute liver failure cases involving acetaminophen and opioid toxicity 5.