From the Guidelines
Long-term use of Percocet can lead to severe side effects, including physical dependence, addiction, chronic constipation, respiratory depression, hormonal imbalances, liver damage, cognitive effects, and hyperalgesia, emphasizing the need for careful medical monitoring and consideration of alternative pain management strategies. According to the CDC clinical practice guideline for prescribing opioids for pain - United States, 2022 1, opioids are not recommended as first-line therapy for many common acute pain conditions due to equivalent or lesser effectiveness for pain relief compared with NSAIDs and risks for long-term opioid use. The guideline emphasizes the importance of maximizing use of nonopioid pharmacologic and nonpharmacologic therapies as appropriate for the specific condition.
Some of the common side effects of long-term opioid use include:
- Constipation
- Mental clouding
- Upper GI symptoms (pyrosis, nausea, bloating)
- Endocrinopathy (hypogonadism/hyperprolactinemia)
- Fatigue
- Infertility
- Osteoporosis/osteopenia
- Reduced libido
- Reduced frequency/duration or absence of menses
- Neurotoxicity
- Myoclonus
- Other changes in mental status (including mood effects, memory problems, increased risk of falls in the elderly)
- Risk of opioid-induced hyperalgesia
- Sleep-disordered breathing
- Increased risk of concurrent benzodiazepine in patients predisposed to sleep apnea
- New-onset sleep apnea
- Worsening of sleep apnea syndromes, as reported in the management of chronic pain in survivors of adult cancers: American Society of Clinical Oncology clinical practice guideline 1.
It is crucial for patients taking Percocet long-term to be aware of these potential side effects and work closely with their healthcare provider to monitor their condition and explore alternative pain management options. The American Society of Clinical Oncology clinical practice guideline 1 highlights the importance of weighing the potential risks and benefits of long-term opioid use in cancer survivors, considering not only pain relief but also improvements in function and individual abilities. Regular medical monitoring and open communication between patients and healthcare providers are essential to minimize the risks associated with long-term Percocet use.
From the FDA Drug Label
The possible side effects of oxycodone hydrochloride tablets are: constipation, nausea, sleepiness, vomiting, tiredness, headache, dizziness, abdominal pain Most common adverse reactions (≥3%) were nausea, constipation, vomiting, headache, pruritus, insomnia, dizziness, asthenia, and somnolence. Other less frequently observed adverse reactions from opioid analgesics, including oxycodone hydrochloride tablets included: Blood and lymphatic system disorders: anemia, leukopenia Cardiac disorders: cardiac failure, palpitation, tachycardia Gastrointestinal disorders: abdominal pain, dry mouth, diarrhea, dyspepsia, dysphagia, glossitis, nausea, vomiting The following adverse reactions have been identified during post-approval use of oxycodone. General disorders and administrative site disorders: drug withdrawal syndrome neonatal Respiratory, thoracic and mediastinal disorders: pharyngeal edema Serotonin syndrome: Cases of serotonin syndrome, a potentially life-threatening condition, have been reported during concomitant use of opioids with serotonergic drugs Adrenal insufficiency: Cases of adrenal insufficiency have been reported with opioid use, more often following greater than one month of use Anaphylaxis: Anaphylactic reaction has been reported with ingredients contained in oxycodone hydrochloride tablets Androgen deficiency: Cases of androgen deficiency have occurred with chronic use of opioids
The side effects of Percocet (oxycodone) long-term use include:
- Gastrointestinal disorders: constipation, nausea, vomiting, abdominal pain
- Central nervous system depression: sleepiness, dizziness, headache
- Cardiac disorders: cardiac failure, palpitation, tachycardia
- Hormonal disorders: adrenal insufficiency, androgen deficiency
- Immune system disorders: anaphylaxis
- Mental health disorders: anxiety, confusion, drug withdrawal syndrome The long-term use of oxycodone can lead to physical dependence and addiction 2, 2.
From the Research
Side Effects of Percocet Long-Term
The side effects of Percocet, a combination of oxycodone and acetaminophen, can be significant when used long-term. Some of the potential side effects include:
- Addiction and dependence 3
- Increased risk of overdose and death 3
- Medication-related adverse events, such as nausea, dizziness, and constipation 4
- Potential for reduced efficacy over time, requiring increased doses 3
- Risk of prescription drug abuse and addiction 3
Comparison to Other Pain Relief Options
Compared to other pain relief options, Percocet may have a higher risk of side effects. For example:
- A study found that oxycodone/acetaminophen resulted in slightly greater pain relief than acetaminophen alone, but was associated with more medication-related adverse events 4
- Other options, such as nonsteroidal anti-inflammatory drugs (NSAIDs), gabapentin, and pregabalin, may have fewer side effects and be effective for certain types of pain 5, 6
Considerations for Long-Term Use
When considering long-term use of Percocet, it is essential to weigh the potential benefits against the risks. Factors to consider include:
- The severity and type of pain being treated 5
- The patient's medical history and risk factors for addiction and overdose 3
- The potential for alternative treatments, such as physical therapy, massage, or other medications 5, 6
- Regular monitoring and assessment of the patient's condition and treatment response 3