Home Drug Guide Oxycodone Hydrochloride and Acetaminophen

Drug Guide

Generic Name

Oxycodone Hydrochloride and Acetaminophen

Brand Names Roxilox, Oxycodone And Acetaminophen, Percocet, Oxycodone 2.5/apap 500, Oxycodone 5/apap 500, Roxicet, Oxycet, Tylox-325, Tylox, Roxicet 5/500, Oxycodone Hydrochloride And Acetaminophen, Xartemis XR

Classification

Therapeutic: Analgesic (Pain Relief)

Pharmacological: Opioid Agonist and Non-Opioid Analgesic combination

FDA Approved Indications

  • Management of moderate to severe pain

Mechanism of Action

Oxycodone binds to opioid receptors in the brain and spinal cord, altering the perception and response to pain; acetaminophen inhibits prostaglandin synthesis in the central nervous system, potentiating the analgesic effect.

Dosage and Administration

Adult: Dosage varies; typically, 5-10 mg oxycodone with 325-500 mg acetaminophen every 6 hours as needed. Adjust based on severity of pain and patient response.

Pediatric: Not approved for children under 12 years of age; dosing depends on weight and age under pediatric guidance.

Geriatric: Start at lower end of dosing range due to increased risk of adverse effects.

Renal Impairment: Use with caution; dosage adjustment may be necessary.

Hepatic Impairment: Use with caution; monitor liver function.

Pharmacokinetics

Absorption: Well absorbed orally.

Distribution: Oxycodone crosses the blood-brain barrier; acetaminophen distributes widely.

Metabolism: Metabolized primarily in the liver via conjugation and CYP enzymes (for oxycodone).

Excretion: Excreted mainly in urine, as conjugates; some in feces.

Half Life: Oxycodone: approximately 3-4.5 hours; acetaminophen: 1-3 hours.

Contraindications

  • Severe respiratory depression
  • Acute intoxication with alcohol or other CNS depressants
  • Severe hepatic impairment

Precautions

  • History of hypersensitivity
  • Risk of addiction, abuse, and misuse
  • Use cautiously in elderly, patients with pulmonary disease, or head injury.

Adverse Reactions - Common

  • Nausea (Common)
  • Drowsiness (Common)
  • Constipation (Common)
  • Dizziness (Common)

Adverse Reactions - Serious

  • Respiratory depression (Serious)
  • Liver toxicity (acetaminophen overdose) (Serious)
  • Addiction, overdose, and death (Serious)

Drug-Drug Interactions

  • CNS depressants (benzodiazepines, sedatives)
  • Alcohol
  • Other opioids
  • MAO inhibitors

Drug-Food Interactions

  • Alcohol, which increases sedation and hepatotoxicity risk

Drug-Herb Interactions

  • Kava kava, valerian, or other CNS depressant herbs

Nursing Implications

Assessment: Monitor pain levels, respiratory status, liver function, and signs of misuse or abuse.

Diagnoses:

  • Risk of respiratory depression
  • Ineffective airway clearance
  • Impaired liver function

Implementation: Administer around the clock or as needed per prescription; monitor vital signs and pain response; educate about hepatic function and signs of overdose.

Evaluation: Pain relief achieved without significant adverse effects; liver function remains stable.

Patient/Family Teaching

  • Do not exceed prescribed dose; any signs of overdose or liver problems should be reported immediately.
  • Avoid alcohol and other CNS depressants.
  • Do not operate heavy machinery until effects are known.
  • Keep medication out of reach of children.

Special Considerations

Black Box Warnings:

  • Risk of addiction, abuse, and misuse leading to overdose and death.
  • Serious or fatal respiratory depression.

Genetic Factors: Genetic variations in CYP2D6 may affect oxycodone metabolism, influencing efficacy and safety.

Lab Test Interference: Potential interference with liver function tests due to acetaminophen.

Overdose Management

Signs/Symptoms: Respiratory depression, extreme drowsiness, unresponsiveness, cold and clammy skin, pinpoint pupils, nausea, vomiting, and coma.

Treatment: Administer naloxone promptly, support airway and breathing, provide symptomatic treatment, and monitor until emergency services arrive.

Storage and Handling

Storage: Store at room temperature, away from moisture, heat, and light.

Stability: Stable under normal conditions; check expiration date regularly.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.