What is Oxycodone with APAP?

Oxycodone with APAP (acetyl-para-amino-phenol) is an opioid drug mixed with acetaminophen or paracetamol and is available only by prescription to treat pronounced pain. It is sold under a number of synonyms like Percocet®, Roxicet®, and Tylox®, and may come in different strengths of each active ingredient. This medication has numerous drug/medical condition interactions and side effects. For most people it is prescribed for short periods of time because of its addictive potential, though it can be used for chronic pain conditions.

Medications like Percocet® were first prescribed in the US in the 1970s. Oxycodone was thought to improve on other prescription pain relievers like codeine, and its combination with acetaminophen increased its pain-relieving properties. Some doctors also felt it was less addictive than drugs like morphine, and prescribed it for people with chronic pain issues, though this inevitably created drug dependence. Dependence could be established within a month or two of use, leading to drug seeking behaviors in some users or increased use of the medication, which can be very dangerous.

In 2009, there was significant call to remove oxycodone with APAP and hydrocodone with APAP from the market. When people took more of this medicine than prescribed, they risked severe side effects from an overdose of acetaminophen. Recent studies show too much acetaminophen may create permanent liver damage or combining the drug with alcohol or chronic drinking issues may accomplish the same. These drugs were not removed from the market, but they are prescribed with more care, and people receiving them are screened for alcohol use and liver disease.

Other medical conditions may contraindicate or alter the dosage of oxycodone with APAP. These include hypotension, hypothyroidism, asthma, pregnancy, disorders of the intestines, epilepsy, brain tumors, certain head injuries, and prostate dysfunction or enlargement. Drugs like neuroleptics, sedatives, barbiturates, some antidepressants, and antihistamines may increase the sedating effects of Percocet®. Other medications, such as anything containing acetaminophen, like pain relievers, and cold and cough preparations must never be used with oxycodone with APAP.

The most common mild adverse effects of this medicine are stomach upset that can include nausea, vomiting and constipation. People may also feel sedated, tired or dizzy, and have a dry mouth. Severe adverse effects include anaphylactic shock from allergy, breathing impairment, extreme vomiting, jaundice and confusion, and these need immediate medical attention.

The addictive potential of oxycodone with APAP means it should be used exactly as prescribed and never shared with others. Should the dose prescribed seem inadequate, patients should discuss with their doctor how to proceed rather than taking a higher dose. After discontinuation, if symptoms of withdrawal occur, patients should talk with their doctor about using a tapered dose schedule instead to reduce these symptoms. Those who feel they can’t stop the medication need medical assistance. Generally, a few days of use for a transient pain condition is unlikely to create dependence.