Percocet Side Effects

Percocet

Percocet Side Effects:  Percocet is a combined analgesic product combining oxycodone and acetaminophen (paracetamol in Europe).  Therefore Percocet side effects are really the separate side effects of oxycodone and the side effects of acetaminophen.   Oxycodone is a potent oral opioid, and is used for the treatment of moderate to severe pain.  Combining oxycodone with acetaminophen increases the analgesic effects of the opioid.  Percocet is available in multiple fixed combination doses includine Percocet 5-325, Percocet  7.5-325, Percocet 10-325, Percocet 10-650, Percocet 7.5-325 and Percocet 7.5-500.  There are also many generic products that include acetaminophen and oxycodone including Roxicet and other generic names.  Unlike sustained release oxycodone products like Oxycontin and others Percocet is designed for immediate release, and so avoids the potential over dosage Oxycontin side effects that can happen from accidental or intentional chewing or crushing Oxycontin that is designed for sustained release.   Percocet side effects mimic those of all opioids and focus around the abuse potential, over dose issues and the issues of central nervous system depression with respiratory depression and death possible with overdoses.

Percocet Black Box Warnings:  Percocet has no black box warnings.

Common Percocet Side Effects:  Most of the common Percocet side effects are related to the central nervous system effects of oxycodone on the opioid mu receptor that both gives it the desired analgesic effects, and the Percocet side effects including sedation, dysphoria, lightheadedness and dizziness, euphoria and dysphoria.  The opioid mu receptors in the gastrointestinal tract lead to common GI Percocet side effects including nausea, vomiting and especially constipation.  Like with other opioids Percocet side effects include itching, and rashes.  The acetaminophen component of Percocet has its own potential Precocet side effects, but fortunately these are uncommon with short term use in recommended doses.  The daily dose of acetaminophen should not exceed 4000 mg, and with prolongued use of moderate to high dose acetaminophen renal toxicity is possible and should be monitored.

Serious Percocet Side Effects:   Serious Percocet side effects are primarily related to the risks of acetaminophen overdose with liver toxicity, and to the risks of diversion, abuse and addiction/tolerance with oxycodone.  The serious oxycodone side effects include central nervous system depression related issues including severe respiratory depression, apnea or respiratory failure and death.  Also related are severe hypotension, circulatory depression, shock, and seizures.  Serious GI Percocet side effects include biliary spasm, paralytic ileus, and hepatotoxicity.  Serious hematologic Percocet side effects can be agranulocytosis, thrombocytopenia, and hemolytic anemia.  Other serious Percocet side effects are withdrawal if abruptly discontinued, dependency and abuse, severe hyposensitivity, renal papillary necrosis and renal failure.  Severe hepatotoxicity can be seen with acetaminophen overdosage, so when high dose oxycodone is needed, the relatively low dose of oxycodone Percocet preparations are not appropriate.

Percocet Drug Interactions and Cautions:  There is a very large list of drugs that can have serious drug interactions with Percocet, and readers should consult the manufacturers prescribing details or discuss with their physician or pharmacist for any questions.  Oxycodone is nearly exclusively metabolized through the CPY 450 3A4 system and so has a long list of other medication that can cause drug interactions.  In addition nearly all sedating medications can lead to excessive sedation when used in combination with Percocet, and caution is advised.  As with other opioids extreme caution is advised in patients with significant respiratory illness and in the elderly.  Almost all antihistamines, tricyclic antidepressants, other opioids, barbiturates, benzodiazapines, and other potentially sedating medications need to be used with caution.  Other acetaminophen containing medications including over the counter Tylenol and other products need to be limited.  Patients with psychologic disorders, brain injuries, seizure disorders, prior history of opioid or other drug or alcohol abuse or problems need to be treated cautiously.  Again the list of potential drug interactions is so extensive that you should always consider discussion of all of your prescription and OTC meds with your pharmacist.

Pregnancy and Lactation:  Percocet is category C in pregnancy though like with other opioid class medications puts infants at risk of withdrawal with late trimester prolonged use.  Percocet is considered probably safe in lactation.

Special Considerations:   Percocet is in the class of opioid-acetaminophen combination products that puts users at risk for acute acetaminophen hepatotoxicity with high dose ingestion, and you should discuss this with your physician or pharmacist if you are approaching the 4000 mg daily dose of acetaminophen.  Abuse, diversion and addiction issues are very prevalent with Percocet and remain serious risks.

Unusual Percocet Side Effects:  Percocet side effects are really predictable and relate to the opioid addiction, sedation, CNS disturbances and GI effects primarily.  As such most are not terribly unusual.