Oxycodone and Aspirin (Oral)

Oxycodone and aspirin is a combination pain medicine which is taken orally to relieve moderate to severe pain caused by a variety of conditions.

Overview

Oxycodone and aspirin is a combination medicine used to relieve moderate to severe pain. Oxycodone is a narcotic analgesic, and it acts on the central nervous system (CNS) to relieve pain. It is a habit-forming drug when used in high doses or for long periods of time and can lead to physical and mental dependency. However, provided that patients only use the dosages prescribed to them by their doctor, the chance of mental dependency (addiction) is low. Doctors may gradually taper off dosage of the medicine when the patient is ready to stop taking it to reduce the risk of physical withdrawal symptoms.

Aspirin is a salicylate and anti-inflammatory analgesic. It acts on the immune system to prevent inflammatory responses which cause pain and fever. It is not a habit-forming drug, and patients cannot develop a physical or mental dependency by taking aspirin regularly. When combined with oxycodone, it can offer more effective pain relief than when used alone.

Oxycodone and aspirin is only available with a doctorâ's prescription. It is designed for oral administration and is provided in tablet form. In the US, its brand names are Percodan, Endodan, and Roxiprin.

Conditions Treated?

  • Moderate to severe pain

Type Of Medicine

  • Analgesic (pain medicine)

Side Effects

As well as its pain-relieving effects, oxycodone and aspirin can cause a variety of unwanted side effects. While it is unlikely that all of these side effects will occur, some of them are serious and require medical attention, and it is important that patients recognize when it is necessary to call a doctor. If you are in any doubt about the seriousness of a side effect, it is safest to check with your doctor.

Consult your doctor immediately if any of the following serious side effects occur:

  • Chest pain or discomfort
  • Tightness in the chest
  • Fast, noisy, or difficult breathing, sometimes with wheezing
  • Irregular, slow, or shallow breathing
  • Shortness of breath
  • Fast, slow, pounding, racing, or irregular heartbeat
  • Weak or feeble pulse
  • Pain in stomach or side, sometimes radiating to the back
  • Cramping, tenderness, or pain in the abdomen
  • Bloating
  • Heartburn
  • Sudden weight gain
  • Constipation
  • Clay-colored stools
  • Black, tarry stools
  • Blood in urine or stools
  • Dark colored urine
  • Difficulty passing urine or dribbling urine flow
  • Painful urination
  • Nausea or vomiting
  • Coughing or vomiting blood
  • Vomiting material that looks like coffee grounds
  • Bleeding gums
  • Nosebleeds
  • Prolonged bleeding from cuts
  • Dry mouth
  • Blurred vision
  • Sunken eyes
  • Wrinkled skin
  • Yellow skin or eyes
  • Pale skin
  • Blue lips, skin, or fingernails
  • Large, flat, blue or purplish patches on skin
  • Skin rash
  • Hives or itching
  • Large, hive-like swellings on face, lips, tongue, throat, hands, legs, feet, or genitals
  • Puffiness or swelling around eyelids, faces, lips, or tongue
  • Pinpoint red or purple spots on the skin
  • Crawling, burning, itching, numb, prickling, or tingling sensations
  • Tingling or numbness in hands, feet, or lips
  • Convulsions
  • Muscle cramping, weakness, or tremors
  • Muscle pain or stiffness
  • Weakness or heaviness in legs
  • Swelling of face, ankles, hands, feet, or lower legs
  • Chills
  • Shivering
  • Low body temperature
  • Feeling of warmth
  • Fever
  • Sweating
  • Thirst
  • Sudden, severe headache
  • Dizziness, drowsiness or lightheadedness when arising
  • Fainting
  • Drowsiness
  • Sleepiness
  • Tiredness or weakness
  • Change in consciousness
  • Loss of consciousness
  • Reduced appetite
  • Depression
  • Agitation
  • Restlessness
  • Hostility or irritability
  • Confusion

The following side effects are less serious, and only require medical attention if they become very severe or prolonged. They may dissipate once the body adjusts to the medicine. If you are struggling to cope with them or have questions about them, consult your doctor.

  • Relaxed, calm feeling
  • False or unusual sense of wellbeing
  • Hallucinations (seeing, hearing, or feeling things that are not really there)
  • Sleepiness
  • Drowsiness, tiredness, weakness, or sluggishness
  • Difficulty sleeping
  • Nightmares
  • Lack or loss of strength
  • Bloated, full feeling
  • Excess gas in the stomach
  • Belching
  • Increased urination
  • Increased thirst or hunger
  • Fruit-like odor on breath
  • Cold sweats
  • Cool, pale skin
  • Flushed, dry skin
  • Redness of the skin
  • Red eyes
  • Change in color perception
  • Double vision
  • Tunnel vision
  • Blurred or reduced vision
  • Halos around lights
  • Overbright appearance of lights
  • Night blindness
  • Constricted, pinpoint, or small pupils
  • Shakiness
  • Slurred speech
  • Weight loss

This may not necessarily be an exhaustive list of all side effects that could be caused by oxycodone and aspirin. If you notice any others not listed here, report them to your doctor straight away. You could also contact the FDA to report them, or your doctor may do this on your behalf.

Dosage

The amount of oxycodone and aspirin you take will be determined by your doctor and may vary depending on the severity of your pain and your medical history. Always follow your doctor's instructions over any other recommended dosages.

For moderate to severe pain, adults usually begin with one oxycodone and aspirin tablet every 6 hours as needed. This may be increased if necessary, but only with a doctor's approval. Patients should never take more than 12 tablets within one 24-hour period. Each tablet typically contains 5mg oxycodone and 325mg aspirin. People with liver or kidney disease may be administered lower doses because the drug is more likely to remain in the body for longer, which will make its effects more potent.

If you feel that your prescribed dosage does not provide you with adequate pain relief, consult your doctor. Never take more oxycodone and aspirin than is prescribed to you, and never increase your dose or take the medicine more frequently without the approval of your doctor.

How to take oxycodone and aspirin

You can take oxycodone and aspirin with or without food. However, if you find that the tablets give you an upset stomach, they may be more tolerable if taken with food.

Do not stop taking oxycodone and aspirin suddenly if you have been using the medicine for a long time. Doing so could cause physical withdrawal symptoms. Doctors usually taper off the dosage of oxycodone and aspirin after long-term use to prevent withdrawal symptoms. If you notice unpleasant withdrawal effects during this process, talk to your doctor as it may be necessary to taper the medicine even more gradually.

Missed doses

If you miss a dose of oxycodone and aspirin, take it as soon as you remember and make sure to adjust your dosing schedule accordingly to ensure you do not take doses too close together. If it is almost time for your next dose, it will probably be easier to skip the missed dose and continue with your original dosing schedule. Do not take extra tablets to make up for a missed dose, as doing so could increase the risk of dangerous side effects.

Interactions

Make sure your doctor knows about all the medicines you take, including those prescribed to you, those purchased over the counter, and any herbal supplements or multivitamins that you take. This will allow your doctor to check for harmful interactions, which could result in worsened side effects, secondary health complications, or some of your medicines becoming less effective. It may be helpful to keep a list of all the medicines you take which you can present to each doctor you see.

It is particularly important to tell your doctor if you are taking blood thinning medicines, such as warfarin (known as Jantoven and Coumadin), or MAO inhibitors. You should not take oxycodone and aspirin within 14 days of taking an MAO inhibitor due to a very dangerous interaction. Examples of MAO inhibitors include:

  • Isocarboxazid (Marplan)
  • Linezolid (Zyvox)
  • Methylene blue injection (Provayblue, Urolene Blue)
  • Phenelzine (Nardil)
  • Rasagiline (Azilect)
  • Selegiline (Eldepryl, Zelapar)
  • Tranylcypromine (Parnate)

The following medicines are not recommended for use at the same time as oxycodone and aspirin, under any circumstances. Your doctor will either avoid prescribing oxycodone and aspirin, or they will change the existing medicines you take.

  • Amifampridine (Firdapse)
  • Defibrotide (Defitelio)
  • Dichlorphenamide (Daranide, Keveyis)
  • Influenza Virus Vaccine, Live
  • Ketorolac (Sprix)
  • Naltrexone (ReVia)

It is also important to note that use of other CNS depressants like oxycodone should not be taken at the same time, or at least not without approval from your doctor. This is because they will enhance the risk of certain side effects, such as respiratory depression (slow breathing) which is incredibly dangerous. Examples of CNS depressants or medicines which contain CNS depressants include:

  • Antidepressants
  • Anxiety medicines
  • Cold and flu medicines
  • Allergy medicines
  • Sleeping pills
  • Muscle relaxants
  • Anti-seizure medicines
  • Tranquilizers

Some of these medicines are available over the counter without a doctor's prescription. You should check with your doctor before taking OTC drugs which may contain a CNS depressant.

Sometimes drug interactions occur which are not recommended, but which may be tolerable if both drugs are deemed important. In these instances, your doctor may reduce your dose of oxycodone and aspirin or the other medicines you take, or they may change the way in which you take them. For example, they may ask you to take certain medicines a certain number of hours before or after oxycodone and aspirin. Always follow your doctor's instructions closely. You could ask them to help you formulate a dosing schedule to ensure you take all your medicines correctly and at the right times.

Warnings

Risk of respiratory depression

Oxycodone and aspirin is a CNS depressant and can cause respiratory depression, in which breathing slows down to such an extent that the patient may become unconscious. Respiratory depression can be fatal. It is very important that patients only take the amount of oxycodone and aspirin prescribed to them to minimize the risk of respiratory depression.

The risk of respiratory depression is heightened if patients consume other CNS depressants at the same time as oxycodone and aspirin, including alcohol. Be sure to tell your doctor about all the medicines you take, including those prescribed and those purchased over the counter, so that they can check whether they are safe for concurrent use with oxycodone and aspirin.

Note that some dental anesthetics are CNS depressants. Tell your dentist that you are taking oxycodone and aspirin before you have dental surgery.

Risk of dependency

Oxycodone is a habit-forming drug, particularly when used in high doses and over long periods of time. To minimize the risk of dependency, only take it as often as directed by your doctor and never increase your dose without your doctor's approval. If you feel the drug is not as effective in relieving pain as you hoped it to be, consult your doctor.

People with a history of drug abuse are at a higher risk of developing a dependency to oxycodone and aspirin. Ask your doctor for advice if you feel that you will be vulnerable to dependency.

Interactions With Medical Conditions

Make sure your doctor knows about all the medical conditions you suffer from, as well as those you have suffered from in the past. Oxycodone and aspirin may interact with certain medical conditions and cause dangerous complications. Your doctor will assess whether the drug is safe for you, and they may administer lower doses or monitor you more closely if there are increased health risks.

The following conditions could increase the risk of certain serious side effects associated with oxycodone and aspirin:

  • Alcohol abuse, or a history of
  • Drug dependency, or a history of, particularly if with narcotic drugs
  • Addison disease (a problem with the adrenal gland)
  • Hyperthyroidism (underactive thyroid)
  • Core pulmonale (a serious heart condition)
  • Hypovolemia (low blood volume)
  • Chronic obstructive pulmonary disease (COPD)
  • Breathing problems, such as sleep apnea or asthma
  • Lung disease
  • Bleeding or clotting problems, such as hemophilia
  • Brain tumor, or a history of
  • Head injury, or history of
  • Gallbladder disease
  • Gallstones
  • Peptic ulcer disease, or history of
  • Problems with urination
  • Prostatic hypertrophy (enlarged prostate, BHP)
  • Kyphoscoliosis (curvature of the spine involving breathing problems)
  • Vitamin K deficiency
  • Mental illness, such as depression

The following conditions may be worsened by oxycodone and aspirin:

  • Seizures, or history of
  • Hypotension (low blood pressure)
  • Pancreatitis (inflammation of the pancreas)

People with kidney disease or liver disease may be more sensitive to the effects of oxycodone and aspirin. This is due to slower removal of the drug from the body, which makes its effects more potent. Consequently, patients may be at a higher risk of experiencing harmful side effects. Doctors may administer lower doses of the drug, or they may avoid prescribing it if the liver of kidney disease is very severe.

Overdose

Taking too much oxycodone and aspirin can be incredibly dangerous. If you think you have taken more of the medicine than you should, call your doctor immediately. If you notice any of the following symptoms of overdose, either in yourself or in someone who is taking oxycodone and aspirin, get emergency help:

  • Extreme drowsiness
  • Severe sleepiness
  • Decreased awareness or responsiveness
  • Restlessness
  • Hearing loss
  • Continued ringing, buzzing, or other unexplained noises in ears
  • Enlarged pupils
  • Diarrhea
  • Extremely high body temperature or fever
  • Fast, weak heartbeat
  • Increase in heart rate

Alcohol

Alcohol is a CNS depressant, and will increase the risk of respiratory depression if consumed while taking oxycodone and aspirin. It will also worsen the drowsiness and sleepiness often cause by the drug. You should not consume any alcohol while taking oxycodone and aspirin tablets. If you feel that you would struggle to avoid all alcohol, ask your doctor for advice. If you have a history of alcohol abuse, your doctor may not prescribe oxycodone and aspirin.

Drowsiness

Oxycodone can cause drowsiness and sleepiness. Do not drive or operate machinery until you know how the medicine affects you. Patients may also experience dizziness, lightheadedness or fainting when arising. To minimize these effects, get up slowly from sitting or lying positions. If you do become dizzy or faint, lie down for a few minutes until the sensation passes, then slowly sit up and wait a short while before standing.

Elderly patients

There is no evidence to suggest that oxycodone and aspirin is any less effective for elderly patients than it is for younger adults. However, elderly patients are more likely to have age-related kidney or liver problems. Since decreased liver or kidney function results in slower removal of the drug from the body, patients may therefore be more sensitive to the drug and could be more likely to experience serious side effects. Doctors are likely to administer lower initial dosages of oxycodone and aspirin in order to minimize the risk of this. They may also request tests to assess kidney and liver function before prescribing the drug.

Pediatric use

Use of oxycodone and aspirin in children is not recommended. Aspirin, when given to children or teenagers with a fever, symptoms of flu, or chicken pox, can cause a potentially fatal condition known as Reye's syndrome. Furthermore, there is little evidence as to the safety and efficacy of oxycodone in children. The drug should not be taken by patients under the age of 18.

Pregnancy and breastfeeding

Prolonged use of narcotics like oxycodone during pregnancy can result in dependency and dangerous physical withdrawal effects in newborn infants. Furthermore, use of salicylate drugs like aspirin during the third trimester of pregnancy can result in health problems for both the mother and fetus. For this reason, oxycodone and aspirin is not recommended for use during pregnancy. Women should use birth control to prevent pregnancy for as long as they are taking oxycodone and aspirin. If you do become pregnant while taking the drug, contact your doctor immediately.

Oxycodone and aspirin is excreted in breast milk, and it can cause CNS depression, drowsiness, and even death in nursing infants. Newborn babies are particularly sensitive to even very small doses of narcotic analgesics such as oxycodone, and aspirin can also have a harmful effect on platelet function. For this reason, oxycodone and aspirin is not recommended for breastfeeding women. Alternative pain relief is recommended, or women should discontinue breastfeeding in order that they can safely take oxycodone and aspirin.

Allergy

Do not take oxycodone and aspirin if you have had an allergic reaction in the past to oxycodone or aspirin. The drug is also not suitable for patients with allergies to any nonsteroidal anti-inflammatory drugs (known as NSAIDS). Tell your doctor about all allergies you suffer from, including pollen, animal, food, dye, chemical, and drug allergies, so that they can check that the ingredients in oxycodone and aspirin tablets are safe for you.

Storage

Oxycodone and aspirin should be stored in the packaging it was provided to you at room temperature. Do not allow it to freeze, and keep it away from direct light, heat, and moisture. Do not store it in the bathroom.

Always store oxycodone and aspirin out of sight and reach of children. It may be extremely harmful if taken by those it is not prescribed to, but particularly by children. Even a single dose of the medicine can cause death if it is taken incorrectly. Take care to also keep it out of reach of pets.

Do not keep leftover oxycodone and aspirin. Ask your healthcare provider how to dispose of it. There may be a local medicine take-back program you could use. Often, these are run by healthcare providers, pharmacies, or garbage or recycling departments. Never throw oxycodone and aspirin tablets in the trash or flush them down the toilet, as they could be extremely harmful to other people or the environment.

Summary

Oxycodone and aspirin is an analgesic suitable for relieving moderate to severe pain. Oxycodone is a narcotic and acts on the central nervous system (CNS) to relieve pain. It is habit-forming when taken for long periods of time or in high doses. Aspirin is a salicylate and works to reduce inflammation and pain.

This drug is not suitable for children or pregnant women. It can be taken by elderly patients, but lower doses may be administered initially. It should be used with caution in patients with a history of seizures, brain injury or tumor, pancreatitis, low blood pressure, heart conditions, breathing problems, bleeding or clotting disorders, urination problems, gallbladder problems, kyphoscoliosis, mental illness, alcohol abuse, or drug dependency.

Oxycodone and aspirin can cause drowsiness or sleepiness, mild vision disturbances, excess gas and bloating, sleeping problems, slurred speech, and shakiness. These do not need to be reported to a doctor unless they become severe or persistent. If patients notice breathing problems, changes to pulse or heartbeat, blood in stools, urine or vomit, abnormal bleeding, pain in the abdomen or stomach, pain, weakness or heaviness in limbs, seizures, or skin rash, they should consult a doctor immediately.

Initially, most patients are instructed to take one oxycodone and aspirin tablet every six hours as needed, but depending on how effective the drug is, this may be increased up to a maximum of 12 tablets each day. Patients with kidney or liver disease may be given smaller doses.

Oxycodone and aspirin can cause respiratory depression. The risk of this is heightened if patients also take other drugs which depress the central nervous system. Examples of such drugs are antihistamines, cold and flu medicines, antidepressants, tranquilizers, sleeping pills, and muscle relaxants. Patients should also avoid alcohol, which is a CNS depressant.

This drug is designed to be taken orally. The tablets should be swallowed whole, without crushing or chewing, with a glass of water. They can be taken either with or without food but taking them with food may help to prevent the stomach discomfort and bloating sometimes associated with the drug. If patients miss a dose, they should take is as soon as they remember and adjust their dosing schedule accordingly so that they do not take two doses very close together. Depending on how long the drug has been used for, doctors may gradually taper off the dose of oxycodone and aspirin to prevent physical withdrawal effects once the patient no longer needs to take the drug.