Oxycodone and Naloxone (Oral)

Prescribed as a combination medicine, Oxycodone and Naloxone is used to treat patients who are suffering with severe, long-term pain.

Overview

As one of the most potent pain medications available, Oxycodone is used to treat severe pain. When combined with Naloxone, it is appropriate for long-term use. As an opioid painkiller, Oxycodone combines with opioid receptors in the spinal cord and brain. This prevents pain signals being sent to the brain and, therefore, prevents the patient from experiencing as many pain sensations.

Although Oxycodone is a highly effect painkiller, it does not treat the root cause of the pain. Despite this, the patient is less likely to feel pain when treated with this medication. Whilst Oxycodone can be extremely effective in reducing severe pain, it can cause patients to experience a number of side-effects, particularly if it is used on a long-term basis.

By combining Naloxone with Oxycodone, however, the side-effects associated with the drug can be relieved. Although Oxycodone is still able to bind to opioid receptors in the spinal column and brain, Naloxone prevents the medicine from affecting the opioid receptors in the gut. As a result, the patient still benefits from the pain relieving properties of Oxycodone but should not experience the intestinal side-effects often associated with the medicine.

Due to its potency, Oxycodone and Naloxone is only prescribed when it is absolutely necessary. As a narcotic analgesic, Oxycodone can be habit-forming and patients may struggle to stop using the medication, particularly if their treatment isn't well monitored. Due to this, Oxycodone and Naloxone is not usually a first-choice treatment. Generally, physicians will attempt to treat patients with other types of painkillers before resorting to Oxycodone and Naloxone if pain persists.

When patients are experiencing severe, long-term pain, however, Oxycodone and Naloxone can be used to reduce their symptoms and increase their quality of life. When used appropriately, the medication is extremely beneficial for patients who are living with on-going or chronic pain.

Conditions Treated

  • Severe, chronic pain

Type Of Medicine

  • Narcotic analgesic

Side Effects

Although Naloxone does reduce some of the side-effects associated with Oxycodone treatment, patients may still experience some adverse effects when taking this medication. The following side-effects may be more prevalent when patients first start using Oxycodone and Naloxone but may dissipate over time:

  • Stomach or abdominal pain
  • Nausea
  • Back pain
  • Muscle stiffness or pain
  • Difficulty having a bowel movement (stool)
  • Joint pain
  • Difficulty moving
  • Redness of the neck, face, arms and, sometimes, upper chest
  • Dizziness
  • Sudden sweating
  • Nervousness or fear
  • Feeling of warmth
  • Trouble sleeping
  • Headache
  • Vomiting
  • Itching skin
  • Rash on the skin

Whilst the above side-effects may not necessarily require medical treatment, patients should seek medical help if they experience any of the following adverse effects when taking Oxycodone and Naloxone:

  • Blurred vision
  • Seizures
  • Confusion
  • Sweating
  • Troubled or difficult breathing
  • Unusual weakness or tiredness
  • Lightheadedness, fainting or dizziness when getting up suddenly from a sitting or lying position
  • Blue or pale fingernails, skin or lips
  • Shallow, slow, fast or irregular breathing

If patients experience any other side-effects when using Oxycodone and Naloxone, they should seek advice from a healthcare professional. Patients should also be aware that an overdose may occur if they take too much of this medicine. If patients exhibit the following symptoms, an overdose may be occurring and they will need to access urgent medical treatment:

  • Enlarged, dilated or bigger pupils (black part of the eye)
  • Severe sleepiness
  • Change in consciousness
  • Loss of consciousness
  • Chest discomfort or pain
  • Increased sweating
  • Clammy, cold skin
  • Increased sensitivity of the eyes to light
  • Coughing that might produce a frothy pink sputum
  • Noisy, fast or difficult breathing, sometimes with wheezing
  • Decreased responsiveness or awareness
  • Swelling in the ankles and legs
  • Unusual drowsiness or sleepiness
  • Irregular or slow heartbeat

Dosage

When patients are prescribed Oxycodone and Naloxone, they should follow their doctor's dosage instructions carefully. If patients are prescribed Oxycodone and Naloxone in extended release form, they will usually be advised to take 10mg of Oxycodone and 5mg of Naloxone every twelve hours.

If patients are prescribed Oxycodone and Naloxone after having taken Oxycodone for some time, they will prescribe a lower dose of the medicine and advised to take it is a split dose (twice per day). The patient's dose will vary, depending on their symptoms, but the maximum dose prescribed does not normally exceed 80mg of Oxycodone and 40mg of Naloxone per day.

When taking extended-release tablets, patients should swallow the tablet whole and should not attempt to crush it, break it or cut it. If patients are unsure how to take this medicine or when to take their next dose, they should seek advice from their physician or pharmacist.

Potential Drug Interactions:

As some medicines can interact with each other, Oxycodone and Naloxone may not be prescribed at the same time as certain other drugs. Patients will not normally be given Oxycodone and Naloxone if they are already taking any of the following medicines, for example:

  • Naltrexone
  • Amifampridine

Similarly, Oxycodone and Naloxone is not usually prescribed alongside the following medicines:

  • Abiraterone
  • Boceprevir
  • Acepromazine
  • Benperidol
  • Alfentanil
  • Baclofen
  • Almotriptan
  • Bromazepam
  • Alprazolam
  • Brompheniramine
  • Alvimopan
  • Bromopride
  • Amineptine
  • Buprenorphine
  • Amiodarone
  • Carbamazepine
  • Amisulpride
  • Butabarbital
  • Amitriptyline
  • Buspirone
  • Amitriptylinoxide
  • Butorphanol
  • Amobarbital
  • Carbinoxamine
  • Amoxapine
  • Conivaptan
  • Amprenavir
  • Chlorzoxazone
  • Anileridine
  • Cobicistat
  • Aprepitant
  • Clarithromycin
  • Aripiprazole
  • Clobazam
  • Asenapine
  • Clomipramine
  • Atazanavir
  • Cariprazine
  • Clozapine
  • Carisoprodol
  • Desvenlafaxine
  • Carphenazine
  • Dezocine
  • Ceritinib
  • Desipramine
  • Dantrolene
  • Chloral Hydrate
  • Cyclobenzaprine
  • Chlordiazepoxide
  • Dexmedetomidine
  • Chlorpheniramine
  • Dextromethorphan
  • Chlorpromazine
  • Darunavir
  • Citalopram
  • Diphenoxylate
  • Clonazepam
  • Diacetylmorphine
  • Clorazepate
  • Dibenzepin
  • Cocaine
  • Diazepam
  • Codeine
  • Dichloralphenazone
  • Erythromycin
  • Difenoxin
  • Eletriptan
  • Escitalopram
  • Enflurane
  • Dihydrocodeine
  • Enzalutamide
  • Dolasetron
  • Haloperidol
  • Donepezil
  • Flibanserin
  • Doxepin
  • Fentanyl
  • Doxylamine
  • Ethylmorphine
  • Droperidol
  • Fluoxetine
  • Duloxetine
  • Flunitrazepam
  • Hydroxytryptophan
  • Estazolam
  • Halothane
  • Fospropofol
  • Halazepam
  • Eszopiclone
  • Hydromorphone
  • Ethchlorvynol
  • Hydroxyzine
  • Ethopropazine
  • Furazolidone
  • Etomidate
  • Idelalisib
  • Fluphenazine
  • Indinavir
  • Flurazepam
  • Granisetron
  • Fluspirilene
  • Hydrocodone
  • Fluvoxamine
  • Imipramine
  • Fosaprepitant
  • Iloperidone
  • Fosphenytoin
  • Diphenhydramine
  • Frovatriptan
  • Iproniazid
  • Hexobarbital
  • Lopinavir
  • Isocarboxazid
  • Lofepramine
  • Isoflurane
  • Lorazepam
  • Itraconazole
  • Lithium
  • Ketamine
  • Loprazolam
  • Ketazolam
  • Tilidine
  • Linezolid
  • Tramadol
  • Ketobemidone
  • Trimeprazine
  • Levomilnacipran
  • Tianeptine
  • Ketoconazole
  • Mitotane
  • Trifluperidol
  • Levorphanol
  • Methylene Blue
  • Lorcaserin
  • Melperone
  • Lormetazepam
  • Methdilazine
  • Lumacaftor
  • Trifluoperazine
  • Methotrimeprazine
  • Lurasidone
  • Trimipramine
  • Naloxone
  • Meclizine
  • Naratriptan
  • Topiramate
  • Medazepam
  • Nalbuphine
  • Tranylcypromine
  • Melitracen
  • Tizanidine
  • Nelfinavir
  • Tolonium Chloride
  • Meperidine
  • Trazodone
  • Nefazodone
  • Mephobarbital
  • Naloxegol
  • Meprobamate
  • Nalmefene
  • Meptazinol
  • Nialamide
  • Mesoridazine
  • Ondansetron
  • Nalorphine
  • Metaxalone
  • Olanzapine
  • Methadone
  • Opium
  • Methocarbamol
  • Opium Alkaloids
  • Methohexital
  • Orphenadrine
  • Methylnaltrexone
  • Opipramol
  • Midazolam
  • Pentobarbital
  • Milnacipran
  • Oxycodone
  • Mirtazapine
  • Oxymorphone
  • Moclobemide
  • Oxazepam
  • Molindone
  • Paliperidone
  • Moricizine
  • Papaveretum
  • Morphine
  • Perampanel
  • Morphine Sulfate Liposome
  • Paroxetine
  • Nicomorphine
  • Perazine
  • Nitrazepam
  • Pentazocine
  • Quetiapine
  • Periciazine
  • Nitrous Oxide
  • Prazepam
  • Nortriptyline
  • Ritonavir
  • Palonosetron
  • Saquinavir
  • Quazepam
  • Paregoric
  • Rizatriptan
  • Perphenazine
  • Remifentanil
  • Phenelzine
  • Rasagiline
  • Phenobarbital
  • Remoxipride
  • Phenytoin
  • Ramelteon
  • Pimavanserin
  • Risperidone
  • Pimozide
  • Sufentanil
  • Piperacetazine
  • Sodium Oxybate
  • Pipotiazine
  • Sertindole
  • Piritramide
  • Sibutramine
  • Posaconazole
  • Selegiline
  • Primidone
  • Sertraline
  • Procarbazine
  • Secobarbital
  • Prochlorperazine
  • Samidorphan
  • Promazine
  • Safinamide
  • Promethazine
  • Tapentadol
  • Propofol
  • Triazolam
  • Suvorexant
  • Propoxyphene
  • Telaprevir
  • Protriptyline
  • Tryptophan
  • Sufentanil
  • Vilazodone
  • Sulpiride
  • Venlafaxine
  • Triflupromazine
  • Sumatriptan
  • Vortioxetine
  • Telithromycin
  • Zotepine
  • Temazepam
  • Zopiclone
  • Thiethylperazine
  • Zolpidem
  • Thiopental
  • Zolmitriptan
  • Thiopropazate
  • Ziprasidone
  • Thioridazine
  • Zaleplon
  • Thiothixene

Although Oxycodone and Naloxone is not usually prescribed in conjunction with the above medicines, doctors may modify the standard dose if patients are given Oxycodone and Naloxone alongside any of the above medicines.

If Oxycodone and Naloxone is taken with any of the following medicines, it may increase the risk of the patient experiencing side-effects:

  • St John's Wort
  • Yohimbine
  • Miconazole
  • Clonidine
  • Voriconazole
  • Rifampin

Patients should also be aware that Oxycodone and Naloxone can interact with over-the-counter medicines, supplements, vitamins and other substances. Due to this, patients should seek medical advice before taking any other vitamins, supplements or medicines whilst they are taking Oxycodone and Naloxone.

In addition to this, Oxycodone and Naloxone may interact with the following substance and patients should not, therefore, consume alcohol whilst taking this medication:

  • Ethanol

Warnings

If patients have any of the following medical conditions, their treatment with Oxycodone and Naloxone may be affected:

  • Seizures
  • Liver disease
  • Kidney disease
  • Pancreatitis
  • Gallstones or gallbladder disease
  • Drug dependency or abuse
  • Low blood pressure (Hypotension)
  • Asthma
  • Respiratory depression
  • Bowel or stomach blockage
  • Paralytic ileus
  • Weakened physical condition
  • Depression
  • Head injuries
  • Serious heart conditions
  • Brain tumor
  • Alcohol abuse
  • COPD (Chronic obstructive pulmonary disorder)
  • Breathing problems

Patients should not suddenly stop using Oxycodone and Naloxone or alter their dose, unless advised to by their doctor.

Using Oxycodone and Naloxone when pregnant may cause harm to the fetus. If patients become pregnant when using this medicine or plan to become pregnant, they should seek medical advice.

Patients should not breastfeed when taking Oxycodone and Naloxone as the medicine could be passed on to the infant and may cause harm.

Taking Oxycodone and Naloxone on a long-term basis may lead to com/health/chronic-constipation/">chronic constipation. Patients should seek medical advice if they experience this side-effect.

Oxycodone and Naloxone may cause dizziness and drowsiness. Patients should not operate machinery, drive or perform potentially dangerous tasks until they know how the medicine affects them.

Oxycodone and Naloxone will increase the effects of other central nervous system depressants and alcohol.

In rare cases, Oxycodone and Naloxone may cause an allergic reaction. If patients experience the following symptoms, they should obtain immediate medical help:

  • Difficulty breathing
  • Itching
  • Rash
  • Hoarseness
  • Difficulty swallowing
  • Swelling of the face, mouth or hands

Storage

When storing Oxycodone and Naloxone at home, patients should keep the medicine out of reach of pets and/or children. Typically, Oxycodone and Naloxone should be kept at room temperature and away from moisture, heat and direct light.

If patients need to dispose of Oxycodone and Naloxone, they should not throw the medicine out with regular household waste. Patients should contact their physician's office or pharmacist in order to dispose of the medicine safely.

Summary

Although Oxycodone and Naloxone can cause a number of side-effects, it is appropriate for long-term pain management. Whilst patients should use less potent pain relief if they are able to, Oxycodone and Naloxone may be prescribed when other painkillers are ineffective or when patients are likely to need long-term treatment for the management of severe pain.