Select a medication above to begin.
Percocet
oxycodone/ acetaminophen
Black Box Warnings .
Appropriate Use
should only be prescribed by healthcare professionals knowledgeable about opioid use and how to mitigate associated risks; reserve opioid analgesics for patients with inadequate tx alternatives; proper dosing and titration essential to decr. respiratory depression risk
Medication Error Risk
ensure accuracy when prescribing, dispensing, and administering oxycodone/acetaminophen oral solution; dosing errors due to confusion between mg and mL or different concentrations can result in accidental overdose and death
Addiction, Abuse, and Misuse
Schedule II controlled substance combination containing an opioid agonist with risk of addiction, abuse, and misuse, which can lead to overdose and death; assess opioid abuse or addiction risk prior to prescribing; regularly reassess all patients for misuse, abuse, and addiction
Respiratory Depression
serious, life-threatening, or fatal cases may occur even with recommended use, especially during tx start or after dose incr; to decr. risk, initiate and titrate dose appropriately
Accidental Ingestion
accidental ingestion of even one dose, especially by children, can result in fatal oxycodone overdose
Risks from Concomitant Use with Benzodiazepines, CNS Depressants
concomitant opioid use with benzodiazepines or other CNS depressants, including alcohol, may result in profound sedation, respiratory depression, coma, and death; reserve concomitant use for patients with inadequate alternative tx options
Neonatal Opioid Withdrawal Syndrome
advise pregnant patients with extended opioid use of risk of potentially life-threatening neonatal opioid withdrawal syndrome; ensure tx by neonatology experts available at delivery
Opioid Analgesic REMS
providers are strongly encouraged to complete risk evaluation and mitigation strategy (REMS)-compliant education program, counsel patients and/or caregivers with each Rx on serious risks, safe use, and importance of reading medication guide
CYP450 3A4 Interaction
concomitant use with CYP450 3A4 inhibitors or D/C of concomitant CYP450 3A4 inducers may incr. oxycodone concentration which may incr. or prolong adverse effects including potentially fatal respiratory depression; monitor patients receiving any concomitant CYP450 3A4 inhibitor or inducer
Hepatotoxicity
acetaminophen associated with acute liver failure including cases of liver transplant and death; most liver injury associated with acetaminophen doses >4000 mg per day and >1 acetaminophen-containing product
Adult Dosing .
Dosage forms: TAB: 2.5 mg/325 mg, 5 mg/325 mg, 7.5 mg/325 mg, 10 mg/325 mg
Special Note
- [prescribing info]
- Info: consider prescribing opioid overdose reversal agent (e.g., naloxone, nalmefene), especially if risk of opioid overdose or accidental ingestion
pain, moderate-moderately severe
- [2.5-10 mg oxycodone PO q6h prn]
- Max: 4 g/day acetaminophen from all sources; Info: use lowest effective dose, shortest effective tx duration; q4h dosing may be needed if severe pain or opioid-tolerance; consider low start dose, titrate slowly in patients 65 yo and older; taper dose gradually to avoid withdrawal symptoms if D/C tx in physically opioid-dependent patients; search 'opioid taper' for epocrates Opioid Tapering decision tool
renal dosing
- [see below]
- renal impairment: decr. usual start dose, amount not defined; Info: titrate slowly
- HD/PD: not defined
hepatic dosing
- [see below]
- hepatic impairment: decr. usual start dose, amount not defined; Info: titrate slowly
Peds Dosing .
- Dosage forms: TAB: 2.5 mg/325 mg, 5 mg/325 mg, 7.5 mg/325 mg, 10 mg/325 mg
Special Note
- [prescribing info]
- Info: consider prescribing opioid overdose reversal agent (e.g., naloxone, nalmefene), especially if risk of opioid overdose or accidental ingestion
pain, moderate-moderately severe (off-label)
- [children/adolescents, <50 kg]
- Dose: 0.05-0.15 mg/kg/dose oxycodone PO q6h prn; Max: 5 mg/dose oxycodone; 75 mg/kg/day up to 4 g/day acetaminophen from all sources; Info: use lowest effective dose, shortest effective tx duration; q4h dosing may be needed if severe pain or opioid-tolerance; taper dose gradually to avoid withdrawal symptoms if D/C tx in physically opioid-dependent patients; search 'opioid taper' for epocrates Opioid Tapering decision tool
- [adolescents, >50 kg]
- Dose: 2.5-10 mg oxycodone PO q6h prn; Max: 4 g/day acetaminophen from all sources; Info: use lowest effective dose, shortest effective tx duration; q4h dosing may be needed if severe pain or opioid-tolerance; taper dose gradually to avoid withdrawal symptoms if D/C tx in physically opioid-dependent patients; search 'opioid taper' for epocrates Opioid Tapering decision tool
renal dosing
- [not defined]
- renal impairment: consider adult renal dosing for guidance
- HD/PD: not defined
hepatic dosing
- [see below]
- hepatic impairment: decr. usual start dose, amount not defined; Info: titrate slowly