Percocet tablets (oxycodone with acetaminophen) are routinely prescribed for post-operative pain control. Oxycodone, a narcotic analgesic is used for its calming effect and for treatment of moderate to severe chronic pain. Acetaminophen is used to reduce both pain and fever. There is no evidence that oxycodone is more effective than any other opioid and in sedative care, morphine remains the standard. However, Percocet can be useful as an alternative opioid if a patient has troublesome adverse effects with morphine.

Oxycodone (one of the two active constituents in Percocet) was first synthesized in a German laboratory in 1916, a few years after the German pharmaceutical company Bayer had stopped the mass production of heroin due to addiction and abuse by both patients and physicians. It was hoped that a thebaine-derived drug would retain the analgesic effects of morphine and heroin with less of the euphoric effect which led to addiction and over-use.

Percocet contains a narcotic and, even if taken in prescribed amounts, can cause physical and psychological dependence when taken for a long time. Because Percocet may be habit-forming, it should be used only by the person it was prescribed for. Percocet should never be given to another person, especially someone who has a history of drug abuse or addiction. Percocet comes as a tablet, capsule, and liquid. When this medication is abused it may be taken orally in pill form, chewed, or crushed (then snorted like cocaine).

Keep the medication in a secure place. Keep track of how many pills have been used from each new bottle of this medicine. Percocet is a drug of abuse and you should be aware if any person in the household is using this medicine improperly or without a prescription.

This medication works by slowing the central nervous system. It should be used with caution with other drugs that have similar side effects. Percocet side effects can change or increase the effects of certain drugs. Take care when combining any of the following drugs/medications while using Percocet:

  • Alcohol - Oxycodone and alcohol can accelerate central nervous system depression. Avoid mixing the two, as this could result in a fatal overdose. Alcohol use combined with acetaminophen can accelerate or increase the risk of liver damage or stomach bleeding.
  • Antihistamines like Tavist or Benadryl
  • Aspirin (or any salicylate, such as salicylamide, or salicylic acid) can cause kidney or liver damage when taken in high doses, and over long periods of time in combination with acetaminophen. When taken in the recommended doses, for a short time, it has not been seen to produce this effect.
  • Benzodiazepines (a class of antidepressants, anti-panic agents, and muscle relaxants) such as Ativan (lorazepam), Valium (diazepam), Halcion (triazolam), Restoril (temazepam), Librium(chlordiazepoxide), Xanax (alprazolam), Tranxene-SD (clorazepate), Paxipam (halazepam), ProSom (estazolam), Klonopin (clonazepam), and others, should be used cautiously with Percocet.
  • Desyrel (trazodone) - Risk of additive CNS depression.
  • MAO inhibitors - Oxycodone must not be mixed with MAO (monoamine oxidase) inhibitors such as the antidepressants Nardil, Marplan, or Parnate. It should not be used within 2 weeks of stopping these medications.
  • Narcotic pain medication of any other kind, like codeine, Demerol (meperidine), Buprenex (buprenorphine), Darvon (propoxyphene), Dilaudid (hydromorphone), MS Contin or Kadian (morphine), nalbuphine, OxyContin (oxycodone), Stadol (butorphanol), Talwin compound (pentazocine), Vicodin (hydrocodone, acetaminophen), or Vicoprofen (hydrocodone, ibuprofen) should not be mixed with Percocet.
  • Norflex (orphenadrine) - Risk of over sedation.
  • Oral contraceptives - These may interact with acetaminophen.
  • Sedatives like Fioricet (butalbital, acetaminophen, and caffeine), Fiorinal, Phenobarbitol, Seconal, or other barbiturates.
  • Skeletal muscle relaxants - such as Flexeril (cyclobenzaprine), Skelaxin (metaxalone), Soma (carisoprodol), or Robaxin (methocarbamol) may increase respiratory depression when mixed with oxycodone.
  • Sleep medication like Ambien (zolpidem), Sonata (zaleplon), or over the counter sleeping pills should be used with oxycodone only as, and if, advised by your doctor.
  • Street drugs of any type must never be mixed with Percocet as this could result in a fatal severe Percocet side effects and even overdose.
  • Tranquilizers such as Haldol (haloperidol), Mellaril (thioridazine), or Thorazine (chlorpromazine) may cause oversedation.
  • Trexan (naltrexone) - Causes narcotic pain medication to be ineffective.
  • Tricyclic antidepressants such as Elavil (amitriptyline), Asendin (amoxapine), Anafranil (clomipramine), Pertofrane or Norpramin (desipramine), Sinequan (doxepin), Tofranil (imipramine), Aventyl or Pamelor (nortriptyline), Vivactil (protriptyline), and Surmontil (trimipramine), may increase the central nervous system suppressant effects from either the antidepressant, or the oxycodone.
  • Ultram (tramadol)
  • Zidovudine (AZT, Retrovir) - Narcotic pain medication increases blood levels of this drug, potentially making side effects more severe.

You should take Percocet cautiously and according to your doctor's instructions as you would take any medication containing a narcotic. If you have ever had a problem with alcohol addiction, make sure your doctor is aware of it.

Do not drive, operate machinery, or do anything else that could be dangerous until you know how you react to Percocet. Percocet may cause dizziness, lightheadedness, blurred vision, or drowsiness; these effects may be made worse if you take Percocet with other medicines or with alcohol. To minimize dizziness or lightheadedness, get up slowly when rising from a seated or lying position. Before you have any medical or dental treatments, emergency care, or surgery, tell the doctor or dentist that you are using Percocet.

Common Percocet Side Effects:

  • constipation
  • constricted pupils
  • depressed feeling
  • dizziness
  • drowsiness
  • euphoria
  • exaggerated feeling of well-being
  • itchy skin `
  • light-headedness
  • nausea
  • sedation
  • skin rash
  • slowed breathing
  • vomiting

As mentioned above, Percocet contains acetaminophen. Adults should not take more than a total of 4 grams (4,000 mg) of acetaminophen in a 24 hour period (3 grams [3,000 mg] per day if you have liver disease). Check with your doctor before taking other pain relievers, cough-and-cold medicines, or allergy medicines as they may also contain acetaminophen. Acetaminophen may cause liver damage.

You may have withdrawal symptoms when you stop using this medication after using it over a long period of time. Do not stop using Percocet suddenly without first talking to your doctor. You may need to use less and less before you stop the medication completely.