Oxycodone

Medically Reviewed by Dr. Harshi Dhingra, M.D.

Last Reviewed: Oct 19, 2022

Warnings

Oxycodone Warnings, Risks, and Complications

Oxycodone can cause serious medical problems in some people. Talk to your doctor about other options for pain relief if you are at a high risk of complications from this medicine. Some of the risks of oxycodone use include:

POTENTIAL FOR OPIOID ADDICTION: Oxycodone is habit-forming. Taking this medicine can lead to misuse, abuse, and opioid addiction, even if you take it at the recommended dose. The risk is higher in people with a personal or family history of alcohol or substance abuse or other mental health conditions. Taking oxycodone at higher doses than prescribed or for the long-term increases the risk of abuse. Misuse of this medication can lead to serious complications, including overdose and death. Your doctor will prescribe the lowest dose of oxycodone for the shortest possible time to treat pain.
The U.S. Food and Drug Administration (FDA) has put oxycodone in the Risk Evaluation and Mitigation Strategy (REMS) program to reduce the risk of misuse, abuse, addiction, and overdose. As a result, oxycodone is only available at certified pharmacies. Also, healthcare providers who prescribe oxycodone are required to undergo special education and training. Your doctor or pharmacist will give you a Medication Guide and discuss the proper use, risks, storage, and disposal of oxycodone with you. Read the Medication Guide carefully and make sure you understand it to ensure the safe use of oxycodone.
LIFE-THREATENING RESPIRATORY DEPRESSION: Taking oxycodone can lead to serious and potentially life-threatening breathing problems, including slowed or stopped breathing and death, even if you take the medicine at the prescribed dose. This risk is highest in the first 24-72 hours of starting oxycodone and after a dose increase. Children and elderly individuals (age 65 years and older) and those with severe bronchial asthma, other lung conditions, sleep apnea, or sleep-related hypoxemia are at greater risk of breathing complications. Taking other medications that can also slow down breathing, such as certain muscle relaxants, benzodiazepines, sedatives, alcohol, and other CNS depressants, may also lead to respiratory depression.
OVERDOSE: You can overdose on oxycodone even at the prescribed dose. An accidental overdose can occur in a child or other family members. Even one tablet of oxycodone can cause an overdose in a child. Overdoses of opioid medications can be life-threatening and may result in death if they are not recognized and treated in time. You are at an increased risk of oxycodone overdose if you take the medicine at higher than prescribed doses or more often than your doctor has prescribed. Symptoms of an opioid overdose can include slowed breathing, slow heartbeat, extreme drowsiness, unusual tiredness, sweating, cold and clammy skin, loss of muscle tone, widened or small pupils, bluish lips and fingertips, and unresponsiveness. An opioid overdose is a medical emergency. You should seek emergency medical attention without delay. Talk to your doctor or pharmacist about a drug called naloxone (Narcan) that can reverse the effects of an opioid overdose.
NEONATAL OPIOID WITHDRAWAL: Using oxycodone for the long term during pregnancy can lead to opioid dependence in the unborn baby. After birth, the baby can experience withdrawal symptoms such as poor feeding, high-pitched crying, irritability, trembling, sleep difficulties, and seizures. Neonatal opioid withdrawal syndrome can be life-threatening if it is not diagnosed and treated in a timely manner. Tell your healthcare professional if you have taken oxycodone during pregnancy. Be vigilant for these symptoms in your baby and seek medical help if they occur.
SLOWED BRAIN ACTIVITY AND REDUCED ALERTNESS: If you use oxycodone in combination with other CNS depressants like alcohol, sleep medications, benzodiazepines, muscle relaxants, antipsychotics, or other opioids, it can lead to a slowing of brain activity, slowed breathing, severe sleepiness, coma, and even death. Give your healthcare professional a complete list of your current medications. Take oxycodone at the lowest dose for the shortest time. Be careful while driving or doing other activities that require focus. Tell your healthcare provider if you have a history of alcohol or substance abuse. Seek emergency medical attention if you experience any of the above-mentioned symptoms. The risk of decreased brain function and alertness is higher in older adults (age 65 plus) and those taking high doses of oxycodone.
ADRENAL INSUFFICIENCY: Long-term use of oxycodone (for more than 1 month) can lead to adrenal insufficiency (low levels of cortisol hormone produced by the adrenal gland). The cortisol hormone helps regulate stress levels, mood, blood pressure, and blood sugar. Tell your doctor right away if you develop symptoms such as nausea, vomiting, loss of appetite, dizziness, weakness, unusual tiredness, or low blood pressure. Your healthcare professional may give you corticosteroid medications or switch you from oxycodone to another medicine if your cortisol levels are low.
LOW BLOOD PRESSURE: Oxycodone can lead to a severe drop in blood pressure. This may lead to lightheadedness and fainting with changes in position from sitting or lying to standing. Older adults (age 65 and above) and those taking other medications that can also cause low blood pressure or antipsychotics called phenothiazines are at increased risk. Blood pressure changes are more likely to occur if a person is dehydrated and after oxycodone dose adjustments. Arise slowly from a lying or sitting position and sit down again for a few minutes if you feel dizzy or faint. Tell your doctor if these symptoms do not go away.
SEIZURES : Treatment with oxycodone can increase the risk of seizures in people who have a history of seizures. Tell your healthcare provider if your seizures are worse or more difficult to control after starting oxycodone. The risk is higher if you are on other medications that can also increase the risk of seizures.

Precautions Before Starting Oxycodone

Tell your doctor if you have had an allergic reaction to oxycodone, any of the active or inactive ingredients in oxycodone products, or any other drugs. Your pharmacy can give you a list of ingredients.

Give your doctor a complete medical history. Oxycodone may not be right for people with certain health conditions, such as paralytic ileus, bowel blockage, low blood pressure, Addison’s disease, seizures, enlarged prostate, urethral stricture, urinary problems, heart disease, kidney disease, liver disease, gallbladder disease, pancreas problems, thyroid problems, diverticulitis, swallowing problems, colon cancer, or esophageal cancer.

Give your doctor or pharmacist a complete list of your medications, including prescription medications, non-prescription medicines, vitamins, supplements, and herbal products, in particular St. John’s Wort and tryptophan. This can help avoid possible interactions between oxycodone and your other medicines.

Talk to your doctor if you plan to have children in the future. Oxycodone can lead to decreased fertility in both men and women.

Tell your doctor if you are pregnant, could be pregnant, planning a pregnancy, or are breastfeeding.

Precautions During Use of Oxycodone

Keep all your healthcare appointments while on oxycodone. Your doctor may want to adjust your dose and monitor you for any adverse reactions.

Let your doctors know that you are on oxycodone before any surgery, including dental procedures.

While on oxycodone, you may feel lightheaded or dizzy. These effects occur when going from a sitting or lying position to standing. When getting out of bed, rest your feet on the floor for a few minutes before standing up.

Oxycodone may make you drowsy and dizzy and affect your concentration. Do not drive, operate machinery, or do other activities that require your complete focus until you know how oxycodone affects you.

Alcohol can make side effects like drowsiness worse. Do not drink alcohol while on oxycodone.

Taking oxycodone can cause constipation. Talk to your doctor about options to treat constipation if you experience difficulty having a bowel movement while on this medicine.

Oxycodone Drug Interactions

The use of oxycodone hydrochloride with certain other medicines can affect how the medicines work. Possible drug interactions between oxycodone and other medicines can also increase the risk of severe adverse events. Your doctor may change the dose of your medications or monitor you carefully for possible side effects if there are known interactions between oxycodone and your other medicines.

Be sure to tell your doctor or pharmacist if you are on monoamine oxidase (MAO) inhibitors or stopped taking these medicines within the past two weeks. MAOIs include isocarboxazid (Marplan), methylene blue, linezolid (Zyvox), phenelzine (Nardil), tranylcypromine (Parnate), and selegiline (Emsam, Eldepryl, Zelapar).

The following medications can have interactions with oxycodone:

Certain antibiotics such as erythromycin (Erytab, Erythrocin) and clarithromycin (Biaxin, in PrevPac)
Certain antifungal medications such as voriconazole (Vfend), itraconazole (Onmel, Sporanox) and ketoconazole (Nizoral)
Benzodiazepines such as diazepam (Diastat, Valium), alprazolam (Xanax), chlordiazepoxide (Librium), clonazepam (Klonopin), estazolam, flurazepam, lorazepam (Ativan), oxazepam, temazepam (Restoril), and triazolam (Halcion)
Seizure medications such as carbamazepine (Carbatrol, Epitol, Equetro, Tegretol, Teril), phenytoin (Dilantin, Phenytek)
Certain medications for human immunodeficiency virus (HIV) such as indinavir (Crixivan), nelfinavir (Viracept), and ritonavir (Norvir, in Kaletra)
Certain tuberculosis medications such as rifabutin (Mycobutin), rifampin (Rifadin, Rimactane, in Rifamate)
Antihistamines (found in cold remedies and allergy medications)
Dextromethorphan (in Nuedexta, in many cough medications)
Water pills or diuretics
Medicines used to treat opioid dependence, such as buprenorphine (Butrans, in Zubsolv, in Suboxone, others)
Naloxone (Narcan, Evzio, others)
Pain medications like butorphanol, nalbuphine, pentazocine (Talwin), tramadol (Ultram, Conzip, in Ultracet), and trazodone (Oleptro)
Medications for muscle spasms, such as cyclobenzaprine (Amrix)
Glaucoma medications
Medications used to treat irritable bowel disease
Medications for urinary problems
Triptan medications for migraine headaches such as eletriptan (Relpax), almotriptan (Axert), frovatriptan (Frova), rizatriptan (Maxalt), naratriptan (Amerge), zolmitriptan (Zomig), and sumatriptan (Imitrex, in Treximet)
Anti-manic drugs like lithium (Lithobid)
Antidepressants like mirtazapine (Remeron)
Selective serotonin-reuptake inhibitors (SSRIs) such as sertraline (Zoloft), escitalopram (Lexapro), citalopram (Celexa), fluoxetine (Prozac, Sarafem, in Symbyax), paroxetine (Prozac, Brisdelle, Pexeva), and fluvoxamine (Luvox)
Serotonin and norepinephrine reuptake inhibitors (SNRIs) such as desvenlafaxine (Pristiq, Khedezla), duloxetine (Cymbalta), venlafaxine (Effexor), and milnacipran (Savella)
Tricyclic antidepressants (TCAs) or mood elevators like clomipramine (Anafranil), amitriptyline, desipramine (Norpramin), imipramine (Tofranil), doxepin (Silenor), nortriptyline (Pamelor), trimipramine (Surmontil), and protriptyline (Vivactil)
5-HT3 receptor antagonists such as dolasetron (Anzemet), alosetron (Lotronex), granisetron (Kytril), palonosetron (Aloxi), and ondansetron (Zofran, Zuplenz)

The above list may not include all the possible interactions of oxycodone. Give your doctor or pharmacist a complete list of your medications, including prescription medications, over-the-counter medicines, dietary supplements, and herbal remedies. Also, tell your healthcare provider if you smoke, drink alcohol, or use recreational drugs because some of these substances can cause serious health complications when used with prescription and non-prescription medicines.

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