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oxycodone/aspirin (Rx)Brand and Other Names:Percodan, Endodan, more...Oxycodan

 
 
 

Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

oxycodone/aspirin

tablet: Schedule II

  • 4.8355mg/325mg
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Relief of Moderate to Moderately Severe Pain

Usual: 1 tablet PO q6hr PRN

Maximum: 12 tablets (4 grams aspirin) per 24 hours

Safety and efficacy not established

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Interactions

Interaction Checker

oxycodone/aspirin and

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    No Interactions Found
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    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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            Adverse Effects

            Frequency Not Defined

            Oxycodone

            • Serious: Respiratory depression, apnea, respiratory arrest, circulatory depression, hypotension, and shock
            • Less serious (reported more in ambulatory patients): Lightheadedness, dizziness, drowsiness or sedation, nausea, and vomiting
            • Other: Euphoria, dysphoria, constipation, and pruritus

            Aspirin

            • May increase risk of hemorrhage due to its effect on the gastric mucosa and platelet function
            • Potential to cause anaphylaxis in hypersensitive patients as well as angioedema especially in patients with chronic urticaria
            • Other adverse reactions include anorexia, reversible hepatotoxicity, leukopenia, thrombocytopenia, purpura, decreased plasma iron concentration, and shortened erythrocyte survival time
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            Warnings

            Contraindications

            Hypersensitivity

            Oxycodone

            • Any situation where opioids are contraindicated including significant respiratory depression (in unmonitored settings or the absence of resuscitative equipment), acute or severe bronchial asthma or hypercarbia
            • Suspected or known paralytic ileus

            Aspirin

            • Reye Syndrome: Aspirin should not be used in children or teenagers for viral infections, with or without fever, because of the risk of Reye syndrome
            • Known allergy to NSAIDs
            • Syndrome of asthma, rhinitis, and nasal polyps May cause severe urticaria, angioedema, or bronchospasm (asthma)

            Cautions

            Oxycodone

            • Respiratory diseases: Anoxia, hypercapnia, respiratory depression
            • Genitourinary: Prostatic hypertrophy, renal impairment, urethral stricture, urinary tract surgery
            • CNS: Seizures, CNS depression, head injury, increased ICP, drug abuse/dependence, emotional lability
            • Metabolic: Thyrotoxicosis, untreated myxedema, hypothyroidism, Addison's disease
            • Other: Anemia, cardiac arrhythmias, vitamin K deficiency, gallbladder disease, gout, hepatic disease/impairment, hypoprothrombinemia

            Aspirin

            • Anemia, GI malabsorption, history of peptic ulcers, gout, hepatic disease, hypochlorhydria, hypoprothrombinemia, renal impairment, thyrotoxicosis, vitamin K deficiency, renal calculi
            • Take with food or 8-12 oz water to avoid GI effects
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            Pregnancy & Lactation

            Pregnancy Category: C; D if used for prolonged periods or near term

            Lactation: do not take if nursing or do not nurse

            Pregnancy Categories

            A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA:Information not available.

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            Pharmacology

            Bioavailability

            Oxycodone: 87%

            Aspirin: 80-100%

            Vd

            Oxycodone: 212 L/kg

            Aspirin: 0.15-0.2 L/kg

            Peak Plasma Time

            Oxycodone: 0.5-1 hr

            Aspirin: 0.25-3 hr

            Half-Life

            Oxycodone: 3-4.5 hr

            Aspirin: 15 min; 2-3 hr (salicylate metabolite)

            Protein Bound

            Oxycodone: 45%

            Aspirin: 70-95% (inversely related to plasma concentration)

            Metabolism

            Oxycodone

            • Extensively metabolized by multiple metabolic pathways to produce noroxycodone, oxymorphone and noroxymorphone
            • CYP3A mediated N-demethylation to noroxycodone is the primary metabolic pathway of oxycodone with a lower contribution from CYP2D6 mediated O-demethylation to oxymorphone

            Aspirin

            • Biotransformation of aspirin occurs primarily in the liver by the microsomal enzyme system
            • Rapidly hydrolyzed to salicylate

            Excretion

            Oxycodone: 8-14% (urine)

            Aspirin: 80-100% (urine)

            Pharmacogenomics

            Oxycodone is metabolized to oxymorphone via CYP2D6; CYP2D6 poor metabolizers may not achieve adequate analgesia

            Ultra-rapid metabolizers (up to 7% of Caucasians and up to 30% of Asian and African populations) may have increased toxicity due to rapid conversion

            Mechanism of Action

            Oxycodone: Opioid agonist; analgesia it the principle therapeutic action

            Aspirin: Prostaglandin inhibition effect results in decreased inflammatory response; in the CNS, affects hypothalamus heat-regulating center to reduce fever; also inhibits platelet aggregation

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            Formulary

            FormularyPatient Discounts

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            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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