Perc 5

Are Oxycodone and Percocet the Same Opioid Pain Medication?


Oxycodone and Percocet are often confused for the same medication. This is understandable as both are opioid pain medications and both have been in the news a lot due to the opioid epidemic.

Percocet is a brand name for a drug that contains a combination of oxycodone and acetaminophen — another pain medication more commonly known by its brand name, Tylenol.

Any drug that contains oxycodone, including Percocet, has a potential for abuse. Both oxycodone and Percocet are considered highly addictive. The key differences between them are:

  • Oxycodone is a derivative of opium and sold under different brand names, including OxyContin.
  • Percocet is a combination of oxycodone and acetaminophen.
  • Oxycodone and Percocet are both classified as narcotic analgesics.

What is oxycodone and what is Percocet?

Oxycodone is a semi-synthetic opiate that is made by modifying thebaine, an organic compound in opium.

Oxycodone is available in different forms. This includes:

  • immediate-release tablets and capsules (Oxaydo, Roxicodone, Roxybond), which are released into the bloodstream right away
  • extended-release tablets and capsules (OxyContin), which are released into the bloodstream gradually
  • oral solution, which is used for managing pain in people who cannot swallow tablets, and is often administered via a gastric tube

Oxycodone acts on your central nervous system (CNS) to block the feeling of pain. Percocet does this as well, but offers a second mode of pain relief from the acetaminophen, which is a non-opiate analgesic that also relieves fever.

Oxycodone uses vs. Percocet uses

Oxycodone is used to treat moderate to severe pain. The extended-release form provides relief of ongoing pain, such as pain associated with cancer.

Percocet is also used to treat moderate to severe pain, but can also be prescribed for conditions associated with fever. It can also be used to treat breakthrough pain when a long-acting pain drug doesn’t provide enough relief.

Percocet is not recommended for long-term use because acetaminophen has been found to cause serious liver damage.

Dosing depends on your need and age, the form of the drug, and whether the drug is immediate-release or extended-release. Both should be taken only as directed by a medical professional.

Oxycodone effectiveness vs. Percocet effectiveness

Both of these medications have been shown to be effective in providing pain relief. There is some that oxycodone in combination with other analgesics, including acetaminophen, may provide more pain relief and fewer side effects.

Oxycodone immediate-release and Percocet begin working within 15 to 30 minutes of taking them, reach their peak effect within 1 hour, and last for 3 to 6 hours.

Oxycodone extended-release tablets are longer-acting. They start to relieve pain within 2 to 4 hours of taking them, and steadily release the oxycodone for about 12 hours.

Both medications can stop providing effective pain relief when taken long-term. This is called tolerance.

When you begin to develop a tolerance to a drug, you need higher doses to get pain relief. This is normal with long-term opiate use.

How quickly a person develops a tolerance varies. Your body will begin to adapt to the medication in as little as one week of taking regular doses.

Oxycodone side effects vs. Percocet side effects

The most common side effects of both oxycodone and Percocet are similar. These include:

Oxycodone is more likely to cause dizziness and feelings of euphoria.

Serious, but less common side effects include:

Percocet contains acetaminophen, which can affect the liver and cause side effects such as upper abdominal pain, black or tarry stools, and yellowing of the skin and eyes.

In low doses, acetaminophen can cause elevated liver enzymes. Taking too much acetaminophen can cause liver damage or liver failure. The risk of liver damage is higher if you already have liver problems, take warfarin, or drink more than three alcoholic beverages per day.

Both oxycodone and Percocet are considered highly addictive and can cause dependence and addiction. Tolerance can lead to physical dependence and physical and mental withdrawal symptoms when the drug is stopped.

Physical dependence is not the same as addiction, but usually accompanies addiction.

Physical dependence and addiction


Oxycodone and Percocet are classified as schedule II drugs. Schedule II drugs have a high potential for misuse. Both can cause physical dependence and opioid addiction.

Physical dependence

Physical dependence occurs when your body develops a tolerance to the drug, requiring more of it to achieve a certain effect.

When your body becomes dependent on the drug, you can experience mental and physical symptoms if you stop taking the drug abruptly. These are called withdrawal symptoms.

Physical dependence can occur even when you take oxycodone or Percocet as directed. Becoming physically dependent on a drug is not the same as having an addiction, but physical dependence often accompanies addiction.

You can prevent withdrawal if you lower your dose slowly, typically over a week so. Your doctor can advise you on the best way to do this.


Opioid addiction refers to being unable to stop using an opioid drug despite its harmful consequences and impact on your daily life. Tolerance, physical dependence, and withdrawal are commonly associated with addiction.

Signs and symptoms of opioid addiction include:

The risk of an opioid overdose is greater in a person who is abusing the drug.

Medical emergency

An overdose is a medical emergency. Call 911 immediately if you or someone else has taken too much oxycodone or Percocet, or if someone experiences any of the symptoms of an overdose, including:

Oxycodone and Percocet drug interactions

Oxycodone and Percocet are known to cause interactions with other drugs. Tell your doctor about any medications you’re taking before you take oxycodone or Percocet.

The following are clinically significant drug interactions with oxycodone. This is not an all-inclusive list — other drugs not listed here may cause an interaction. Significant drug interactions include:

  • inhibitors of CYP3A4 and CYP2D6, such as macrolide antibiotics (erythromycin), azole-antifungal agents (ketoconazole), and protease inhibitors (ritonavir)
  • CYP3A4 inducers, including carbamazepine and phenytoin
  • CNS depressants, such as benzodiazepines and other sedatives or hypnotics, anxiolytics, muscle relaxants, general anesthetics, antipsychotics, and tranquilizers
  • certain types of antidepressants, including tricyclic antidepressants (TCAs), selective serotonin reuptake inhibitors (SSRIs), 5-HT3 receptor antagonists, serotonin and norepinephrine reuptake inhibitors (SNRIs), and triptans
  • monoamine oxidase inhibitors (MAOIs), sometimes used to treat depression, early onset Parkinson’s disease, and dementia
  • other mixed agonist/antagonist and partial agonist opioid analgesics
  • diuretics, used to treat high blood pressure and other conditions
  • anticholinergic drugs, such as ipratropium (Atrovent), benztropine mesylate (Cogentin), and atropine (Atropen)

Drug interactions with the acetaminophen in Percocet include:

Other risk factors

Oxycodone and Percocet are powerful medications that shouldn’t be taken without consulting a doctor. Certain medical conditions can affect the use of these medications. Be sure to tell a doctor if you have any other medical conditions, including:

Oxycodone cost vs. Percocet cost

The cost of oxycodone and Percocet varies depending on the strength and form.

The price also varies greatly depending on whether you buy a brand-name drug, such as OxyContin or Percocet, or the generic version of the drug. Generic versions are cheaper.

These prescription medications are usually covered, at least in part, by insurance.


Oxycodone and Percocet are both very powerful prescription opioid pain medications with a high misuse potential, but they’re not exactly the same.

Oxycodone is one of the active ingredients in Percocet, which also contains acetaminophen. Speak to a doctor about which one is right for your condition.


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  • Common Brand Names: Percocet®, Percodan®, Oxycontin® and Roxicodone®

  • Drug Schedule: Schedule 2
  • Abuse Potential: Very high twice the potency of Morphine

  • Available As: Tablets, capsules, oral liquid, suppositories

  • Note: Often combined with Tylenol® or Ibuprofen

  • Consumption: Swallowed, chewed, injected, snorted, smoked

  • Common Street Names:
    • Oxy
    • O.C.
    • Oxycotton
    • Oxycet
    • Percs

  • Street Values: Percocet®: $6-$8 each, Roxicodone® 30mg: $20+ each

                                       Percocet® (Oxycodone) 5mg & 10mg


Click here for images of oxycodone products that do not contain any other ingredients such as Roxicodone® and Oxycontin®.

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Percocet vs. Vicodin: Differences, similarities, and which is better for you

Drug overview & main differences | Conditions treated | Efficacy | Insurance coverage and cost comparison | Side effects | Drug interactions | Warnings | FAQ

Percocet and Vicodin are two FDA-approved prescription drugs used for the treatment of severe pain. These drugs are classified in a group of medications called opioids, or narcotics, analgesics. Opioid analgesics work by binding to mu-opioid receptors in the brain, weakening and blocking pain signals. By doing this, they relieve severe pain (hence the nickname painkillers). Percocet and Vicodin are classified by the DEA as Schedule II drugs because they have a high potential for substance abuse and may lead to psychological or physical dependence/opioid addiction. Percocet and Vicodin have many similarities, but they also have some differences, which we will discuss below.

What are the main differences between Percocet and Vicodin?

Percocet and Vicodin are combination drugs (each pill contains two drugs) used for pain management (severe, acute pain). Percocet contains oxycodone and acetaminophen. Acetaminophen is the generic of Tylenol and is also referred to as APAP, so the drug name often appears as oxycodone/APAP. Percocet contains 325 mg of acetaminophen, and 2.5 mg, 5 mg, 7.5 mg, or 10 mg of oxycodone.

Vicodin contains both hydrocodone and APAP. Vicodin contains hydrocodone/APAP 5/300 mg. Vicodin ES contains hydrocodone/APAP 7.5/300 mg. Vicodin HP contains hydrocodone/APAP 10/300 mg.

Both Percocet and Vicodin are available in brand name and generic form. Percocet and Vicodin are intended to be used for short-term pain relief; however, some patients with chronic pain continue taking Percocet or Vicodin for longer, depending on the healthcare provider’s instruction. All patients who take Percocet or Vicodin should be closely monitored.

Main differences between Percocet and Vicodin
Drug classOpioid (narcotic) analgesicOpioid (narcotic) analgesic
Brand/generic statusBrand and genericBrand and generic
What is the generic name?Oxycodone/APAP
What form(s) does the drug come in?Tablet: 2.5/325 mg, 5/325 mg, 7.5/325 mg, 10/325 mgTablet: 5/300 mg, 7.5/300 mg, 10/300 mg
What is the standard dosage?One 5/325 mg tablet every 6 hours as needed for painOne or two 5/300 mg tablet every 4 to 6 hours as needed for pain (maximum 8 tablets per day)
How long is the typical treatment?Short-term; some patients continue longer under a doctor’s directionShort-term; some patients continue longer under a doctor’s direction
Who typically uses the medication?AdultsAdults

Conditions treated by Percocet and Vicodin

Percocet and Vicodin both have one indication—for the management of pain that is severe enough to require an opioid analgesic, when other treatments (non-opioids) are not tolerated or not adequate to control the pain.

Management of pain severe enough to require an opioid analgesic, and for which alternative treatments are inadequateYesYes

Is Percocet or Vicodin more effective?

In a study of emergency room patients who had acute fractures and were treated with Percocet or Vicodin, pain relief was the same at 30 and 60 minutes with either drug. The study authors concluded that both Percocet and Vicodin provided similar effects in terms of pain relief.

Another study compared oxycodone/APAP (5/325 mg) to hydrocodone/APAP (5/325 mg). Note: The dose of APAP (Tylenol) was 325 mg, as opposed to 300 mg that Vicodin contains. The study looked at patients who had acute pain and compared how the two drugs worked after discharge from the emergency room. Both drugs were similarly effective in reducing pain (by about 50%).

The best drug for you can be determined by your healthcare provider, who can take into account your medical condition(s) and history, as well as any other medications you take that can potentially interact with Percocet or Vicodin.

Coverage and cost comparison of Percocet vs. Vicodin

State laws often limit the first fill of a narcotic prescription to a small quantity. Percocet is covered in its generic form by most insurance and Medicare Part D plans. A typical prescription of generic Percocet could cost over $50 but starts at $11 with a SingleCare discount coupons at participating pharmacies.

Vicodin is usually covered in its generic form by most insurance companies, and by some Medicare Part D plans. (Some plans prefer Norco, which contains 5, 7.5, or 10 mg of hydrocodone, and 325 mg of APAP.) A typical prescription of generic Vicodin runs about $200. A SingleCare coupon can reduce the price to less than $100.

Typically covered by insurance?Yes (generic)Yes (generic)
Typically covered by Medicare Part D?Yes (generic)Varies
Standard dosageOxycodone/APAP 5/325 mg tabletsHydrocodone/APAP 5/300 mg tablets
Typical Medicare Part D copay$0-$25$98-$152
SingleCare cost$11-$18$28-$40

Serious adverse effects that can occur with Percocet or Vicodin are respiratory depression (slowed breathing and not getting enough oxygen), apnea, respiratory arrest, low blood pressure, and shock.

The most common side effects of Percocet are lightheadedness, dizziness, drowsiness, sedation, nausea, and vomiting. Other side effects include euphoria, dysphoria (feeling unwell or unhappy), constipation, and itching.

The most common side effects of Vicodin are lightheadedness, dizziness, sedation, nausea, and vomiting. Other side effects include lethargy, mental cloudiness, constipation, mood changes, and itching.

Serotonin syndrome is a serious, life-threatening reaction that could occur with Percocet or Vicodin, especially when taken with other drugs that increase serotonin.

This is not a full list of side effects. Consult your healthcare provider for a complete list of side effects of Percocet or Vicodin.

Drug interactions of Percocet vs. Vicodin

Taking Percocet or Vicodin with medications that are metabolized by enzymes called  CYP3A4 or CYP2D6 may result in a drug interaction. These drugs are enzyme inhibitors and include certain antibiotics, antifungals, and protease inhibitors. Using one of these drugs with Percocet or Vicodin can result in a buildup of opioids in your body, which can be very dangerous.

Other drugs are enzyme inducers, and have the opposite effect—they lower the opioid level so that it is not as effective or can cause withdrawal symptoms.

Benzodiazepines or other CNS depressants (including other opioids) in combination with Percocet or Vicodin can cause low blood pressure, slowed breathing, profound sedation, coma, or even death.

Taking Percocet or Vicodin with medications that increase serotonin levels increases the risk of serotonin syndrome, a very serious or even life-threatening condition. These drugs include certain antidepressants, muscle relaxants, MAO inhibitors (MAO inhibitors should not be used within 14 days of Percocet or Vicodin), and triptans.

If you are taking Percocet or Vicodin, remember that they contain Tylenol (APAP), and many over-the-counter cough and cold medications and pain relievers contain APAP as well. Check with your pharmacist, who can help you select an OTC medication that does not contain APAP.

Other drug interactions may occur. Consult your healthcare provider for a full list of drug interactions of Percocet and Vicodin.

Macrolide antibioticsYesYes
Azole antifungalsYesYes
RitonavirProtease inhibitorsYesYes
CYP3A4 enzyme inducersYesYes
Muscle relaxantsYesYes
SSRI antidepressantsYesYes
SNRI antidepressantsYesYes
Tricyclic antidepressantsYesYes
Hydrochlorothiazide (HCTZ)
MAO inhibitors (MAOI)YesYes

Warnings of Percocet and Vicodin

Both Percocet and Vicodin come with a boxed (black box) warning, which is the strongest warning required by the FDA. Here are other warnings:

  • Potential for abuse, misuse, and addiction, which can result in overdose and death. Take your medication as prescribed, and only for the purpose it was prescribed.
  • Serious, life-threatening respiratory depression can occur. Patients should be monitored, especially during the beginning of treatment and with any change in dose. Elderly patients and patients who have lung problems are at higher risk for respiratory depression.
  • Accidental ingestion by anyone, especially children, may cause a fatal overdose.
  • The use of opioids for a prolonged time during pregnancy can cause neonatal opioid withdrawal syndrome, which can be life-threatening.
  • Tylenol (acetaminophen) has been associated with liver problems, which could result in the need for a liver transplant or death. Patients should be aware of the maximum daily dose of acetaminophen (ask your healthcare provider) and should not use other products that contain acetaminophen.
  • Using opioids with benzodiazepines (such as Xanax) or other central nervous system (CNS) depressants can cause serious respiratory depression, profound sedation, coma, or even death. If the combination of an opioid and a benzodiazepine cannot be avoided, the lowest dose should be prescribed, and the medication should be used for the shortest duration possible. The patient should be closely monitored.

Other warnings include:

  • Low blood pressure may occur—monitor blood pressure.
  • In rare cases, acetaminophen can cause serious skin reactions, including acute generalized exanthematous pustulosis (AGEP), Stevens-Johnson Syndrome (SJS), and toxic epidermal necrolysis (TEN), which may be fatal. If a skin reaction occurs, stop the drug immediately and seek emergency treatment. Acetaminophen can also cause hypersensitivity reactions, which may include swelling around the lips and face, or skin reactions. If this occurs, seek emergency treatment.
  • Opioid pain relievers should not be used in patients who have a head injury, or in a patient with impaired consciousness. Also, patients with gastrointestinal obstruction should not use opioids.
  • Patients with seizure disorders have an increased risk of seizures when taking opioids.
  • When discontinuing an opioid, taper the medication gradually (as directed by your healthcare provider) to avoid symptoms of withdrawal. Never stop taking the medication abruptly.
  • Do not drive or operate machinery until you know how you will react to the medication.
  • Do not drink alcohol while taking Percocet or Vicodin.
  • Keep your medication out of the reach of children and others, preferably in a locked cabinet or drawer. When you are finished with your course of treatment, do not save the medication. The CDC has resources on how to safely dispose of your opioid medication.
  • Opioids should not be taken during pregnancy, because they can cause harm to the fetus. Using opioids for a prolonged time during pregnancy can lead to a life-threatening condition called neonatal opioid withdrawal syndrome.

Frequently asked questions about Percocet vs. Vicodin

What is Percocet?

Percocet is an opioid pain reliever and contains oxycodone and acetaminophen. It should only be used for severe, acute pain, for a short period of time, unless otherwise instructed by your healthcare provider.

What is Vicodin?

Vicodin is also an opioid pain reliever. It contains hydrocodone and acetaminophen. It is used for severe, acute pain, and should only be used for a short period of time unless otherwise instructed by your healthcare provider.

Are Percocet and Vicodin the same? / Which is more powerful, Percocet or Vicodin?

They are similar, but not the same. Both contain Tylenol or acetaminophen. Percocet also contains oxycodone, a strong painkiller. Vicodin also contains hydrocodone, which is a strong painkiller.

Is Percocet or Vicodin better?

Both drugs seem to be similarly effective, as seen in the studies described above. If you have severe, acute pain, that is not controlled with a non-opioid medication, your doctor may recommend trying Percocet or Vicodin on a short-term basis. Consult your healthcare provider for more information.

Can I use Percocet or Vicodin while pregnant?

No. Taking Percocet or Vicodin can cause harm to the baby, and taking it for a prolonged period of time can cause neonatal opioid withdrawal syndrome (also known as neonatal abstinence syndrome), which can be life-threatening.

Can I use Percocet or Vicodin with alcohol?

No, you should not use Percocet or Vicodin with alcohol. The combination could increase the risk of CNS and respiratory depression, which could lead to a coma or death. Also, the combination of alcohol and acetaminophen can increase the risk for liver problems.

Can you take oxycodone with Vicodin?

Generally, no. If you are taking an opioid for acute pain, you would not take another opioid. For example, patients should not take oxycodone with Vicodin because the combination increases the risk of CNS and respiratory depression, psychomotor impairment, low blood pressure, and severe constipation.

However, some patients with chronic pain, who are carefully monitored under the care of a pain management specialist take a different, long-acting form of oxycodone, called Oxycontin, and take Vicodin for breakthrough pain if needed.

If you are taking an opioid pain reliever for acute pain, you would not take another opioid.

Is tramadol stronger than Percocet?

Ultram (tramadol) is a strong painkiller. Tramadol is in the DEA Schedule IV, which means it has a low potential for abuse and low risk of dependence. Percocet is in Schedule II, which means it has a high potential for abuse, and could potentially lead to severe psychological or physical dependence. Although Percocet is placed in a higher schedule, both drugs have similar side effects. Consult your healthcare provider for more information.

Is Percocet an opiate or opioid?

Often, we see these terms used interchangeably, but they are not exactly the same.

An opiate is a drug that comes from opium, as in the poppy plant. An opioid can be natural or synthetic. Percocet is an opioid—it is synthetic and not found naturally in opium.


Oxycodone/Acetaminophen (Percocet®)

How to Take Oxycodone/Acetaminophen

This form of oxycodone is a pill that can be taken with or without food. You should take the pill whole; if you can’t, contact your care team. Oxycodone/acetaminophen comes in various dosages. The pill is usually taken either as needed for pain or on a regular schedule decided by your care provider. When oxycodone/acetaminophen is swallowed, it gets absorbed by your body. It will begin working to relieve pain in about 15 to 30 minutes, although it reaches its peak effect in 1 hour. It will continue to work for 3 to 6 hours.

It is important to make sure you are taking the correct amount of medication every time. Before every dose, check that what you are taking matches what you have been prescribed.

Because this medication contains both oxycodone and acetaminophen, an overdose of oxycodone/acetaminophen has the same liver toxicity as an overdose of acetaminophen. There is a maximum amount of acetaminophen that a person can take per day. If someone takes too much oxycodone/acetaminophen, the acetaminophen in it can permanently damage the liver. Be sure to read labels of any other medications you take and do not take any additional acetaminophen. Also, oxycodone/acetaminophen should not be used with alcohol, because the acetaminophen can increase the likelihood that the liver will become damaged.

This medication can interact with other medications that depress the central nervous system like barbituates (including phenobarbital), tranquilizers (including Haldol®, Librium® and Xanax ®), other narcotics, and general anesthetic. It can also interact with many commonly prescribed medications, as well as herbal supplements. Be sure to tell your healthcare provider about all medications and supplements you take.

DO NOT share this medication or give it to someone else, as severe breathing problems and death can occur.

This medication can cause dizziness, sleepiness, and confusion. You should not drive or operate machinery while taking this medication until you know how it will affect you.

Storage and Handling

Store this medication at room temperature in the original container. Due to the risk of diversion (someone else taking your narcotic medication to obtain a high, rather than for symptom relief), you may want to consider keeping your medication in a lockbox or other secure location. Keep this medication out of reach of children and pets.

To prevent someone from accidentally taking this medication, it should be disposed of when no longer needed through a medicine take-back program or by dropping them off at a DEA-authorized collector. For locations near you, check Ask your pharmacist or care team for assistance in the disposal of unused medications. If you cannot use these options, you can flush these medicines down the sink or toilet as soon as they are no longer needed.

Where do I get this medication?

Oxycodone/acetaminophen pills are available through retail and mail-order pharmacy. Your oncology team will work with your prescription drug plan to identify an in-network retail/mail order pharmacy for medication distribution. Mail order delivery must be hand-delivered and signed for. This medication cannot be "called in" or electronically prescribed to your local pharmacy; you must provide the original prescription to the pharmacist. Many pharmacies do not keep this medication in stock but will order it for you. There may be a delay in availability, so plan prescription refills accordingly.

Insurance Information

This medication may be covered under your prescription drug plan. Patient assistance may be available to qualifying individuals without prescription drug coverage. Co-pay cards, which reduce the patient’s co-pay responsibility for eligible commercially (non-government sponsored) insured patients, are also offered by the manufacturer. Your insurance company may require you to utilize other pain medications prior to authorizing a prescription for this medication. This is called step therapy. Due to risk for diversion and misuse, the quantity of medication you receive may be limited to a 2 week or 1 month supply.

Possible Side Effects of Oxycodone/Acetaminophen

There are a number of things you can do to manage the side effects of oxycodone/acetaminophen. Talk to your care team about these recommendations. They can help you decide what will work best for you. These are some of the most common or important side effects: 

Slowed Breathing or Low Blood Pressure

You may experience low blood pressure or slowed breathing while taking an opioid painkiller. This usually only occurs when the dose of medication is too high or it is increased too quickly. This rarely happens to patients who have been taking opioid medications for a long time.

These side effects can also result from an overdose of opioids. If you suspect that you or someone you know has taken an overdose of opioids, call 911 immediately. If you feel extremely tired, lightheaded, dizzy, sweaty, nauseated, or short of breath, you need to see a doctor immediately. Sometimes patients who have taken too much opioid medication will be so sleepy that they can't be awakened or aroused. These side effects are emergency situations. If any of these symptoms occur, you should seek emergency medical attention.

Sleepiness (Somnolence)

Feeling sleepy, drowsy or lightheaded may accompany the use of opioid pain medication. Some people just don't "feel like themselves" on these medications. Avoid driving or any other potentially dangerous tasks that require your concentration and a clear head until you feel normal again. Avoid alcohol or other sedatives while using these medications unless they are specifically prescribed by your care team. Most people will begin to feel like themselves after a few days on the medications. If you continue to feel "out of it" after a couple of days, talk to your healthcare provider about adjusting your dosages.

Concerns About Addiction, Tolerance, and Dependence

Many people who are prescribed opioid pain relievers are worried that they may become addicted to these medications. This fear stems from the fact that opioid medications can cause euphoria and pleasure when used by people who are not in pain. However, when these medications are used to treat physical pain, it is unlikely that patients will become addicted to them. Addiction is a psychological need for the drug that very rarely affects people who take opioids for pain control. People addicted to opioids use them for the purpose of getting "high". These people also crave opioids, lack control over their use, and will continue to use opioids despite knowing they are causing them harm. People experiencing pain use opioids to relieve their pain.

A person on long-term opioids may stop getting proper pain relief after taking these medications for a while. This phenomenon is called tolerance. As patients develop tolerance, they will need higher doses to get good pain relief. Tolerance is a completely normal aspect of taking opioid pain medications and is nothing to be concerned about. The point of using these medications is to keep pain well-controlled, and the exact doses that a patient requires are not important as long as they can be kept comfortable. If you think you need to change the dose, work with your healthcare team to find the right dose to make you comfortable. Do not try to change the dose on your own, as this may cause unwanted side effects.

As a person takes regular doses of opioids, for as little as a week, their bodies will begin to adapt to the medications. This causes tolerance, but it can also cause dependence. Dependence means that the body "gets used to" the opioids. Dependence DOES NOT equal addiction. Dependence is a natural, physical phenomenon that happens to everyone on long-term opioid therapy. The important thing to know about dependence is that once a patient becomes dependent on opioids, they will feel very sick if they stop the medication abruptly. This is called withdrawal and the symptoms it causes can start within 2 days of abruptly stopping opioids and may last up to 2 weeks. Withdrawal is preventable if you lower the opioid dose slowly, generally over a week or so, with the help and guidance of your health care team. The exact amount of time to wean varies based on dose, how long you’ve been taking them, and some other individual factors. It is important to remember that dependence is normal and happens to everyone who takes opioids for a long period of time. Talk to your provider if you have any concerns. 

Liver Toxicity

This medication can cause liver toxicity, which your oncology care team may monitor for using blood tests called liver function tests. Notify your healthcare provider if you notice yellowing of the skin or eyes, your urine appears dark or brown, or you have pain in your abdomen, as these can be signs of liver toxicity.

Constipation Caused by Pain Medications

Constipation is a very common side effect of pain medications that continues as long as you are taking the medications. This side effect can often be managed well with the following preventative measures:

  • Drinking 8-10 glasses of water a day. Warm or hot fluids can be helpful.
  • Increasing physical activity when possible.
  • Attempting a bowel movement at the same time each day.
  • Eating plenty of fruits and vegetables.
    • Four ounces of prune juice or 3-4 dried prunes/plums can help promote bowel movements.
    • However, high fiber foods (ex. bran flakes, high fiber cereals) and fiber supplements (such as Metamucil) can actually make constipation from pain medications worse and should be avoided.

Your care team may recommend a bowel regimen, using stool softeners and/or laxatives, to prevent or treat constipation. Stool softeners (such as docusate sodium or Colace) work by bringing water into the stool, making it softer and easier to pass. A stimulant or laxative (such as Dulcolax (bisacodyl) or Senakot (senna)) works by stimulating the movements of stool through the bowel. Your provider may recommend Miralax (Polyethylene glycol 3350), which is an osmotic laxative. It works by causing water to be retained in the stool, softening the stool so it is easier to pass. These medications can be taken together. Untreated constipation can lead to a bowel blockage, so be sure to notify your healthcare team if you do not have a bowel movement for 3 or more days.

Nausea and/or Vomiting

Nausea, with or without vomiting, can be a side effect of opioid pain medications. For some patients, it lasts just a few days to weeks after starting the medication, but for some it is a long-term side effect. Nausea and vomiting can interfere with pain management if the nausea and/or vomiting affects the patient's ability to take the medication. You may find that eating or not eating when taking this medication may be helpful for you. Talk to your healthcare team so they can prescribe medications to help you manage nausea and vomiting.

Less common, but important side effects can include:

  • Serotonin Syndrome: This medication can cause a high level of serotonin in your body, which in rare cases, can lead to serotonin syndrome. Symptoms can include shivering, agitation, diarrhea, nausea and vomiting, fever, seizures, and changes in muscle function. Symptoms can arise hours to days after continued use, but can also occur later. This is a serious side effect and you should contact your care provider immediately if you have any of these side effects.
  • Adrenal Insufficiency: Adrenal insufficiency (inadequate function of the adrenal gland) is a rare but serious side effect of taking this medication. It most often occurs after taking the medication for one month or longer. Symptoms are not very specific but can include nausea, vomiting, anorexia, fatigue, weakness, dizziness, and low blood pressure. It is important to contact your care provider if you experience any of these side effects.
  • Allergic Reaction: Although it is uncommon, some people have allergic reactions to certain opioid preparations. If after taking morphine or other opioids, you experience chest tightness, swelling, wheezing, fever, itching, blue skin color, or cough, you need to call 911. These side effects are emergency situations. If any of these symptoms occur, you should seek emergency medical attention.

Reproductive Concerns

Chronic exposure of an unborn child to this medication could result in the child being born small and/or early, or having symptoms of withdrawal (including respiratory distress, behavioral changes, and seizures) after birth. Effective birth control should be used while on this medication. Even if your menstrual cycle stops or you believe you are not producing sperm, you could still be fertile and conceive. You should not breastfeed while receiving this medication as it is passed through a mother’s milk.


5 perc

acetaminophen and oxycodone

What is the most important information I should know about acetaminophen and oxycodone?

MISUSE OF OPIOID MEDICINE CAN CAUSE ADDICTION, OVERDOSE, OR DEATH. Keep the medication in a place where others cannot get to it.

An overdose of acetaminophen can damage your liver or cause death. Call your doctor at once if you have pain in your upper stomach, loss of appetite, dark urine, or jaundice (yellowing of your skin or eyes).

Taking opioid medicine during pregnancy may cause life-threatening withdrawal symptoms in the newborn.

Fatal side effects can occur if you use opioid medicine with alcohol, or with other drugs that cause drowsiness or slow your breathing.

Stop taking this medicine and call your doctor right away if you have skin redness or a rash that spreads and causes blistering and peeling.

What is acetaminophen and oxycodone?

Acetaminophen and oxycodone is a combination medicine used to relieve moderate to severe pain.

Acetaminophen and oxycodone may also be used for purposes not listed in this medication guide.

What should I discuss with my healthcare provider before taking acetaminophen and oxycodone?

You should not use this medicine if you are allergic to acetaminophen or oxycodone, or if you have:

  • severe asthma or breathing problems; or
  • a blockage in your stomach or intestines.

Tell your doctor if you have ever had:

  • breathing problems, sleep apnea;
  • liver disease;
  • a drug or alcohol addiction;
  • kidney disease;
  • a head injury or seizures;
  • urination problems; or
  • problems with your thyroid, pancreas, or gallbladder.

If you use opioid medicine while you are pregnant, your baby could become dependent on the drug. This can cause life-threatening withdrawal symptoms in the baby after it is born. Babies born dependent on opioids may need medical treatment for several weeks.

Do not breastfeed. This medicine can pass into breast milk and cause drowsiness, breathing problems, or death in a nursing baby.

How should I take acetaminophen and oxycodone?

Follow all directions on your prescription label. Never take this medicine in larger amounts, or for longer than prescribed. An overdose can damage your liver or cause death. Tell your doctor if you feel an increased urge to use more of this medicine.

Never share this medicine with another person, especially someone with a history of drug abuse or addiction. MISUSE CAN CAUSE ADDICTION, OVERDOSE, OR DEATH. Keep the medicine in a place where others cannot get to it. Selling or giving away acetaminophen and oxycodone is against the law.

Measure liquid medicine carefully. Use the dosing syringe provided, or use a medicine dose-measuring device (not a kitchen spoon).

If you need surgery or medical tests, tell the doctor ahead of time that you are using this medicine.

You should not stop using this medicine suddenly. Follow your doctor's instructions about tapering your dose.

Store at room temperature away from moisture and heat. Keep track of your medicine. You should be aware if anyone is using it improperly or without a prescription.

Do not keep leftover opioid medication. Just one dose can cause death in someone using this medicine accidentally or improperly. Ask your pharmacist where to locate a drug take-back disposal program. If there is no take-back program, flush the unused medicine down the toilet.

What happens if I miss a dose?

Since this medicine is used for pain, you are not likely to miss a dose. Skip any missed dose if it is almost time for your next dose. Do not use two doses at one time.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose of acetaminophen and oxycodone can be fatal.

The first signs of an acetaminophen overdose include loss of appetite, nausea, vomiting, stomach pain, sweating, and confusion or weakness. Later symptoms may include pain in your upper stomach, dark urine, and yellowing of your skin or the whites of your eyes.

Overdose can also cause severe muscle weakness, pinpoint pupils, very slow breathing, extreme drowsiness, or coma.

What should I avoid while taking acetaminophen and oxycodone?

Avoid driving or operating machinery until you know how this medicine will affect you. Dizziness or drowsiness can cause falls, accidents, or severe injuries.

Do not drink alcohol. Dangerous side effects or death could occur.

Ask a doctor or pharmacist before using any other medicine that may contain acetaminophen (sometimes abbreviated as APAP). Taking certain medications together can lead to a fatal overdose.

What other drugs will affect acetaminophen and oxycodone?

You may have breathing problems or withdrawal symptoms if you start or stop taking certain other medicines. Tell your doctor if you also use an antibiotic, antifungal medication, heart or blood pressure medication, seizure medication, or medicine to treat HIV or hepatitis C.

Opioid medication can interact with many other drugs and cause dangerous side effects or death. Be sure your doctor knows if you also use:

  • cold or allergy medicines, bronchodilator asthma/COPD medication, or a diuretic ("water pill");
  • medicines for motion sickness, irritable bowel syndrome, or overactive bladder;
  • other narcotic medications --opioid pain medicine or prescription cough medicine;
  • a sedative like Valium --diazepam, alprazolam, lorazepam, Xanax, Klonopin, Versed, and others;
  • drugs that make you sleepy or slow your breathing --a sleeping pill, muscle relaxer, medicine to treat mood disorders or mental illness;
  • drugs that affect serotonin levels in your body --a stimulant, or medicine for depression, Parkinson's disease, migraine headaches, serious infections, or nausea and vomiting.

This list is not complete. Other drugs may affect acetaminophen and oxycodone, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed here.

Where can I get more information?

Your doctor or pharmacist can provide more information about acetaminophen and oxycodone.

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

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How Long Does Percocet (Acetaminophen/Oxycodone) Stay in Your System?

Percocet is a pain reliever that's prescribed for people with moderate to severe pain. It contains the narcotic oxycodone, an opiate analgesic medication, and acetaminophen (Tylenol), a non-narcotic pain reliever and fever reducer.

Percocet is a Schedule II drug, meaning it has a high potential for abuse, potentially leading to severe psychological or physical dependence.

Knowing how long Percocet remains in your system can help prevent an accidental overdose caused by taking your next dose of medication too soon, or by interactions with other medications you're taking.

How Long Does Percocet Stay in Your System?

Blood: Up to 24 hours

Saliva: Up to two days

Urine: Up to four days

Hair: Up to 90 days

How Long Does It Take to Feel the Effects?

Percocet is mostly known for pain relief but it also makes some people feel relaxed and even sleepy. The pain-relieving effects of Percocet can typically be felt about 20 to 30 minutes after taking the drug.

Common side effects of Percocet include:

  • Blurred vision
  • Confusion or muddied thinking
  • Constipation
  • Dizziness
  • Drowsiness or sleepiness
  • Headache
  • Itching
  • Nausea
  • Upset stomach
  • Vomiting

When taken in large doses or misused, Percocet can cause the following side effects:

  • Confusion
  • Depression
  • Flushing or sweating
  • Low blood pressure
  • Mood swings
  • Problems with coordination
  • Slowed breathing
  • Trouble concentrating

How Long Does Percocet Last?

The half-life of a drug is how long it takes, on average, for half of the initial dose to be metabolized and leave your system. It takes several half-lives to completely eliminate the drug from your system. Understanding the half-life of Percocet can help you avoid an overdose.

Percocet has a half-life in your blood of 3.5 hours, but that varies depending on your liver function. This means that it will take an average of 19 hours to eliminate all Percocet from your system. In urine tests, traces of Percocet can generally be detected for 24 to 48 hours, starting 2 hours after the initial dose.

The average half-life of immediate-release oxycodone is about 3.2 hours in your bloodstream. Oxymorphone, a metabolite of oxycodone, further metabolizes in the liver as noroxymorphone before it passes out of the body through urine.

For many people, Percocet is out of the bloodstream within 24 hours, but it's traceable in your saliva and urine for up to 4 days and your hair for much longer.

Percocet can be detected in:

  • Blood for 24 hours after the last dose is taken
  • Saliva for up to two days after the last dose is taken
  • Urine for up to four days after the last dose is taken
  • Hair for up to 90 days after the last dose is taken

False Positive Testing

If you take a urine drug screen while taking Percocet, it will be positive for opioids, so let the clinic know what you're taking ahead of time. It's also always a good idea to disclose any drugs and supplements you are taking to the testing agency, in case they can trigger a false positive.

Factors That Affect Detection Time

Drugs stay in people's systems for different amounts of time due to a multitude of factors, including metabolism, age, other medications you're on, how long you've been taking the drug, and overall health.

  • Age: Adults over the age of 40 have been study-proven to clear the oxycodone in Percocet from their systems at a slower rate than younger adults.
  • Duration of use: Percocet can build up in your body, so if you have been taking it for pain for some time, it will be detectable for a longer period of time after your last dose.
  • Kidney and liver function: People with impaired kidney and liver function metabolize Percocet at a slower rate.
  • Metabolism: The faster your metabolic rate, which can be influenced by age, hydration, and physical activity, the quicker your body will excrete the drug.

How to Get Percocet Out of Your System

While drinking lots of fluids or exercising may help dilute your urine or speed up your metabolism slightly, these are not proven methods to get Percocet out of your system more quickly.

Your best bet is to stop taking the drug—but never without first talking to your doctor. Because Percocet can lead to physical dependence, you may experience unpleasant symptoms of withdrawal if you stop cold turkey.

Symptoms of Overdose

The risks of overdose from Percocet come both from the oxycodone opiate and acetaminophen. If you take Percocet and get to the point where it feels like it's no longer controlling your pain, don't increase your dose on your own—call your doctor and discuss the problem.

Be sure to check that you aren't taking multiple medicines that contain acetaminophen. Because acetaminophen is used in a large number of combination medications, an overdose can happen when you don't realize that you're taking it in more than one medication.

Combination drugs like Percocet are now limited to 325 milligrams of acetaminophen per tablet, capsule, or other dosage unit to help prevent these dangerous overdoses.

If you suspect you have taken more than 4,000 milligrams of acetaminophen in 24 hours, contact your doctor immediately, even if you feel well and don't have any symptoms. An overdose of acetaminophen can result in irreversible liver damage and death.

Some of the symptoms of Percocet overdose include:

  • Blue color of skin, fingernails, lips
  • Cold, clammy skin
  • Difficulty breathing
  • Dizziness
  • Excessive sleepiness
  • Fainting
  • Slowed or stopped breathing
  • Limp or weak muscles
  • Loss of consciousness or coma
  • Slow or stopped heartbeat

If you suspect someone has overdosed on Percocet, call 911 immediately. First responders should be able to revive the overdose victim by using a medication called Narcan (naloxone) if they're notified quickly.

Understanding Opioid Overdoses

Dangerous Interactions

When oxycodone is combined with alcohol, other opioids, benzodiazepines, or other central nervous system depressants like certain cold or allergy medicines, it can result in profound sedation, breathing suppression, coma, and even death. Talk to your doctor or pharmacist about how other medications you may be taking could interact with Percocet.

Oxycodone can also interact with the following medications, creating a potentially dangerous increase in the level of oxycodone when they're taken with Percocet or discontinued while using Percocet.

  • Antibiotics
  • Antifungal agents
  • CYP3A4 and CYP2D6 inhibitors

Let your doctor know about all of the over-the-counter and prescription medications, herbs, and supplements you're taking so they can be monitored and adjusted.

It's also important to tell your doctor if you have a history of breathing problems like bronchitis or asthma. The oxycodone in Percocet can produce serious or life-threatening breathing problems, especially after you've first started the prescription or when you're increasing the dosage.

Getting Help

Stopping Percocet suddenly can cause extremely unpleasant opioid withdrawal symptoms that can begin 6 to 30 hours after taking the drug. For most people, symptoms of withdrawal should markedly improve within 5 to 7 days. If your symptoms are lingering or getting worse, it’s important to seek medical help.

Symptoms of Percocet withdrawal include:

  • Appetite loss
  • Chills
  • Cramps
  • Depression
  • Diarrhea
  • Feeling irritable and/or anxious
  • Feeling restless
  • Irregular heartbeat
  • Muscle or joint aches
  • Nausea
  • Problems sleeping
  • Rapid breathing
  • Runny nose
  • Sweating
  • Vomiting
  • Weakness
  • Yawning

How Long Does Withdrawal From Opioids Last?

If you want to decrease or stop taking Percocet, your doctor can help you taper off the drug safely and prescribe other medications and lifestyle modifications to help manage your pain and discomfort.

Be honest with your healthcare provider if you think you may have developed a dependence or addiction to the drug. You may need long-term recovery support to cope with the physical and psychological effects of opioid use disorder. Addiction treatment may include maintenance medication, outpatient or inpatient treatment, as well as a support group like Narcotics Anonymous or SMART Recovery.

Here Is a Look at How Effective Drug Addiction Treatment Is

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Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

  1. U.S. Department of Justice. Drug Enforcement Administration. List of Controlled Substances. Updated May 2020.

  2. U.S. National Library of Medicine. PERCOCET- oxycodone hydrochloride and acetaminophen tablet. Updated July 21, 2010.

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  4. Endo Pharmaceuticals Inc. PERCOCET (Oxycodone and Acetaminophen Tablets, USP) [package insert]. 2006.

  5. Lautieri A. How Long Do Opiates Stay in Your System? American Addiction Centers. Updated June 4, 2020.

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  10. U.S. Food and Drug Administration. FDA Drug Safety Communication: Prescription Acetaminophen Products to be Limited to 325 mg Per Dosage Unit; Boxed Warning Will Highlight Potential for Severe Liver Failure. Updated February 7, 2018.

  11. Bunchorntavakul C, Reddy KR. Acetaminophen (APAP or N-Acetyl-p-Aminophenol) and Acute Liver Failure. Clin Liver Dis. 2018;22(2):325-346. doi:10.1016/j.cld.2018.01.007

  12. Brande L. Percocet Overdose. Updated September 5, 2019.

  13. U.S. Department of Health & Human Services Substance Abuse and Mental Health Services Administration. Opioid Overdose Prevention Toolkit.

  14. van der Schrier R, Roozekrans M, Olofsen E, et al. Influence of Ethanol on Oxycodone-induced Respiratory Depression: A Dose-escalating Study in Young and Elderly Individuals. Anesthesiology. 2017;126(3):534-542. doi:10.1097/ALN.0000000000001505

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  16. American Addiction Centers. What Drugs Can Cause Breathing Problems? Updated June 10, 2020.

  17. MedlinePlus. Opiate and opioid withdrawal. Updated June 2, 2020.

Additional Reading
  • U.S. Food and Drug Administration. Oxycontin Prescribing Information. Updated August 2015.


You will also like:

My Story: How one Percocet Prescription Triggered my Addiction


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