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Acetaminophen and Oxycodone: Headache and Migraine Drug Profiles

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Updated: August 10, 2006

A narcotic analgesic (oxycodone) and acetaminophen used together may provide better pain relief than either medication used alone. In some cases, relief of pain may come at lower doses of each medication.

Narcotic analgesics act in the central nervous system (CNS) to relieve pain. Many of their side effects are also caused by actions in the CNS. When narcotics are used for a long time, your body may get used to them so that larger amounts are needed to relieve pain. This is called tolerance to the medication. When narcotics are used for a long time or in large doses, they may become habit-forming (causing mental or physical dependence). Physical dependence may lead to withdrawal symptoms when you stop taking the medication.

Acetaminophen is not habit forming, but it may cause other unwanted effects, including liver damage, if too much is taken. In the case of headache and Migraine it very often causes if taken more than two or three days a week.

Before Using This Medication
In deciding to use a medication, the risks of taking the medication must be weighed against the benefits. This is a decision you and your doctor will make. Consider the following:

Allergies
Tell your doctor if you have ever had any unusual or allergic reaction to acetaminophen or to a narcotic analgesic. Also tell your doctor about any other allergies.

Pregnancy-

  • For acetaminophen: Although studies on birth defects with acetaminophen have not been done in pregnant women, it has not been reported to cause birth defects or other problems.
  • For narcotic analgesics: There is no information about whether oxycodone causes birth defects in animals. Too much use of a narcotic during pregnancy may cause the fetus to become dependent on the medication. This may lead to withdrawal side effects in the newborn baby. Also, some of these medications may cause breathing problems in the newborn baby if taken just before or during delivery.

Breast-feeding
Acetaminophen passes into the breast milk. It is not known whether oxycodone passes into the breast milk. However, these medications have not been reported to cause problems in nursing babies.

Children
Breathing problems may be especially likely to occur when narcotic analgesics are given to children younger than 2 years of age. These children are usually more sensitive than adults to the effects of narcotic analgesics. Also, unusual excitement or restlessness may be more likely to occur in children receiving these medications.

Acetaminophen has been tested in children and has not been shown to cause different side effects or problems in children than it does in adults.

Older adults-Elderly people are especially sensitive to the effects of narcotic analgesics. This may increase the chance of side effects, especially breathing problems, during treatment.

Acetaminophen has been tested and has not been shown to cause different side effects or problems in older people than it does in younger adults.

Other medications
Always be sure your doctor knows of all medications and supplements you are taking. With acetaminophen and oxycodone, it is especially important for your doctor to know if you are taking any of the following:

  • Central nervous system (CNS) depressants
  • Monoamine oxidase (MAO) inhibitors (isocarboxazid/Marplan, phenelzine/Nardil, procarbazine/Matulane, selegiline/Eldepryl, tranylcypromine/Parnate) (taken currently or within the past 2 weeks) 
  • Tricyclic antidepressants (amitriptyline/Elavil, amoxapine/Asendin, clomipramine/Anafranil desipramine/Pertofrane, doxepin/Sinequan, imipramine/Tofranil, nortriptyline/Aventyl, protriptyline/Vivactil, trimipramine/Surmontil)-Taking these medications together with a narcotic analgesic may increase the chance of serious side effects
  • Naltrexone/Trexan-Naltrexone keeps narcotic analgesics from working to relieve pain; people taking naltrexone should take pain relievers that do not contain a narcotic
  • Zidovudine/AZT, Retrovir-Acetaminophen may increase the blood levels of zidovudine, which increases the chance of serious side effects

Too much acetaminophen with some other medications may increase the chance of unwanted effects. The risk depends on how much of each medication you take, and on how long you take the medications together. If your doctor directs you to take these medications together on a regular basis, follow directions carefully. However, do not take this medication together with any of the following medications for more than a few days, except under doctor's supervision:

  • Aspirin or other salicylates
  • Diclofenac/Voltaren
  • Diflunisal/Dolobid
  • Etodolac/Lodine
  • Fenoprofen/Nalfon
  • Floctafenine/Idarac
  • Flurbiprofen/Ansaid
  • Ibuprofen/Motrin, Advil
  • Indomethacin/Indocin
  • Ketoprofen/Orudis
  • Ketorolac/Toradol
  • Meclofenamate/Meclomen
  • Mefenamic acid/Ponstel
  • Nabumetone/Relafen
  • Naproxen/Naprosyn
  • Oxaprozin/Daypro
  • Phenylbutazone/Butazolidin
  • Piroxicam/Feldene
  • Sulindac/Clinoril
  • Tenoxicam/Mobiflex
  • Tiaprofenic acid/Surgam
  • Tolmetin/Tolectin

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