Percocet: Uses, Side Effects, Misuse & More

April 18, 2022

Table of Contents

Percocet is a brand-name medication containing both the opioid drug oxycodone and the non-opioid pain reliever acetaminophen. It is prescribed primarily for the treatment of acute moderate to severe pain, 

As a central nervous system depressant, Percocet can cause breathing issues, lowered heart rate, and reduced blood pressure. It is also extremely habit-forming and commonly misused.

Percocet misuse can lead to a potentially life-threatening overdose as well as a high rate of opioid use disorder. Nearly 3 million adults, ages 12 and older, in the United States had an opioid use disorder (OUD) in 2020. 

OUD is regularly treated with medications and behavioral therapeutic techniques.

What Is Percocet?

Percocet is a strong prescription combination medication that is dispensed in tablet form.

Since it has oxycodone in it, Percocet depresses the central nervous system and changes how your brain perceives pain.

Oxycodone is a semi-synthetic opioid and a controlled substance with a high potential for misuse. It is classified as a Schedule II substance, which means that it is highly regulated.

Percocet Uses

Percocet is prescribed to treat moderate to severe pain. 

Due to its high potential for misuse, Percocet is recommended only to those for whom non-opioid pain management methods are ineffective or not tolerated. Doctors should attempt other forms of analgesia before prescribing Percocet and minimize use when possible.

Percocet is designed to be taken by mouth, generally about once every six hours as needed to control pain.

Side Effects

Percocet can cause serious and life-threatening respiratory depression.

Opioid drugs suppress the central nervous system and can cause breathing issues, sedation, low blood pressure and heart rate, and a lowered body temperature. Percocet can also cause mental impairment and make it dangerous or difficult to operate a motor vehicle or heavy machinery.

These are potential side effects of the oxycodone in Percocet:

  • Dry mouth
  • Headache
  • Changes in heart rate
  • Drowsiness
  • Flushing
  • Stomach pain
  • Mood changes
  • Chest pain 
  • Irregular menstruation
  • Decreased sex drive
  • Inability to get and keep an erection
  • Itching
  • Lightheadedness
  • Agitation and hallucinations
  • Dizziness
  • Swelling
  • Seizures
  • Nausea, vomiting, weakness, and loss of appetite
  • Trouble swallowing or breathing

Percocet is also habit-forming and can lead to physical and psychological dependence, even when taken as directed. It has a high risk for misuse.

Precautions

Percocet can cause respiratory depression. As a result, it should not be taken by people with a compromised airway or those who suffer from asthma, COPD or other respiratory conditions. 

It should also not be taken by those with a known abdominal obstruction, including paralytic ileus, or anyone who may be allergic or hypersensitive to oxycodone or acetaminophen.

Percocet can cause neonatal opioid withdrawal syndrome in babies born to mothers who take it for a prolonged period of time during pregnancy. It can also be fatal if accidentally ingested, especially by children.

Be sure to talk to your doctor about any medications or supplements you are taking, as many of these can interact with Percocet.

Interactions

Both the acetaminophen and the oxycodone components of Percocet can interact with other medications. Hepatotoxicity can lead to acute liver failure with high doses of acetaminophen, meaning that Percocet should be used with caution with other products containing this analgesic.

Percocet can also interact negatively with the following:

  • Other CNS (central nervous system) suppressant medications such as benzodiazepines
  • Cytochrome P450 34A inhibitors and inducers 
  • St. John’s wort and tryptophan
  • Cough medications
  • Buprenorphine products
  • Antidepressants
  • Antihistamines
  • Medications for migraines

Percocet Overdose

In 2019, nearly 50,000 people in the United States died from an opioid overdose. This represents over 70% of all drug overdose deaths that year. 

Since Percocet contains the potent opioid drug oxycodone, it has a high risk for overdose that increases with misuse or combination with another depressant substance.

These are signs of an opioid overdose:

  • Pinpoint pupils
  • Shallow breathing or trouble breathing
  • Irregular blood pressure and heart rate
  • Nausea or vomiting
  • Dizziness
  • Bluish tint to skin, nails, and/or lips
  • Cold and clammy to the touch
  • Loss of balance and coordination
  • Mental confusion or agitation
  • Extreme drowsiness or loss of consciousness

If any of the signs of a Percocet overdose are evident, seek immediate medical attention.

Withdrawal Symptoms

Percocet is habit-forming, as opioid drugs make changes to chemical makeup and circuitry of the brain. In some individuals, even with limited use, the brain can become dependent on Percocet and leave the individual with withdrawal symptoms with discontinuation of the drug. 

When the drug processes out of the brain and body, it can take time for the system to regulate. This leads to withdrawal, which can include both emotional and physical symptoms.

Physical withdrawal symptoms include the following:

  • Fatigue
  • Nausea, diarrhea, and vomiting
  • Abdominal pain and cramps
  • Headaches
  • Sweats and chills
  • Goosebumps
  • Sleep issues
  • Dizziness
  • Muscle aches and back pain

Emotional side effects of withdrawal can include the following:

  • Anxiety
  • Depression
  • Irritability
  • Restlessness
  • Difficulty concentrating and focusing

Percocet Misuse 

Oxycodone products, including Percocet, are some of the most misused prescription opioid medications. 

In 2020, approximately 3.2 million Americans ages 12 and older abused an oxycodone product. Among those using an oxycodone product, 14.5% misused them in 2020. 

Percocet tablets can be chewed or crushed and snorted or injected for a high.

Anytime Percocet is altered or taken in a way that is not directed, it is considered misuse. Opioid drugs are extremely addictive, causing compulsive use and increasing the risk for a fatal overdose.

Signs of Percocet Misuse

Percocet can be misused in the following ways:

  • Taking the medication without a legitimate prescription for it
  • Continuing to take Percocet after a prescription has run out
  • “Shopping” different doctors to get Percocet prescriptions
  • Taking the medication in a way other than intended, such as crushing, snorting, injecting, or chewing it
  • Increasing the dosage or taking it in between doses
  • Forging a prescription or stealing the medication
  • Making up symptoms to get Percocet
  • Combining Percocet with other medications or substances

In addition to these signs, Percocet misuse is often recognizable by mood swings, changes in eating and sleeping habits, and social circles. Someone misusing Percocet will often isolate themselves or spend most of their time talking, using, or thinking about the medication. 

Physical appearance can decline, and regular obligations begin to be overlooked. Financial difficulties, troubles at school or work, and interpersonal relationships issues often occur.

Side Effects of Percocet Misuse

Percocet misuse increases the risk for a possible fatal drug overdose. 

Percocet contains a potent opioid drug with a high rate of accidental overdose potential, which goes up when the drug is misused. If the drug is not taken exactly as prescribed and under direction of a medical professional, all of the possible side effects and risks increase.

Percocet can lead to physical dependence, even when taken as directed. When misused, the odds for developing opioid use disorder increase. This is a serious potential side effect of Percocet misuse.

Treatment Options

Treatment for opioid use disorder is highly individual and based on personal circumstances. It can include the following options:

  • Detox
  • Inpatient or residential treatment programs
  • Outpatient programs
  • Group therapy and counseling sessions
  • Dual diagnosis treatment for co-occurring disorders
  • Medical management, including MAT (Medications for Addiction Treatment)
  • Peer support groups

Often, a combination of treatment methods is beneficial to achieve and support recovery.

Elena Hill, MD, MPH

Elena Hill, MD; MPH received her MD and Masters of Public Health degrees at Tufts Medical School and completed her family medicine residency at Boston Medical Center. She is currently an attending physician at Bronxcare Health Systems in the Bronx, NY where she works as a primary care physician as well as part time in pain management and integrated health. Her clinical interests include underserved health care, chronic pain and integrated/alternative health.

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Citations

  1. Key Substance Use and Mental Health Indicators in the United States: Results from the 2020 National Survey on Drug Use and Health. Substance Abuse and Mental Health Services Administration (SAMHSA). https://www.samhsa.gov/data/report/2020-nsduh-annual-national-report. October 2021. Accessed March 2022.
  2. Oxycodone. Drug Enforcement Administration (DEA). https://www.dea.gov/factsheets/oxycodone. Accessed March 2022.
  3. Percocet. Endo Pharmaceuticals, Inc. https://www.endo.com/File%20Library/Products/Prescribing%20Information/PERCOCET_prescribing_information.html. June 2018. Accessed March 2022.
  4. Oxycodone. U.S. National Library of Medicine (NLM). https://medlineplus.gov/druginfo/meds/a682132.html. March 2022. Accessed March 2022.
  5. Drug Overdose Deaths. Centers for Disease Control and Prevention (CDC). https://www.cdc.gov/drugoverdose/deaths/index.html. March 2021. Accessed March 2022.

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