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Percocet (Oxycodone and Acetaminophen): Risks and Treatment

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Percocet is a prescription pain medicine that combines oxycodone, an opioid, with acetaminophen, the pain and fever reducer found in Tylenol. It can be habit-forming, and an overdose can slow or stop breathing. Too much of the acetaminophen in it can also cause serious liver damage.

What Percocet Is

Percocet is one of several oxycodone combination products. MedlinePlus describes these products as medicines used to relieve severe pain. Oxycodone belongs to a group of drugs called opiate (narcotic) analgesics. NIDA classifies it as a semi-synthetic opioid, meaning it is made in a lab by chemically changing natural opioids from the opium poppy.

Acetaminophen is a pain reliever and fever reducer. On its own it treats mild to moderate pain; in Percocet it is paired with oxycodone for pain severe enough to need an opioid.

Percocet should be taken only by the person it was prescribed to, and only as the prescriber and label direct. Questions about how much to take or when belong with your doctor or pharmacist.

How Percocet Affects the Brain and Body

Oxycodone relieves pain by changing the way the brain and nervous system respond to it. Opioids attach to opioid receptors in the brain and spinal cord, which reduces how intensely pain signals are felt. They also act on parts of the brain involved in emotion and reward, which can produce a pleasant, relaxed feeling. That reward effect is what makes opioids prone to misuse.

Common side effects include nausea, vomiting, headache, drowsiness and constipation. Because oxycodone can make you sleepy, MedlinePlus advises not driving or doing anything dangerous until you know how it affects you.

Short- and Long-Term Risks

Slowed breathing

Oxycodone can cause serious or life-threatening breathing problems, especially during the first 24 to 72 hours of treatment and any time the dose is increased. Alcohol, street drugs and certain medicines raise the risk of breathing problems, heavy sedation or coma. The FDA requires its strongest warning, a boxed warning, on opioid pain medicines and benzodiazepines about using them together, because the combination can cause extreme sleepiness, slowed breathing, coma and death.

Liver damage from acetaminophen

MedlinePlus warns that taking too much acetaminophen can cause liver damage, sometimes serious enough to need a liver transplant or cause death. Acetaminophen is in many cold, flu and pain products, and labels may list it as APAP. Taking one of those along with Percocet can push you past a safe amount without realizing it. Ask your pharmacist before combining any products, and tell your doctor if you drink alcohol regularly or have ever had liver disease.

Counterfeit pills and fentanyl

NIDA warns that fentanyl is often found in illegally made counterfeit pills, which can be made to look like prescription oxycodone. Fentanyl is far stronger than morphine, and a small amount can be fatal. Any pill that did not come from a pharmacy should be treated as possibly containing fentanyl.

Pregnancy and others in your home

Tell your doctor if you are pregnant or plan to become pregnant. MedlinePlus notes that regular use during pregnancy can cause life-threatening withdrawal symptoms in the baby after birth. Percocet can also seriously harm other people, especially children, if they take it. Keep it locked up and keep track of how many tablets are left.

Overdose: Signs and What to Do

Signs of an opioid overdose include:

  • Being unable to wake up or respond
  • Slow, shallow or irregular breathing, or unusual snoring
  • Bluish or purplish lips or fingernails
  • Small pupils, limp muscles, and cold, clammy skin

Call 911 right away. Give naloxone (Narcan) if you have it. Naloxone can reverse an opioid overdose, is sold over the counter without a prescription, and usually comes as a nasal spray that anyone can use. Stay with the person until help arrives, and give another dose if symptoms come back. If someone you live with takes Percocet, ask a pharmacist about keeping naloxone at home.

An acetaminophen overdose may cause no symptoms at first. If someone has taken more Percocet or acetaminophen than directed, get medical help right away even if they seem fine. Poison Control is available at 1-800-222-1222.

Is Percocet Addictive? Dependence and Withdrawal

Yes. MedlinePlus warns that oxycodone combination products may be habit-forming, and NIDA notes that the risk of developing a substance use disorder exists even when opioids are taken as prescribed. The risk rises with misuse, higher doses and longer use.

Two related changes can happen with regular use:

  • Tolerance: the same dose works less well over time.
  • Physical dependence: the body adapts to the drug, so stopping causes withdrawal. Dependence is not the same as addiction, but it often comes with it.

Stopping Percocet suddenly after regular use can cause withdrawal symptoms such as restlessness, teary eyes, runny nose, yawning, sweating, chills, muscle aches, anxiety, nausea, diarrhea and a fast heartbeat. Doctors usually lower the dose gradually. Withdrawal is not something to tough out alone: medications, including one called lofexidine, are approved to ease symptoms. If you have been misusing Percocet, a supervised setting such as a Florida detox center is safer than quitting on your own.

Signs that use may be becoming a problem

Addiction is marked by compulsive drug seeking and use even when it causes harm. Signs worth taking seriously, in yourself or someone you love, include:

  • Taking more than prescribed, or running out of a prescription early
  • Getting pills from friends, family or other sources
  • Craving the medicine or thinking about it often
  • Continuing to use it after the pain it was prescribed for has eased
  • Problems at work, at home or with relationships linked to its use

None of these makes someone a bad person. They are signs that it is time to talk honestly with a doctor or a treatment provider.

Percocet and the Law

Oxycodone is a Schedule II controlled substance under federal law. That means it has an accepted medical use but a high potential for misuse. Having or sharing Percocet without a valid prescription is illegal.

Treatment for Percocet Use in Florida

Percocet addiction is treated as opioid use disorder, and medication is the standard of care. The FDA-approved medications are methadone, buprenorphine and naltrexone. Research links them to a lower risk of returning to drug use and of dying from an overdose. Behavioral therapy works best alongside medication, not instead of it.

Florida programs offer this care in outpatient clinics, intensive outpatient programs and residential settings. Our guide to medication-assisted treatment in Florida explains how it works, and you can search licensed programs by location in our rehab directory. If a loved one is in danger and refuses help, Florida’s Marchman Act allows involuntary assessment and stabilization for substance use.

Getting Help Now

  • Emergency or possible overdose: call 911 and give naloxone if you have it.
  • Crisis or thoughts of suicide: call or text 988, the Suicide & Crisis Lifeline.
  • Treatment referrals: call the SAMHSA National Helpline at 1-800-662-4357. It is free, confidential and open 24/7 in English and Spanish.

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Frequently Asked Questions About Percocet (Oxycodone and Acetaminophen): Risks and Treatment

What is Percocet?

Percocet is a prescription painkiller that combines oxycodone, an opioid, with acetaminophen, the pain and fever reducer in Tylenol. It is prescribed for pain severe enough to need an opioid. Oxycodone is a Schedule II controlled substance, which means it has accepted medical use but a high potential for misuse and addiction. Take Percocet only if it was prescribed to you, and only as directed.

Is Percocet addictive?

Yes, Percocet can be addictive because it contains oxycodone. MedlinePlus warns that oxycodone combination products may be habit forming. With repeated use, the body can become physically dependent, so stopping causes withdrawal, and tolerance can build, so the same dose works less well. Not everyone who takes Percocet develops an addiction, but the risk rises with misuse, higher doses and longer use.

What are the signs of a Percocet overdose?

Signs of an opioid overdose include being unable to wake up, slow or shallow breathing, bluish or purplish lips and nails, and tiny pupils. Call 911 right away. Give naloxone (Narcan) if you have it; it is sold over the counter and can reverse an opioid overdose. Taking Percocet with alcohol, benzodiazepines, sleep medicines or street drugs raises the risk of dangerously slowed breathing.

Can Percocet damage your liver?

Yes, the acetaminophen in Percocet can cause serious liver damage if you take too much. MedlinePlus warns that too much acetaminophen can cause liver damage severe enough to need a transplant or cause death. Many cold, flu and pain products also contain acetaminophen, so taking them with Percocet can push you past a safe amount without realizing it. Ask your pharmacist before combining any products.

What happens if you stop taking Percocet suddenly?

Stopping Percocet suddenly after regular use can cause opioid withdrawal. Symptoms can include muscle aches, cramps, anxiety, sweating, nausea, vomiting, chills and diarrhea. Doctors usually lower the dose gradually to prevent this, so talk with your prescriber before you stop. If you have been taking more than prescribed or getting pills elsewhere, ask about medically supervised withdrawal rather than quitting on your own.

How is Percocet addiction treated?

Percocet addiction is treated as opioid use disorder, and medication is the standard of care. The FDA-approved medications are methadone, buprenorphine and naltrexone. They reduce cravings and lower the risk of returning to use and of overdose death, and they work best with counseling. Many Florida programs offer this care in outpatient or residential settings; see our guide to medication-assisted treatment in Florida.