Classes
DEA Class; OTC
Common Brand Names; Combunox
Analgesics, NSAID/Opioid Combos
Description
Fixed combination tablet combines the opioid analgesic agent, oxycodone HCl, with the nonsteroidal anti- inflammatory (NSAID) agent, ibuprofen
Oxycodone: Binds to opiate receptors within neuronal membranes of synapses, which in turn blocks pain perception in the cerebral cortex; inhibits the flow of pain sensations into the higher centers
Ibuprofen: Inhibits synthesis of prostaglandins in body tissues by inhibiting cyclooxygenase; at least 2 isoenzymes, cyclooxygenase-1 (COX-1) & -2 (COX-2)
Indications
Indicated for short-term management of acute, moderate to severe pain
Use lowest effective dose for the shortest duration consistent with individual patient treatment goals
Contraindications
Coronary artery bypass graft (CABG) surgery, treatment of peri-operative pain; increased incidence of myocardial infarction and stroke
Hypersensitivity to ibuprofen, other NSAIDs, oxycodone, or any component of the formulation
ASA allergy
Acute or severe bronchial asthma
Known or suspected gastrointestinal obstruction
Significant respiratory depression
Hypercarbia
Adverse Effects
>10%
Dizziness (5-19%)
Drowsiness (7-17%)
Nausea (9-25%)
1-10%
Constipation (1-5%)
Diarrhea (2%)
Dyspepsia (1-2%)
Flatulence (1%)
Hypotension (1-3%)
Vomiting (5%)
Headache (10%)
Fever (3%)
Diaphoresis (2%)
Weakness (1-3%)
Warnings
Cases of serotonin syndrome, a potentially life-threatening condition, reported with concomitant use of serotonergic drugs; this may occur within the recommended dosage range; the onset of symptoms generally occur within several hours to a few days of concomitant use, but may occur later than that; discontinue therapy immediately if serotonin syndrome is suspected
Pregnancy and Lactation
Pregnancy Category: C <30 weeks gestation; category D if 30 weeks gestation or greater because of potential for NSAIDs to cause premature closure of the ductus arteriosus
Lactation
Drug is present in breast milk; published lactation studies report variable concentrations of drug in breast milk with administration of immediate-release formulation to nursing mothers in early postpartum period
Maximum Dosage
Adults
Usual dose: 5 mg/400 mg PO q6 hr PRN
Dosage should not exceed 20 mg/1600 mg (4 tablets) q24 h and should not exceed 7 days duration
Safety and efficacy not established
How supplied
oxycodone/ibuprofen
Tablet: Schedule II
- 5mg/400mg