Percocet Use, Side Effects, and Risks

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Percocet is a prescription pain medication commonly prescribed by medical doctors. Because it is partly made up of oxycodone, an opioid drug, there is a high risk of Percocet addiction when you use it for any amount of time.

What is Percocet?

Percocet falls into the class of drugs called analgesics (drugs that relieve pain) and is made up of 2 types of medications: oxycodone and acetaminophen.

Acetaminophen is a pain reliever and fever reducer that is also available in over-the-counter (OTC) medications such as Tylenol, Excedrin, and Nyquil.

Oxycodone is an opioid that is used to treat pain, often after surgery. It is a semisynthetic opioid, which means that it is legally produced using opioids derived from the opium plant, and is chemically similar to morphine.

In addition to pain relief, Percocet and other medications with opioids can produce feelings of calmness and intense happiness (euphoria, or feeling “high”). This is why they can be very addictive. Percocet is often used to treat chronic, ongoing pain, such as pain related to cancer, although the safety and effectiveness of long-term opioid therapy have been called into question.¹

Percocet is available in both immediate-release (IR) and extended-release (ER) forms. IR means that the medicine starts working within minutes after taking it and delivers pain relief for up to 6 hours. It is used for acute (brief and severe) pain after surgery or on an as-needed basis. ER means that it is slowly released into the bloodstream and provides pain relief over a 12-hour period. Doctors usually prescribe only 2 doses of Percocet ER per day.²

Percocet Side Effects

If used as prescribed, Percocet effectively reduces pain. Common Percocet side effects are dizziness and nausea.³

Less frequent side effects include:³

Constipation
Headache
Vomiting
Sleepiness
Skin rash
Diarrhea
Insomnia
Skin blistering
Cough
Insomnia
Fatigue
Hot flashes

Some very significant, but rare, side effects include:³

Slow breathing or difficulty breathing
Chest discomfort
Heart palpitations (feeling like your heart is racing, pounding, or skipping a beat)
Thought and memory impairments
Hypertension (high blood pressure)
Myoclonus (muscle twitches)
Hypogonadism (failure of the gonads—testes in men and ovaries in women—to function properly)

Percocet Effects: Misuse and Long-Term Use

Long-term use or using Percocet other than as prescribed may result in an increased risk of:

Developing an opioid use disorder (OUD)—continuing to use opioids despite the negative impacts on your life⁴
Percocet addiction or dependence
Overdose or toxic levels of the medication in your system
Developing recurrent and treatment-resistant depression⁵
Heroin use⁵

The longer that Percocet is used post-surgery, the higher the likelihood of long-term use. Doctors will commonly prescribe it for 7 days or less as taking it for 10 or more days post-surgery increases the likelihood of continued use of opioid pain medications.⁶

Factors that could put you at an increased risk for misuse of Percocet include:

Having clinical depression⁷
Having another mental health disorder
History of misuse of other medications
History of alcohol abuse or illicit (illegal) substance use
Family history of a substance use disorder

Alternatives to Percocet

Given the potential for developing a Percocet addiction, alternative pain medications have been developed.

MSIR

Morphine sulfate, immediate-release (MSIR), is one such alternative. It also is an opioid analgesic that has the same pain-relieving effect as oxycodone but with a much lower degree of euphoria, making it less addictive. One study found that MSIR combined with acetaminophen was just as effective as Percocet in managing pain in the emergency room.⁸

Tramadol

Tramadol is another opioid analgesic and is available under the trade name ULTRAM. It is used to treat moderate to severe pain, however, it is much less potent and therefore there is a lower risk for misuse.⁹

Tapentadol

Tapentadol is another opioid analgesic that might be an alternative to Percocet and could have even lower abuse potential compared to tramadol. Clinical trials thus far have shown that it provides effective pain relief for lower back pain, acute pain, and pain from nerve damage due to diabetes. It is available in both immediate release (for moderate to severe acute pain) and extended release (severe pain) forms.¹⁰

In one study, tapentadol IR and ER were found to have lower abuse potential compared to other pain medications, including oxycodone. This may be because it doesn’t affect the part of the brain associated with reward as strongly as other opioids do.¹⁰

Percocet Withdrawal and Overdose Risk

Suddenly stopping Percocet use may result in withdrawal, especially if you take it for a long time or in high doses. Withdrawal means that your body had gotten so used to the drug and needed it to function that it struggles without it when suddenly stopped. To help avoid withdrawal, your doctor will usually taper the Percocet dose (slowly decrease the dose over time).

Symptoms of Percocet withdrawal include:

Vomiting
Diarrhea
Restlessness
Sleep problems
Involuntary leg movements

There is also a high risk of Percocet overdose because there can be a small difference between the therapeutic dosage and too high of a dosage. The appropriate dosage and the dosage that could cause toxicity for you depends on factors such as your pain response, other medications you are taking, and the rate at which the doctor is tapering or reducing your dose.¹¹Your risks for toxicity increase with higher doses and longer duration of use.

Signs of Percocet overdose include:

Slow breathing
Bluish-colored lips and fingernails
Cold, damp skin
Shaking
Vomiting
Passing out
Going in and out of consciousness

If you experience Percocet withdrawal or overdose, go to a hospital as soon as possible. Percocet addiction treatment usually involves medication to alleviate or avoid painful symptoms.

If you are concerned about your level of Percocet use or you have continued to use it despite negative consequences, please consider getting an initial consultation with a licensed mental health professional, preferably someone that specializes in substance use issues. Getting treatment earlier helps to reduce future risks.

If you think you or a loved one is experiencing overdose or withdrawal due to Percocet, call 911. If you are concerned about your level of Percocet use or that of a loved one, call 800-681-1058 (Who Answers?) for 24/7 help.

Is Percocet Right For Me?

You will probably have an appointment with your surgeon or doctor before your surgical procedure. Depending on the surgery and how much pain your doctor thinks you will experience after it, they may recommend opioids or OTC medications. Be sure and talk with your doctor about:

Your experience with pain and what helped you manage it
Any other medications you are taking, including OTC meds
Any medications you are allergic to
How much and how often you consume alcohol
If you’re pregnant, think you might be pregnant, or are trying to get pregnant
If there are other options for pain medication aside from Percocet
What effects you can expect from Percocet, including side effects
The type and severity of the pain after surgery
How long the post-surgery recovery period lasts
What to do if you miss a dose of the prescribed Percocet
Any other concerns you may have

A doctor will determine the Percocet dosage (or dosage of another medication) based on your medical condition and history.

How to Take Percocet Safely

To reduce risks associated with Percocet use:

Take only as directed by your doctor
Avoid alcohol while taking it
Tell your doctor if your pain is not under control
Tell your doctor if you experience side effects and which ones
Consult your doctor before taking another medication or OTC drug

References

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Vadivelu, N., Kai, A.M., Kodumudi, V., Sramcik, J., & Kaye, A.D. (2018). The opioid crisis: A comprehensive overview. Current Pain and Headache Reports, 22.
Sullivan, M.D. (2018). Depression effects on long-term prescription opioid use, abuse and addiction. The Clinical Journal of Pain, 34(9), 878-884.
Shah, A., Hayes, C.J., & Martin, B.C. (2017). Characteristics of initial prescription episodes and likelihood of long-term opioid use – United States, 2006-2015. Center for Disease Control and Prevention Morbidity and Mortality Weekly Report, 66(10), 265-269.
Edlund, M.J., Forman-Hoffman, V.L., Winder, C.R., Heller, D.C., Kroutil, L.A., Lipari, R.N., & Colpe, L.J. (2015). Opioid abuse and depression in adolescents: Results from the national survey on drug use and health. Drug and Alcohol Dependence, 152, 131-138.
Fassassi, C., Dove, D., Davis, A., Butt, M., Masoudi, A., Drapkin, J., Gohel, A., Silver, M., Likourezos, A., & Motov, S. (2020). Analgesic efficacy of morphine sulfate immediate release vs. oxycodone/acetaminophen for acute pain in the emergency department. The American Journal of Emergency Medicine. Advanced online publication.
Subedi, M., Bajaj, S., Kumar, M.S., & Mayur, Y.C. (2019). An overview of tramadol and its usage in pain management and future perspective. Biomedicine & Pharmacotherapy, 111, 443-451.
Butler, S.F., McNaughton, E.C., & Black, R.A. (2015). Tapentadol abuse potential: A postmarketing evaluation using a sample of individuals evaluated for substance abuse treatment. Pain Medicine, 16, 119-130.
Opioid toxicity.