Combunox

  • Generic Name or Active Ingridient: Oxycodone Hydrochloride And Ibuprofen
Drug Class: Combunox > Oxycodone Hydrochloride And Ibuprofen > Oxycodone > Fully Synthetic Opioid > Opioids > Opioid Agonist > Analgesic.

Uses

Physicians prescribe Combunox to treat moderate to severe pain. Combunox is intended to treat short-term pain due to acute illness or injury, not pain associated with chronic illnesses.

Learn More about Combunox Uses

Administration/Dosage

Each Combunox tablet contains 5 mg of oxycodone hydrochloride and 400 mg of ibuprofen.

Physicians should prescribe a low initial dose of Combunox and then adjust the patient's dose according to his condition and response to treatment. The typical dose is one tablet orally, not to exceed four tablets in a 24-hour period. Use should not exceed 7 days. To reduce the risk for side effects and dependence, use the lowest dose of Combunox for the shortest time possible.

If your doctor has suggested you take Combunox on a regular schedule to provide round-the-clock coverage for pain and you miss a dose, take the missed dose as soon as possible. If it is nearly time to take another dose and you can tolerate the pain, skip the missed dose and resume your normal schedule. Notify the prescribing physician if you are unable to maintain your dosing schedule, either because your current dosing schedule does not adequately cover your pain or if you have trouble remembering to take your medicine on time.

Read More about Combunox Administration and Dosage

Action

When the cells of your body are in distress due to illness or injury, they send a chemical message through the nervous system to your brain. Your brain then perceives pain and reacts appropriately to that pain. The oxycodone in Combunox works by binding to pain receptors in your nervous system, replacing messages of pain with messages of pleasure or euphoria. Combunox, like other opioids, changes the way your brain perceives pain.

The cells of your body produce a hormone known as prostaglandin. This hormone promotes inflammation, pain and fever. The ibuprofen in Combunox blocks the enzymes responsible for producing prostaglandin, effectively reducing swelling, discomfort and fever.

Combined into one Combunox dose, oxycodone and ibuprofen work together to provide more pain relief than either medicine could provide alone.

The oxycodone in Combunox acts directly on the respiratory center in the brain to depress breathing. Like other opioids, this may cause dangerous respiratory depression, where breathing is not sufficient to exchange oxygen and carbon dioxide.

Oxycodone also acts directly on the part of the brain responsible for the cough reflex. Combunox makes your brain apathetic to the need to cough.

The oxycodone in Combunox also acts on smooth muscle organs, such as those in the digestive system, in a way that slows digestion and causes constipation.

More about How Combunox Works

Precautions

Give the prescribing physician and pharmacist filling the prescription a list of your allergies, including allergies to ibuprofen, oxycodone or any other opioid, such as morphine or codeine. Get help right away at the first sign of an allergic reaction after taking Combunox. An allergic reaction is a serious medical emergency that can turn quickly into a life-threatening situation, known as anaphylaxis. Symptoms of an allergic reaction include rash, hives and difficulty breathing, along with swelling of the lips, tongue or face.

Tell the prescribing physician about your serious illnesses such as head injuries, brain tumors, seizures, breathing problems such as asthma or COPD, bowel conditions such as paralytic ileus or have recently had heart bypass surgery. If you have a history of these or other particular medical conditions, your doctor may change your Combunox dosage or switch you to a different analgesic. Combunox may worsen these illnesses or interfere with treatment, or these medical conditions may change with the way Combunox works. Do not take this medication if you have been experiencing diarrhea related to antibiotic use, are taking sodium oxybate or an MAO inhibitor.

Combunox can make you drowsy, dizzy and less alert. Do not drive a motor vehicle or other heavy machinery until you know how this medication affects you. Alcohol and some prescription and over-the counter medications can worsen these effects associated with oxycodone and ibuprofen.

Combunox may make you dizzy when you stand up too quickly from a seated or laying position; injuries sustained from falls make this a dangerous side effect. Alcohol, hot weather, fever or exercise can make this worse. To lessen this side effect, put your feet on the floor and sit at the edge of the bed for a few minutes before standing. Rise to a seated position slowly at sit at the side of the bed for a moment; stand up slowly from a seated position while hanging onto someone or something sturdy. Sit down at the first sign of dizziness.

Do not consume alcohol or take other medicines that cause drowsiness while taking Combunox. This medication will add to the effects of alcohol and other depressants. Check the labels of food, beverages and medicines to learn the alcohol content; ask a pharmacist to help you determine if a product contains alcohol if you are uncertain.

A physician may recommend laboratory tests while you take Combunox, including complete blood counts and liver and kidney function. These tests monitor your condition and alert your physician to any side effects.

Taking high doses of Combunox or using this medication for a long time may result in physical dependence or addiction, resulting in uncomfortable withdrawal symptoms or behavioral problems when you stop using Combunox. Tell your doctor if you or a family member has a history of dependence or addiction to drugs or alcohol. Your physician may choose a different course of treatment or adjust your opioid dosage accordingly.

Elderly patients may be more sensitive to the effects of Combunox. Physicians should monitor older patients carefully for signs of breathing problems or stomach bleeding.

Read More about Combunox Precautions

Warnings

The use of NSAIDS increases the risk for serious or fatal cardiovascular and blood clotting events, heart attack and stroke. The risk may increase with continued use. Individuals with heart problems and those who are at risk for cardiovascular disease are at greater risk for these adverse events.

Do not use Combunox for pain associated with coronary artery bypass graft, sometimes called "cabbage" or CABG, surgery.

The ibuprofen in Combunox may lead to onset of new hypertension, or high blood pressure, or worsening of pre-existing hypertension in a way that increases the risk for cardiovascular events. Prescribing physicians should closely monitor patients with a family or personal history of hypertension, or patients taking other medications that can influence blood pressure.

The NSAID ibuprofen is associated with fluid retention and edema in some consumers. Patients with fluid retention or heart failure should use Combunox with caution.

Combunox should never be used in situations where opioids are not appropriate, including in patients suffering from respiratory depression in unmonitored settings without resuscitative equipment. Combunox is not appropriate for individuals with severe or acute bronchial asthma or for those who suffer the problem known as hypercarbia, a condition characterized by too much carbon in the blood.

The ibuprofen in Combunox increases the risk for serious gastrointestinal adverse events including inflammation, bleeding, ulceration, and perforation of the stomach, small intestine, or large intestine. These serious adverse events can occur at any time, with or without warning symptoms, in patients treated with NSAIDs. These events can be fatal.

Individuals who have experienced asthma, rash or allergic-type reactions after taking aspirin or NSAIDs should not use Combunox.

Avoid taking Combunox late in pregnancy. NSAIDs taken late in pregnancy may cause premature closure of the ductus arteriosus, blood vessel that allows blood to go around the baby's lungs before birth.

Do not stop taking Combunox abruptly unless directed to do so by a physician. Sudden cessation may cause uncomfortable withdrawal symptoms in individuals who have grown physically dependent on opioids.

More Warnings about Using Combunox

Drug Interactions

Combunox may interact in an unfavorable or unsafe ways with other prescriptions, over-the-counter medications, vitamins and herbal remedies. Give the prescribing physician and pharmacist filling the order a complete and updated list of medicines, including over-the-counter supplements. Never stop, start or change the way you take any medication, including non-prescription remedies, while taking Combunox without first discussing it with your doctor.

Do not take Combunox in combination with other opioids, alcohol or illicit substances that cause respiratory depression.

More Drug Interactions

Side effects

Most people do not experience side effects while taking Combunox but, as with all medications, it is possible to have some adverse reactions from Combunox. Some individuals experience common, non-serious side effects. Rarely, serious side effects are associated with Combunox.

Continue taking Combunox but tell your doctor if minor side effects become intolerable or if they do not go away on their own. Common digestive side effects include constipation, diarrhea, indigestion, nausea, stomach pain, upset stomach and vomiting. You may also notice an increase in weakness, anxiety, nervousness, sleeplessness, dizziness, drowsiness, tiredness and headaches while taking Combunox.

Some side effects can be severe or life threatening. Stop taking Combunox and talk to your doctor right away if you experience severe side effects such as:

  • Black, Tarry or Bloody Stools
  • Blurred Vision
  • Chest Pain
  • Dark Urine
  • Fainting
  • Fast or Irregular Heartbeat
  • Fever
  • Flu-like Symptoms
  • Increased or Decreased Urination
  • Irregular or Difficult Breathing
  • Mental or Mood Changes
  • Red, Swollen, Blistered or Peeling Skin
  • Severe or Persistent Dizziness
  • Severe or Persistent Nausea or Stomach Pain
  • Shortness of Breath
  • Slurred Speech
  • Stiff Neck
  • Swelling of the Arms or Legs
  • Unusual Tiredness or Weakness
  • Unusual Weight Gain
  • Vomit that Resembles Coffee Grounds
  • Yellowing of the Skin or Eyes

Learn More about Combunox Side Effects

Overdose

Combunox overdose is a serious, life-threatening medical emergency. If you suspect that you or someone you know is suffering from an overdose of Combunox or any other medication, seek emergency assistance immediately by going to the emergency room or calling an ambulance. If you are a very long distance from professional help, contact your local poison control center at 1-800-222-1222. Overdose symptoms include blurred vision or cold and clammy skin. Seek medical help immediately if you notice confusion, severe dizziness, drowsiness, or coma, severe muscle weakness, slow, shallow, or difficult breathing.

Emergency department doctors and nurses help patients overcome Combunox overdose by administering medications such as naloxone, which drop Combunox to safe levels very quickly. Nurses observe the patient's condition and administer naloxone as necessary, as the narcotic effects of Combunox frequently outlast those of naloxone.

Nurses also monitor the patient for dangerous complications, such as respiratory depression, aspiration and dehydration, and take appropriate action such as starting IVs and establishing an airway to help the patient breathe. CPR is sometimes necessary in Combunox overdose cases.

Learn More about Combunox Overdose

Abuse

The U.S. Drug Enforcement Agency, or DEA, has classified this substance as a Schedule II narcotic, which means it carries a high potential for abuse. The DEA prohibits refills on Schedule II drugs as a way to curb prescription drug abuse.

Pharmaceutical companies legally manufacture Combunox for legal and compassionate therapy for patients in severe pain. Abusers obtain Combunox through forged prescriptions, bogus prescription call-ins to pharmacies, "doctor shopping" as well as theft from pharmacies and friends. The DEA calls this practice "diversion" as illicit users divert prescription opioids such as Combunox from their prescribed purpose,.

Continuous abuse, or using high doses of Combunox for non-medical purposes either to get high or to treat a condition for which the doctor had not intended, increases the risk for developing increased tolerance, physical dependence or addiction to Combunox.

Read More about Combunox Abuse

Withdrawal

Withdrawal symptoms are a natural and expected consequence of an abrupt drop in the level of Combunox in the body of an individual physically dependent on opioids. Withdrawal presents itself in a handful of unpleasant and persistent physical, flu-like symptoms that can last five or more days as the levels of Combunox toxins slowly decrease. Rehabilitation professionals call this process detoxification. The psychological symptoms of withdrawal may last much longer, presenting a special challenge to recovery.

The human body adapts to the presence of foreign substances in the body, including drugs such as Combunox, by adjusting its chemical balance to accommodate those drugs. The body eventually becomes tolerant of these substances, meaning an individual must take an ever-increasing amount of opioids to achieve the desired effect. With continuous use, the body might grow dependent on the chemical, which means the user must maintain a certain level of Combunox for the body to feel "normal." When the level of Combunox drops rapidly in an opioid-dependent individual, the body struggles to maintain its chemical balance. This struggle manifests itself through uncomfortable, flu-like withdrawal symptoms.

Withdrawal symptoms vary from person to person and are dependent on how long you have been using Combunox and how frequently you take it. Physical and psychological symptoms of withdrawal may be severe enough to prevent you from quitting Combunox without the help of a qualified rehabilitation specialist. Learn More about Withdrawal from Combunox

Detox

Detoxification is the process of removing Combunox from the body and dealing with the resulting withdrawal symptoms. Many individuals try to self-detoxify, or quit "cold turkey" instead of seeking the help of qualified rehabilitation professionals. Self-detoxification from Combunox is an uncomfortable and inefficient approach to quitting opioid addiction. With no medications to ease withdrawal symptoms or help from trained professionals, self-detox takes five or more days, with the most grueling day occurring on or about the fourth day. During detoxification, the patient cannot sleep or stay awake, eat, lay still or move around comfortably.

Without trained medical personnel to monitor him during the uncomfortable and lengthy Combunox withdrawal process, the individual may suffer serious complications. He may vomit and inhale stomach contents, known as aspiration, which may lead to pneumonia or lung infections. Excessive vomiting and diarrhea frequently result in dangerous dehydration.

The primary complication of detoxification is relapse to Combunox abuse, which may result in overdose. Detoxification lowers the body's tolerance to opioids, so the person can possibly overdose on a lower dose than he used to take before attempting detoxification.

While withdrawal symptoms are not fatal, withdrawal from Combunox is demoralizing, frustrating, embarrassing and depressing, especially without professional rehabilitation. The psychological aspects of withdrawal mislead many individuals to believe they are incapable or unworthy of a life without opioids.

Learn More about Combunox Detoxification Programs

Storage

Keep Combunox at temperatures between 59 degrees and 86 degrees Fahrenheit, ideally at 77 degrees Fahrenheit.

Keep Combunox and all other medications away from children and pets. Put Combunox and other prescription painkillers where adults cannot take this opioid on purpose or by mistake. It is illegal to give Combunox or other prescription opioids to others, even if they experience symptoms similar to your own.

Dispose of Combunox when you no longer need it or when a doctor suggests you stop using it to reduce the risk for abuse or diversion. Ask your pharmacist how to dispose of Combunox - local and state laws regarding opioid disposal may vary.