Percodan-Demi

Uses

Doctors prescribe Percodan-Demi to relieve a patient's moderate to severe pain. Percodan-Demi contains a powerful opioid pain reliever, oxycodone, and a milder analgesic, aspirin. Together, these analgesics provide more complete pain relief than either medication could alone.

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Other, off label uses for this medicine

A doctor may suggest you use Percodan-Demi to treat pain combined with a cough, fever and inflammation. The oxycodone component of Percodan-Demi soothes a cough while the aspirin reduces fever and swelling.

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Administration/Dosage

Take Percodan-Demi exactly as described on the prescription label; contact your doctor or pharmacist if you do not understand the instructions. Take with or without food. Take Percodan-Demi with food or milk if this medication upsets your stomach.

Never administer Percodan-Demi or other preparations containing aspirin to a child or teenager with a fever, especially to a youngster with chicken pox or flu symptoms. Aspirin use in children and teenagers under these conditions may cause Reye's syndrome, a serious and sometimes fatal condition.

Older people may be more sensitive to the effects of Percodan-Demi. Physicians should prescribe a low initial dose and monitor elderly individuals closely to establish the patient's tolerance.

Drink 6 to 8 full glasses of water each day you take Percodan-Demi to soften stool and ease constipation. Increase dietary fiber, known to regulate the digestive tract. Do not use stool softeners or laxatives without first discussing it with your doctor.

Doctors typically suggest you take Percodan-Demi as needed at the first onset of pain, rather than on a regular schedule. If your physician told you to take Percodan-Demi on a schedule and you miss a dose, take the missed dose as soon as you can. If it is almost time to take another dose and you are able to tolerate the pain, skip the missed dose and resume your normal schedule. Never double up on doses in an effort to make up for missed doses.

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Action

Body cells damaged by injury or illness produce large quantities of the enzyme, COX-2, which then releases prostaglandin, a chemical messenger. Prostaglandin binds to pain receptors at nerve endings and sends messages about the illness or injury through the nervous system to the brain. The brain responds by perceiving pain and taking other appropriate actions.

If you stub your toe, for example, the injured cells in your toe would products COX-2 and prostaglandins that send a message through your nervous system. Your brain receives and interprets the information, perceives pain and makes you take action such as saying "Ouch" and hopping around on one foot.

The oxycodone in Percodan-Demi reduces discomfort by binding to nerve endings. It interrupts the information about pain and instead sends messages of pleasure and euphoria. The oxycodone in Percodan-Demi, like other opioids, changes the way your brain perceives pain.

Oxycodone suppresses cough by depressing the cough reflex directly on the part of your brain responsible for breathing, the medulla. This opioid also acts on smooth muscle organs, like those in your intestines, in a way that can slow processes such as digestion.

The aspirin in Percodan-Demi adheres to COX-2 and prevents it from producing prostaglandin. As a result, the brain receives only a partial or incomplete pain message.

Prostaglandin also signals wounded cells to release fluids, causing swelling and inflammation. Aspirin reduces this swelling and inflammation by impeding prostaglandin production.

Aspirin also affects the hypothalamus, the area of your brain known responsible for regulating body temperature. This makes aspirin an effective fever reducer.

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Precautions

Do not use Percodan-Demi if you are allergic to aspirin, oxycodone, other opioids such as codeine or morphine or any non-steroidal anti-inflammatory drug, or NSAID, such as Advil, Aleve, Indocin and Motrin. An allergic reaction is a serious, potentially fatal medical condition that requires immediate professional attention.

Symptoms of an allergic reaction include hives, rash, difficulty breathing and swelling of the face, lips, tongue or throat.

Medical History

You may not be able to take Percodan-Demi if you currently are under a doctor's care for or have a history of certain medical conditions. Percodan-Demi may worsen your illness or interfere with treatment.

Tell your physician about any significant illnesses or conditions, including:

  • Asthma
  • Curvature of the Spine
  • History of Brain Tumor
  • History of Drug or Alcohol Addiction
  • History of Head Injury
  • History of Stomach Ulcer or Bleeding
  • Kidney Disease
  • Liver Disease
  • Mental Illness
  • Pancreas Disorder
  • Seizure Disorder, e.g. Epilepsy
  • Serious Breathing Disorder
  • Stomach or Intestinal Disorder

Percodan-Demi can make you dizzy, drowsy or impair your thinking. Do not drive a motor vehicle or operate heavy machinery until you know how Percodan-Demi affects you. Avoid dangerous activities that require quick reflexes.

Do not drink alcoholic beverages or use products containing while using Percodan-Demi. Alcohol increases the risk for stomach bleeding.

Alert your dentist or surgeon to your Percodan-Demi use before scheduling an operation or procedure. You may need to stop using Percodan-Demi before the procedure to reduce your risk for bleeding.

The oxycodone component of Percodan-Demi is habit-forming. Take Percodan-Demi exactly as prescribed to reduce your risk for developing a drug habit. Stop taking Percodan-Demi when you no longer need it for pain or when a doctor tells you to stop using it.

Never share prescription medication with another person, even if he expresses symptoms similar to your own. It is illegal to give a prescription medication to another person.

Pregnancy

The FDA classifies Percodan-Demi as a pregnancy category D, which means this medication may cause harm to an unborn baby and withdrawal symptoms or breathing difficulties in newborns. Taking Percodan-Demi or other preparations containing aspirin may cause bleeding in the mother and baby during delivery.

Tell the prescribing physician if you are pregnant or plan to become pregnant while using Percodan-Demi. Call your doctor if you become pregnant while taking this medication to discuss the benefits and risks. Do not take aspirin while pregnant unless directed to so by a physician. Use an effective form of birth control while using Percodan-Demi.

The oxycodone and aspirin in Percodan-Demi passes readily to breast milk and onto a nursing baby. Do not use this medication while breastfeeding.

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Warnings

Stop using Percodan-Demi and call your doctor immediately if you have black, bloody, or tarry stools and coughing up blood or vomit that looks like coffee grounds. These are symptoms of bleeding in your stomach or intestines, a serious and life threatening condition.

Do not use Percodan-Demi if you have a bleeding disorder or a recent history of stomach or intestinal bleeding. Do not use Percodan-Demi if you use a blood thinner such as warfarin, commonly known as Coumadin or Jantoven.

Do not quit Percodan-Demi suddenly, especially if you have been taking high doses or using this medication for a long time. Stopping Percodan-Demi abruptly causes unpleasant withdrawal symptoms in a person who has grown dependent upon opioids. Taper your Percodan-Demi use by taking smaller doses increasingly further apart. Talk with a doctor or rehabilitation professional if withdrawal symptoms keep you from quitting Percodan-Demi.

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Drug Interactions

Some medications may interact with Percodan-Demi in unfavorable or unsafe ways. Give the prescribing doctor and pharmacist filling your prescription a complete list of everything you take, including prescriptions, over-the-counter preparations, supplements, vitamins and herbal remedies. Do not start, stop or change the way you take any medication while using Percodan-Demi without first consulting with your physician.

Some medications interact with Percodan-Demi. Tell your doctor and pharmacist if you take a diuretic, commonly known as a water pill, or if you take oral insulin or other oral diabetes medicines. Be sure your healthcare provider knows if you are taking a blood thinner such as warfarin, sold under the brand name Coumadin. Do not use Percodan-Demi alongside an non-steroidal anti-inflammatory, or NSAID. Examples of NSAIDs include indomethacin and naproxen, sold under the brand names Indocin, Aleve, Naprosyn and others.

Tell your physician if you use an ACE inhibitor such as benazepril, captopril, fosinopril, enalapril, lisinopril, quinapril and others. Brand name ACE inhibitors include Lotensin, Capoten, Monopril, Vasotec, Prinivil, Zestril, Accupril, among others.

Talk with your doctor if you use a beta-blocker such as atenolol, labetalol, metoprolol, nadolol, propranolol, sotalol, timolol and others. Brand name beta-blockers include Tenormin, Normodyne, Trandate, Lopressor, Toprol, Corgard, Inderal, InnoPran, Betapace and Blocadren.

Notify the prescribing physician if you use acetazolamide, brand name Diamox, or methotrexate, which is sold under the brand names Rheumatrex and Trexall. Make sure she knows if you use atropine brand name Donnatal, or dimenhydrinate, sold under the brand name Dramamine. Tell her if you use Transderm-Scop, which is the brand name preparation containing scopolamine.

You may not be able to use Percodan-Demi if you use a steroid medications or a bronchodilator such as Atrovent or Spiriva. Tell your doctor if you use a bowel or bladder medications such as Detrol, Bentyl, Anaspaz, Cystospaz or Levsin.

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Side effects

Percodan-Demi, like all medications, may cause side effects in some individuals. Most of the commonly reported side effects are not serious and disappear with continued use. Contact the prescribing physician if these non-serious side effects become intolerable or if they do not go away on their own.

Non-serious side effects include:

  • Bloating
  • Constipation
  • Diarrhea
  • Dizziness
  • Drowsiness
  • Dry Mouth
  • Gas
  • Headache
  • Headache
  • Heartburn
  • Nausea or Vomiting
  • Ringing in the Ears
  • Sweating
  • Upset Stomach

Some side effects are serious or life threatening. Stop using Percodan-Demi and consult a physician immediately if you experience any serious adverse reaction while taking this medication. Serious side effects include:

  • Black, Bloody or Tarry Stools
  • Coughing Up Blood or Vomit that Looks Like Coffee Grounds
  • Shallow Breathing
  • Slow Heartbeat
  • Fast Heart Rate
  • Feeling Light-Headed or Fainting
  • Confusion or Hallucinations
  • Easy Bruising or Bleeding
  • Urinary Problems

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Overdose

An overdose of Percodan-Demi is a serious, potentially fatal emergency requiring immediate medical treatment. If you think you or another person has overdosed, contact poison control center at 1-800-222-1222 or go to the nearest hospital, emergency department, urgent care clinic, doctor's office or fire department. Call an ambulance if it is the quickest way to get the patient to the hospital.

When the patient arrives at the hospital, emergency department personnel administer naloxone or other drugs to drop Percodan-Demi to safe levels rapidly. Doctors and nurses establish an airway to help the patient breathe and pump excess Percodan-Demi from the stomach. The medical team performs other emergency, life-saving treatments such as CPR whenever necessary to counteract toxic levels of Percodan-Demi.

Overdose symptoms include:

  • Blue Lips
  • Cold, Clammy Skin
  • Coma
  • Confusion
  • Diarrhea
  • Extreme Drowsiness
  • Fainting
  • Muscle Weakness
  • Nausea or Vomiting
  • Pinpoint Pupils
  • Ringing in the Ears
  • Shallow Breathing or Absence of Breathing
  • Slow Heart Rate
  • Weak Pulse

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Abuse

Recreational users favor the oxycodone in Percodan-Demi because of the pleasant and euphoric feeling opioids provide. Abusers buy opioids illegally on the streets, by filing bogus prescriptions with pharmacies or seeking multiple prescriptions from several doctors in a practice called "doctor shopping." The DEA calls these practices "diversion" because of the way abusers divert drugs from their normal, prescribed uses. Some recreational users divert opioids by stealing or receiving drugs for free from friends or family members.

Long-term Percodan-Demi abuse increases the risk for physical dependence and opioid addiction in some individuals, especially if they consume increasingly larger doses to get high. Physical dependence results in uncomfortable withdrawal symptoms; opioid addiction causes craving and drug-seeking behaviors.

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Withdrawal

Anyone who takes Percodan-Demi for a long time can become opioid-dependent and experience withdrawal symptoms when they stop using this drug. Rehabilitation professionals recognize withdrawal symptoms as a predictable and normal physiological process and not necessarily a sign of illicit drug abuse.

The body adjusts to the presence of some foreign compounds, such as opioids, by altering its own chemical balance. With continuous use, the body begins to depend on a certain level of the drug in order to feel "normal." If opioid levels drop drastically, the dependent body battles to maintain chemical stability. The opioid-dependent individual experiences this struggle, known as detoxification, through uncomfortable withdrawal symptoms.

Physical withdrawal symptoms associated with Percodan-Demi detoxification can last five days or more while the dependent body gradually adjusts to lowered opioid levels. Withdrawal frequently causes powerful psychological symptoms, such as depression and anxiety. These psychological symptoms are often as devastating to recovery as are the physical withdrawal symptoms.

Specific withdrawal symptoms vary in severity and duration from person to person. Symptoms can be dose-dependent, meaning they are worse for individuals who took high doses or used Percodan-Demi for a long time.

Withdrawal symptoms include:

  • Anxiety
  • Diarrhea
  • Hallucinations
  • Nausea
  • Shakiness
  • Sweating
  • Tremors
  • Trouble Sleeping

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Detox

Detoxification is the medical process of decreasing the level of opioids in an opioid-dependent person. This detoxification process occurs either because the individual used less Percodan-Demi than usual or because she took a medication such as naloxone to decrease the level of opioids in her body.

Detoxification is a long and difficult journey, especially if you attempt self-detoxification without specially trained professionals to develop a treatment plan or medications that alleviate your withdrawal symptoms.

During standard detoxification treatment, physicians give drugs such as naloxone to reduce opioid levels alongside medications to address the resulting withdrawal symptoms. The patient then receives a variety of medications, including drugs to calm anxiety, ease diarrhea, quiet tremors and help the patient sleep.

Standard detoxification treatments effectively reduce withdrawal time and relieve uncomfortable physical symptoms but do little to help ease the psychological distress a patient endures during the detoxification process. Many patients report standard detoxification left them feeling demoralized and unworthy of a successful recovery.

Rapid detox is the most humane way to help an individual overcome Percodan-Demi dependence. During rapid detox, board certified anesthesiologists administer anesthesia and sedatives alongside the usual detoxification drugs. The patient dozes in a pleasant "twilight sleep " during the arduous detoxification procedure. When she awakens, she will have no memory of the grueling and demoralizing withdrawal process.

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Storage

Keep Percodan-Demi at room temperature, away from heat, light and moisture. Put Percodan-Demi where children and pets cannot reach it. Store Percodan-Demi in a place where adults or teenagers will not take this medication by accident or on purpose.

Keep track of your Percodan-Demi and account for all missing doses.

Discard Percodan-Demi when you no longer use it to control your pain or when a doctor tells you to stop using it. Flush unused Percodan-Demi down the toilet.

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Facts

  • Percodan-Demi

Programs