Oxycodone, a schedule II prescription narcotic, has benefit as a pain reliever for moderate to severe pain, but also has great potential for abuse. Both time-release oxycodone, called oxycontin and oxycodone combined with acetaminophen, sold as Percocet or combined with aspirin, sold as Percodan, have legitimate and abusive uses. In 2008, 50.1 million oxycodone prescriptions were dispensed in the United States, according to the Drug Enforcement Administration. Oxycodone can cause liver damage when taken in large quantities, especially when taken in combination with acetaminophen.
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Oxycodone, a semi-synthetic opioid agonist, has similar effects to morphine, but oxycodone is about twice as potent. Oxycodone alone appears to have the potential to cause liver enzyme elevations, according to an article published online in the May 2008 issue of “Journal of Medical Case Reports” by Australian researchers from Cairns Base Hospital. The researchers reported the case of a man who developed cholestatic hepatitis with elevated liver enzymes after taking time-released oxycontin after surgery in the prescribed amounts of 40 mg each morning and 20 mg at night.
Combination Drug Effects
Acetaminophen, an over-the-counter drug sold as Tylenol, is used in combination with oxycodone in the prescription drug Percocet. Acetaminophen can have serious, life-threatening effects on the liver when taken in large amounts. Taking more than 4 g of acetaminophen per day can cause liver damage; in rare cases, doses as low as 2.5 g per day have caused liver damage, according to the United States Food and Drug Administration. The FDA asked drug manufacturers to begin limiting the amount of acetaminophen in prescription drugs to 325 mg per tablet or capsule in 2011 and add liver damage warning to drugs containing acetaminophen in 2009.
The symptoms of elevated liver enzymes and liver damage vary. If bilirubin levels are elevated, the whites of the eye and the skin turn yellow, a condition called jaundice. If you don’t develop jaundice, you may experience fatigue and upper right quadrant abdominal pain, although you may feel no symptoms at all. If fulminant liver failure occurs from a combination oxycodone and acetaminophen overdose, psychosis, stupor, coma and death can occur.
Oxycodone alone may cause elevated liver enzymes, but damage occurs more frequently when large amounts of acetaminophen are also ingested. Drinking alcohol can also potentiate the effects of oxycodone on the liver; alcoholic patient can develop liver toxicity after even small doses of acetaminophen, Drugs.com reports.
- Drug Enforcement Administration: Oxycodone; June 2009
- PubMedHealth; Oxycodone; February 2011
- "Journal of Medical Case Reports;"Cholestatic Hepatitis as a Possible New Side-Effect of Oxycodone: A Case Report; Vincent Ho, et al.; May 2008
- Drugs.com: Oxycodone
- U.S. Food and Drug Administration; Acetaminophen Overdose and Liver Injury — Background and Options for Reducing Injury; May 2009