Percocet is a widely prescribed medication used to manage moderate to severe pain, but like other opioids, it comes with a risk of dangerous drug interactions. If you are prescribed Percocet, understanding its potential interactions with other medications, supplements and substances is essential for your safety.
Crossroads Treatment Centers understands the dangers associated with opioid use, including Percocet. As part of our commitment to helping individuals overcome opioid dependency, we provide substance use disorder treatment that addresses individual needs with a whole-person care approach.
Antacids
Antacids, commonly used to relieve indigestion and acid reflux, can interfere with how Percocet is absorbed in the stomach. Some antacids, particularly those containing Magnesium or Aluminum Hydroxide, can delay or reduce the absorption of the opioid component of Percocet, potentially decreasing its effectiveness.
In some cases, this interaction can cause fluctuations in pain relief, leading patients to take more Percocet than prescribed. Patients using antacids regularly should inform their doctor to ensure proper management of their pain medication.
Alcohol
Combining Percocet with alcohol is particularly dangerous because both substances depress the central nervous system. When taken together, the interaction can significantly increase the risk of respiratory depression, which can lead to shallow breathing or difficulty waking up. In extreme cases, mixing Percocet and alcohol can result in coma or death. Even moderate drinking while on Percocet should be avoided, as the combination can intensify side effects like dizziness, drowsiness and confusion.
Benzodiazepines
Benzodiazepines, such as Lorazepam (Ativan) or Alprazolam (Xanax), are prescribed for anxiety and insomnia, but their sedative effects make them a dangerous combination with Percocet. Both drugs slow down brain activity, increasing the risk of extreme sedation, respiratory failure and overdose.
The FDA has issued warnings about the high potential for fatal outcomes when benzodiazepines are taken with opioids like Percocet. If you are on either of these medications, your healthcare provider should closely monitor your dosage.
Antidepressants
Selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) are commonly prescribed to treat depression and anxiety. These medications, including Fluoxetine (Prozac) and Duloxetine (Cymbalta), raise serotonin levels in the brain. When combined with Percocet, which also affects serotonin, the risk of serotonin syndrome can become a significant concern.
Serotonin syndrome is a potentially life-threatening condition marked by agitation, rapid heart rate, high blood pressure and confusion. Patients taking antidepressants must consult their doctor before starting Percocet to avoid potentially dangerous interactions with antidepressants.
Muscle Relaxers
Medications like Cyclobenzaprine (Flexeril) and Methocarbamol (Robaxin) are muscle relaxers commonly prescribed for muscle spasms or pain. These drugs can cause drowsiness, and when combined with Percocet, the sedative effects are amplified. The result can be extreme fatigue, impaired motor skills and an increased risk of accidents or falls. More concerning is the potential for respiratory depression, where breathing becomes dangerously slow.
Antihistamines
Over-the-counter antihistamines such as Diphenhydramine (Benadryl) or Cetirizine (Zyrtec) are often used to treat allergies or cold symptoms. However, these medications can cause drowsiness, and when mixed with Percocet, this side effect can be intensified.
The sedative combination may impair your ability to drive or perform tasks that require alertness. Additionally, taking Percocet with sedating antihistamines increases the risk of breathing difficulties. You should check with your healthcare provider or pharmacist before combining these drugs.
Monoamine Oxidase Inhibitors (MAOIs)
MAOIs, such as Selegiline or Phenelzine, are a class of antidepressants used to treat mood disorders like depression and Parkinson’s disease. Combining MAOIs with Percocet can lead to dangerously high levels of serotonin in the brain, increasing the risk of serotonin syndrome.
Additionally, the combination can cause dangerously high blood pressure. Because MAOIs have a long-lasting effect, patients should avoid taking Percocet for at least 14 days after discontinuing MAOI treatment to prevent life-threatening complications.
Other Opioids
Taking Percocet alongside other opioid medications, including Hydrocodone or Fentanyl, greatly increases the risk of overdose. The combined effects can overwhelm your central nervous system, leading to respiratory failure, coma or death.
Patients who are prescribed multiple opioids should inform their healthcare provider immediately, as alternative treatments for pain management may be needed to avoid life-threatening side effects. If you or a loved one is struggling with opioid use, opioid use disorder (OUD) treatment may be necessary to manage the risk. Crossroads treats 25,000+ patients per month and is an expert in treating OUD.
Cough Suppressants
Over-the-counter cough medications containing Dextromethorphan (in products like Robitussin DM) can cause drowsiness and sedation. Mixing Percocet with these medications increases the risk of extreme tiredness, dizziness and respiratory depression. While these medications are commonly used to treat cold symptoms, patients taking Percocet should avoid using cough suppressants unless advised otherwise by their doctor.
Antipsychotics
Medications like Risperidone (Risperdal) and Olanzapine (Zyprexa) are antipsychotics used to manage schizophrenia and bipolar disorder. These medications lower the seizure threshold and may increase the risk of seizures when combined with Percocet.
Additionally, the sedative effects of both drugs can intensify, leading to profound drowsiness, confusion or even respiratory problems. If you are taking antipsychotic medications, discuss the potential risks with your healthcare provider before using Percocet.
Diuretics
Diuretics, commonly called “water pills,” manage high blood pressure and reduce fluid retention. However, when taken with Percocet, these medications can be less effective. Percocet may promote the release of antidiuretic hormones, leading to fluid retention and diminished diuretic efficacy. Patients using diuretics alongside Percocet should be monitored for signs of fluid retention and increased blood pressure.
Anticonvulsants
Anticonvulsant medications, such as Carbamazepine (Tegretol) and Phenytoin (Dilantin), used to control seizures, may decrease the effectiveness of Percocet. These medications speed up the metabolism of Percocet in the liver, leading to lower levels of the drug in the bloodstream. As a result, patients may not experience adequate pain relief and could be tempted to take higher doses, increasing the risk of side effects or overdose.
St. John’s Wort
St. John’s Wort is an herbal supplement commonly used to treat mild depression and anxiety. However, it can interact with Percocet by increasing the risk of serotonin syndrome, especially when combined with other medications that affect serotonin levels. Symptoms of serotonin syndrome include confusion, rapid heart rate and high blood pressure.
Naltrexone
Naltrexone, often used in substance use disorder treatment, blocks the effects of opioids. Patients recovering from opioid addiction and taking Naltrexone should avoid Percocet, as the combination can trigger withdrawal symptoms such as nausea, agitation and muscle aches.
Blood Thinners
Medications like Warfarin are prescribed to prevent blood clots but taking Percocet while on blood thinners can increase the risk of bleeding. It is especially concerning for patients prone to gastrointestinal bleeding or other complications. Patients taking blood thinners should closely monitor for signs of excessive bleeding or bruising and notify their healthcare provider of any issues.
Grapefruit and Grapefruit Juice
While many people don’t think of fruit as a risk factor for drug interactions, grapefruit and grapefruit juice can interact with Percocet and other medications. Grapefruit inhibits the enzyme responsible for metabolizing Percocet, leading to higher drug levels in your bloodstream.
This can amplify the effects of the opioid, resulting in increased drowsiness, dizziness and the risk of overdose. If prescribed Percocet, avoid consuming grapefruit or its juice or consult your healthcare provider about any potential risks.
Protease Inhibitors
Protease Inhibitors are antiviral drugs often prescribed to treat HIV. Medications like Ritonavir and Lopinavir can interfere with the metabolism of Percocet, leading to increased levels of the drug in the bloodstream. This raises the risk of opioid toxicity, including respiratory depression, extreme drowsiness and difficulty waking up. Those taking Protease Inhibitors should discuss safe pain management options with their healthcare provider before using Percocet.
Beta-Blockers
Beta-blockers, such as Propranolol and Atenolol, are commonly used to treat high blood pressure and heart conditions. When combined with Percocet, these medications can further slow the heart rate and reduce blood pressure, leading to symptoms of hypotension, such as dizziness or fainting. Additionally, the sedative effects of both drugs can be enhanced, resulting in extreme fatigue and lethargy. If you are on beta-blockers, discuss the potential risks with your doctor before taking Percocet.
Antifungal Medications
Certain antifungal medications, including Ketoconazole and Itraconazole, can interfere with the way Percocet is broken down in the liver. It can result in higher concentrations of the opioid in the bloodstream, increasing the risk of overdose. Symptoms of opioid toxicity, such as extreme drowsiness, confusion and respiratory depression, can occur when these medications are combined.
Antibiotics
Some antibiotics, particularly Macrolides like Erythromycin and Clarithromycin, can slow down the metabolism of Percocet. This might cause the drug to accumulate in your system, raising the risk of side effects such as drowsiness, dizziness and respiratory issues. Individuals on antibiotic therapy should inform their doctor about their Percocet use to avoid potential complications and to determine the safest course of treatment.
NSAIDs (Non-Steroidal Anti-Inflammatory Drugs)
While non-steroidal anti-inflammatory drugs (NSAIDs) such as Ibuprofen or Naproxen are commonly used to relieve pain, combining them with Percocet can increase the risk of gastrointestinal bleeding. The opioid component of Percocet can cause constipation, while NSAIDs may irritate the stomach lining, leading to ulcers or bleeding. If you need additional pain relief while taking Percocet, consult your healthcare provider to make sure that the combination is safe and effective for you.
Barbiturates
Barbiturates, such as Phenobarbital and Butalbital, are central nervous system depressants often used to treat seizures and anxiety. When combined with Percocet, barbiturates can severely depress the central nervous system, leading to life-threatening complications such as respiratory failure, extreme sedation or even coma.
The FDA has issued strong warnings against combining opioids like Percocet with Barbiturates due to these high risks. Patients on barbiturates should explore alternative pain relief options with their healthcare provider.
Navigating Drug Interactions with Percocet
Understanding the potential drug interactions with Percocet is essential for preventing severe side effects and complications. From common medications like antihistamines and muscle relaxers to more specialized treatments like anti-seizure drugs and barbiturates, each can significantly impact how Percocet works in your body.
Crossroads Treatment Centers provides SUD treatment to help individuals facing the challenges of opioid dependency. If you or a loved one are prescribed Percocet, it is crucial to communicate openly with your healthcare provider about any other medications or supplements you are taking for a safe and effective treatment plan. If you or someone you know is struggling with managing opioid use, please reach out to us today.