Percocet and Surgery Risks and Side Effects

Percocet is a pain medication commonly prescribed for moderate to severe pain after surgery. It is a narcotic and only available by prescription. It is also known as an opioid or analgesic and contains two medications, Tylenol (acetaminophen), a non-opioid pain reliever, and the opioid oxycodone.

Percocet is an opioid, which means that it is a morphine-based medication and should be taken with caution. It is known by several brand names, including Primlev, Roxicet, Endocet, and Xartemis XR.

Uses

Percocet is used for the treatment of moderate to severe pain. It typically is used for a short time during the early days of postsurgical recovery.

Patients may have difficulty coughing or performing limited amounts of exercise like taking short walks due to pain, which increases the risk of pneumonia (an infection of the lungs) and blood clots after surgery. Decreasing pain helps make these routine tasks tolerable, and it can lower the risk of side effects.

Dosage

Percocet is given as an oral medication and is available in many strengths. When prescribed after surgery, the pill typically contains 5 milligrams, 7.5 milligrams, or 10 milligrams of oxycodone.

Each pill contains 325 milligrams or more of Tylenol. It may be given every 4–6 hours, usually on an as-needed basis. Pain will still be present but will be more tolerable. 

How Does Percocet Work?

Percocet works in two ways. Oxycodone partially blocks the sensation of pain from reaching the brain. This doesn’t mean that you won’t feel pain, but it will decrease the intensity of pain that you feel. 

Acetaminophen relieves inflammation and may make the oxycodone portion of the medication more effective. 

Side Effects

Side effects include:

• Along with pain relief, some patients will feel very relaxed when taking Percocet.
• Individuals who are taking this type of medication for the first time, or who rarely take this type of medication, may feel sleepy.
• Blood pressure is often lower when taking pain medication, as blood pressure often increases in response to pain.
• Decreased respiratory drive, which results in breathing slower and less deeply, is a known issue when taking Percocet.

Tylenol Issues

Tylenol, also known as paracetamol or acetaminophen, can be dangerous in high doses. Too much Tylenol can cause permanent liver damage, liver failure, or even death.

The maximum recommended dosage is 4,000 milligrams (4 grams) per day. This maximum dosage is safe in the short term but should be avoided in the long term.

If you have liver disease, you should avoid Tylenol whenever possible, unless directed by your healthcare provider.

Risks

Risks include:

• Percocet should not be taken by a pregnant woman unless deemed necessary. Prolonged use by a pregnant woman can result in addiction in a newborn.
• Breastfeeding mothers should not use Percocet. Both the oxycodone and acetaminophen components can pass to the infant and lead to significant breathing issues.
• Constipation is common with all opioid-based medications. Drinking more water and eating high-fiber foods may help. Oral laxatives (bisacodyl, senna) are usually safe for opioid-induced constipation. A stool softener may be added while taking these medications.
• Patients with liver disease may require smaller doses than typical or less-frequent dosing.
• This medication should not be combined with other pain medications that cause respiratory depression (decreased breathing) or medications that are sedating, such as sleeping pills. The combination of several medications that induce sleep or decrease breathing can be life-threatening.
• Percocet should not be taken while drinking alcohol.
• Percocet should not be taken with an MAO inhibitor, such as: Marplan (isocarboxazid), Nardil (phenelzine), Azilect (rasagiline), Eldepryl or Zelapar (selegiline), Parnate (tranylcypromine).
• This medication may need to be slowly decreased if taken for an extended time, as physical addiction may occur.
• Percocet should only be taken as directed and only as long as your pain makes it necessary.

Tolerance

When taken over time, the effects of Percocet decrease as you become used to the medication. You may require a higher dose long term to obtain the same level of pain relief.

One way of dealing with tolerance is a "drug holiday." Your healthcare provider may request that you take a drug holiday, meaning you refrain from taking Percocet for a period of time or you take a smaller dose in order to decrease your tolerance for the medication. After this period your original dose will likely be more effective again. 

This reduction in dosage may also be needed prior to surgery. If you routinely take Percocet for pain, reducing your dose prior to surgery will make the original dose more effective for your surgical pain.

Physical Dependence

Percocet can be physically addicting. Physical dependence happens when your body becomes accustomed to taking this medication for an extended length of time.

Withdrawal means that your body has started to expect Percocet to be routinely available. Using this medication as directed is key to preventing addiction and abuse.

Percocet does have a high potential for abuse, meaning when individuals seek Percocet even though they are not having pain. They are looking for the high that comes with the medication, or the sedative effects. This type of addiction may require professional treatment.

You should not share any Percocet that you may have left over after a procedure, and you should not sell your medication. This is illegal and has the potential to harm others. Discard leftover medication, as it can be harmful if taken by children, and is often stolen.

You may want to refrain from telling people you are taking pain medications, as home invasions have been reported by individuals with prescription narcotics in the house.

A Word From Verywell

While many people have concerns about the addictive nature of Percocet, when used as directed and for only as long as is necessary to recovery from acute surgical pain, the risk of addiction is low. Appropriate pain management can speed the healing process and make the return to normal activities both quicker and less painful.