Oxycodone/Ibuprofen, Oral oks-i-KOH-done eye-byoo-PROH-fen

What are other names for this medicine?

Type of medicine: narcotic analgesic (painkiller)

Generic and brand names: oxycodone and ibuprofen, oral; Combunox Tablets

What is this medicine used for?

This medicine is taken by mouth to help relieve pain. It contains both a narcotic pain reliever (oxycodone) and ibuprofen.

What should my healthcare provider know before I take this medicine?

Before you take this medicine, tell your healthcare provider if you have ever had:

• an allergic reaction to any medicine
• a head injury or brain tumor
• Addison's disease
• asthma or other breathing problems
• blood disorders or bleeding problems
• heart disease, heart failure, or heart surgery
• high or low blood pressure
• kidney or liver disease
• pancreatitis
• problems with edema (swelling of the hands, ankles, or feet)
• problems with drug or alcohol abuse
• seizures
• stomach or intestinal blockage or constipation
• thyroid problems
• trouble urinating or an enlarged prostate gland
• ulcers

Tell your provider if you take steroids such as prednisone, medicine that reduces the chance of blood clots forming such as warfarin (Coumadin), or if you take an aspirin a day for heart disease or stroke.

Females of childbearing age: Talk with your healthcare provider if you are pregnant or plan to become pregnant. This medicine should not be used during the third trimester of pregnancy because it may harm the baby. Do not breast-feed while taking this medicine without your healthcare provider's approval.

How do I take it?

Check the label on the medicine for directions about your specific dose. Take this medicine exactly as your healthcare provider prescribes. Do not stop taking this medicine without your healthcare provider's approval. Do not take more or take it for a longer period of time than prescribed because this medicine may be habit-forming. Usually you will take it for 10 days or less. Also, taking too much of this medicine may increase your risk of side effects. Do not take more than 4 tablets in a 24 hour period.

You may take this medicine with or without food. Taking it with meals may lessen the chance the drug will upset your stomach.

What if I overdose?

If you or anyone else has intentionally taken too much of this medicine, call 911 or go to the emergency room right away. If you pass out, have seizures, weakness or confusion, or have trouble breathing, call 911. If you think that you or anyone else may have taken too much of this medicine, call the poison control center. Do this even if there are no signs of discomfort or poisoning. The poison control center number is 800-222-1222.

Symptoms of an acute overdose may include: extreme drowsiness, pinpoint pupils, confusion, breathing that stops, slow heartbeat, nausea, diarrhea, stomach pain, sweating, seizures, irregular heartbeat, bloody stools, dark urine, yellowing of the skin or eyes, muscle weakness, vomiting blood, decreased urination, coma.

What should I watch out for?

Warning: Occasionally this medicine may cause bleeding, ulcers, or perforation of the stomach, small intestine, or large intestine. These problems may occur with or without warning symptoms. If you have abdominal pain, a black tarry stool, or a bloody stool, stop taking this medicine and call your healthcare provider right away.

Taking this medicine for a long time may make it more likely that you will have a heart attack or stroke. Talk with your healthcare provider about this. Do not use this medicine just before or after having heart bypass surgery (also called coronary artery bypass graft, or CABG).

You may need to have lab tests regularly to see how this medicine affects you. Keep all appointments for these tests.

This medicine increases the effects of alcohol and other drugs that slow down your nervous system. Do not drink alcohol or take other medicines unless your healthcare provider approves.

This medicine may make you drowsy or dizzy. Do not drive or operate machinery unless you are fully alert.

You may feel dizzy or faint when you get up quickly after sitting or lying down. Getting up slowly may help.

Adults over the age of 65 may be at greater risk for side effects from this medicine. Talk with your healthcare provider about this.

This medicine may make you constipated. Drinking lots of water, exercising, or taking more fiber may help. You may need to take a laxative or stool softener while taking this medicine. Talk with healthcare provider or pharmacist about this.

This medicine is a controlled substance. It is illegal for you to give it to anyone else.

If you need emergency care, surgery, lab tests, or dental work, tell the healthcare provider or dentist you are taking this medicine.

What are the possible side effects?

Along with its needed effects, your medicine may cause some unwanted side effects. Some side effects may be very serious. Some side effects may go away as your body adjusts to the medicine. Tell your healthcare provider if you have any side effects that continue or get worse.

Life-threatening (Report these to your healthcare provider right away. If you cannot reach your healthcare provider right away, get emergency medical care or call 911 for help): Allergic reaction (hives; itching; rash; trouble breathing; tightness in your chest; swelling of your lips, tongue, and throat); slurred speech; weakness in one part or side of your body; sudden, severe headache with stiff neck.

Serious (report these to your healthcare provider right away): Black tarry or bloody stool; swelling of your feet, ankles, legs, or other parts of your body; fever; yellowing of your skin or eyes; vision changes; trouble urinating; unusual bruising or bleeding; severe stomach cramps; bloody vomit.

Other: Headache, nausea, vomiting, diarrhea, constipation, drowsiness, dizziness, thirst, dry mouth, heartburn, sweating.

What products might interact with this medicine?

When you take this medicine with other medicines, it can change the way this or any of the other medicines work. Nonprescription medicines, vitamins, natural remedies, and certain foods may also interact. Using these products together might cause harmful side effects. Talk to your healthcare provider if you are taking:

• ACE inhibitors such as benazepril (Lotensin), captopril, enalapril (Vasotec), fosinopril, lisinopril (Prinivil), and quinapril (Accupril)
• alcohol
• angiotensin II blockers such as candesartan (Atacand), losartan (Cozaar), and valsartan (Diovan)
• antianxiety medicines such as alprazolam (Xanax), clonazepam (Klonopin), clorazepate (Tranxene), diazepam (Valium), lorazepam (Ativan), and oxazepam
• anticholinergic medicines such as atropine sulfate, benztropine (Cogentin), dicyclomine (Bentyl), hyoscyamine (Levsin), methscopolamine (Pamine), propantheline, and trihexyphenidyl
• antihistamines such as chlorpheniramine (Chlor-Trimeton), clemastine fumarate (Tavist), and diphenhydramine (Benadryl)
• antipsychotics such as chlorpromazine, perphenazine, prochlorperazine, promazine, thioridazine, and trifluoperazine
• antiseizure medicines such as carbamazepine (Tegretol), felbamate (Felbatol), gabapentin (Neurontin), lamotrigine (Lamictal), levetiracetam (Keppra), oxcarbazepine (Trileptal), phenytoin (Dilantin), primidone (Mysoline), tiagabine (Gabitril), topiramate (Topamax), and valproic acid (Depacon, Depakene, Depakote)
• aspirin or other salicylates
• beta blockers such as acebutolol (Sectral), atenolol (Tenormin), betaxolol (Kerlone), bisoprolol (Zebeta), carteolol, esmolol (Brevibloc), metoprolol (Lopressor, Toprol XL), nadolol (Corgard), pindolol, propranolol (Inderal), sotalol (Betapace), and timolol
• cholestyramine (Questran) and colestipol (Colestid)
• corticosteroids such as dexamethasone, methylprednisolone (Medrol), and prednisone
• cyclosporine (Sandimmune, Neoral)
• digoxin (Lanoxin)
• diuretics such as furosemide (Lasix) and hydrochlorothiazide (Microzide)
• lithium (Lithobid)
• MAO inhibitor antidepressants such as isocarboxazid (Marplan), phenelzine (Nardil), selegiline (Eldepryl, Emsam), and tranylcypromine (Parnate) (Do not take this medicine and an MAO inhibitor within 14 days of each other.)
• medicines to treat or prevent blood clots such as cilostazol (Pletal), clopidogrel (Plavix), dalteparin (Fragmin), dipyridamole (Persantine), enoxaparin sodium (Lovenox), heparin, and warfarin (Coumadin)
• methotrexate
• muscle relaxants such as baclofen (Lioresal), carisoprodol (Soma), cyclobenzaprine (Flexeril), dantrolene (Dantrium), methocarbamol (Robaxin), and tizanidine (Zanaflex)
• naltrexone (ReVia)
• narcotic pain medicines such as buprenorphine (Buprenex, Subutex), butorphanol (Stadol NS), codeine, fentanyl (Duragesic, Actiq), hydrocodone (Vicodin, Lortab), hydrocodone with acetaminophen (Vicodin), meperidine (Demerol), methadone (Dolophine), morphine (MS Contin, Oramorph SR), nalbuphine (Nubain), oxycodone (OxyContin), oxycodone/acetaminophen (Percocet, Tylox), and pentazocine (Talwin)
• natural remedies such as cat's claw, dong quai, evening primrose, feverfew, garlic, ginger, ginkgo, ginseng, gotu kola, green tea, kava, red clover, St. John's wort, and valerian
• nonsteroidal anti-inflammatory drugs (NSAIDs) such as diclofenac (Voltaren, Cataflam), ibuprofen (Motrin, Motrin IB, Advil), indomethacin (Indocin), ketoprofen (Orudis, Orudis KT, Oruvail), ketorolac (Toradol), nabumetone (Relafen), naproxen (Naprosyn, Anaprox, Aleve, Naprelan), oxaprozin (Daypro), piroxicam (Feldene), and sulindac (Clinoril)
• sedatives such as butabarbital (Butisol), phenobarbital, triazolam (Halcion), zaleplon (Sonata), and zolpidem (Ambien)
• tricyclic antidepressants such as amitriptyline, desipramine (Norpramin), doxepin, imipramine (Tofranil), and nortriptyline (Pamelor)

Do not drink alcohol while you are taking this medicine.

If you are not sure if your medicines might interact, ask your pharmacist or healthcare provider. Keep a list of all your medicines with you. List all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take. Be sure that you tell all healthcare providers who treat you about all the products you are taking.

How should I store this medicine?

Store this medicine at room temperature. Keep the container tightly closed. Protect it from heat, high humidity, and bright light.

This advisory includes selected information only and may not include all side effects of this medicine or interactions with other medicines. Ask your healthcare provider or pharmacist for more information or if you have any questions.

Ask your pharmacist for the best way to dispose of outdated medicine or medicine you have not used. Do not throw medicine in the trash.

Keep all medicines out of the reach of children.

Do not share medicines with other people.