8 Percocet Side Effects to Know About and How to Manage Them

Percocet (oxycodone / acetaminophen) is an opioid medication used to treat severe pain. But since it has several risks, it’s usually reserved for people whose pain doesn’t improve with non-opioid medications. 

Like other opioids, Percocet is a controlled substance, and it has a risk of some severe side effects. This is especially true if it’s taken in a way that’s different from how it’s prescribed. However, when taken as prescribed, most Percocet side effects are mild.

Percocet side effects at a glance

Both Percocet tablets and oral liquid contain two medications: oxycodone (Oxycontin, Roxicodone) and acetaminophen (Tylenol). Oxycodone is an opioid, and acetaminophen is a non-opioid, over-the-counter (OTC) pain reliever.

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Mild Percocet side effects include:

• Nausea and vomiting

• Constipation

• Drowsiness

• Itching

• Dry mouth

• Sweating

• Trouble sleeping

• Dizziness

• Low blood pressure when changing positions (orthostatic hypotension) 

• Sexual problems, such as erectile dysfunction

In some cases, these mild side effects improve as a person adjusts to taking the medication. However, more severe side effects can also occur, including:

• Severe mood changes, such as confusion 

• Suicidal thoughts and behaviors

• Severely low blood pressure

• Falls

• Withdrawal symptoms if stopped abruptly

• Serious skin reactions, such as Stevens-Johnson Syndrome (SJS)

• Increased risk of seizures in people with existing seizure conditions

• Adrenal insufficiency (low cortisol levels)

• Increased sensitivity to pain with long-term use

• Serotonin syndrome when combined with medications that increase serotonin levels

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Percocet also comes with a few boxed warnings — a category of FDA-issued warnings that are assigned to medications with particularly severe risks. Although these risks are rare, they can be life-threatening. Percocet has boxed warnings for the following risks:

• Misuse and opioid use disorder

• Slowed breathing and overdose

• Accidental ingestion, especially in children, which can lead overdose 

• Increased side effects if taken with other substances that can slow breathing, such as benzodiazepines or alcohol

• Neonatal opioid withdrawal syndrome if taken during pregnancy

• Drug interactions with medications that can increase Percocet levels

• Liver failure with high acetaminophen dosages

Here, we’ll take a closer look at eight potential Percocet side effects and how to manage them.

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• Medications to avoid with Percocet: Many medications can make Percocet side effects worse. Avoiding these medications when taking Percocet can help keep you safe.

• Avoiding alcohol with opioids: Severe Percocet risks, like misuse and overdose, are more likely if you drink alcohol while taking the medication. That’s why it’s best to avoid this combination.

• Other pain-relief methods: Non-opioid medications and treatment methods are often safer options for treating pain. Learn about several non-opioid pain-relief alternatives.

1. Nausea and vomiting

Nausea and vomiting are some of the most common opioid side effects, and Percocet is no exception. These side effects often improve on their own within a few weeks of starting the medication, however. 

In the meantime, you can usually manage nausea at home. Taking Percocet with food and making sure you drink enough water throughout the day can help. You can also try eating smaller, more frequent meals, instead of three larger daily meals.

If these strategies don’t work or your nausea gets worse, contact your prescriber. You may need a lower Percocet dosage. Or your prescriber may recommend an anti-nausea medication as a short-term solution.

2. Constipation

Opioids, like Percocet, interfere with how food moves through your digestive system. As a result, they commonly cause constipation. But unlike nausea, constipation from Percocet may last the entire time you’re taking the medication. 

Your prescriber may recommend taking a laxative to prevent constipation when you first start treatment with Percocet. They can help you choose from the several OTC options available, if needed. Otherwise, there are several other ways to prevent constipation from Percocet, such as staying hydrated, moving your body throughout the day, and adding fiber to your diet.

If your constipation is severe or doesn’t improve, let your prescriber know. Constipation that lasts a long time can cause other health issues. Depending on the situation, your prescriber may recommend a prescription medication to treat opioid-induced constipation.

3. Drowsiness

Drowsiness is another common Percocet side effect. Drowsiness related to Percocet may improve after your body gets used to the medication. But for some people, drowsiness can be a lasting side effect that affects their quality of life.

Higher Percocet dosages increase the risk of drowsiness. That’s why it’s best to take the lowest effective dosage for the shortest amount of time possible. It’s also best to avoid taking other medications that cause drowsiness, including benzodiazepines and sleep medications, with Percocet. 

When you first start taking Percocet, avoid activities that require you to be alert, such as driving a car. Once you know how the medication affects you, speak with your prescriber to see if you can safely resume these activities.

If your drowsiness doesn’t improve, or it’s preventing you from doing daily activities, you may need a lower Percocet dosage. Or your prescriber may recommend that you stop taking the medication altogether. But don’t make any changes without talking to them first.

Good to know: Like other opioids, Percocet can affect how well you sleep at night. It can change how long you spend in different stages of sleep and may affect your breathing patterns during sleep. Poor-quality sleep at night can further contribute to daytime drowsiness. So talk to your prescriber if you feel you're not getting a good night’s sleep while taking Percocet. They may want to evaluate you further.

4. Dizziness and falls

Percocet can also cause dizziness and low blood pressure. Like drowsiness, this can make it difficult to do activities that require focus, such as driving a car or operating heavy machinery.

Additionally, dizziness and low blood pressure from Percocet can cause falls. Research shows the risk of falls with opioids is greater in the first month after starting treatment and with higher dosages. Older adults are also at greater risk than others. In fact, experts recommend that adults over 65 should avoid opioids if possible.

If you feel dizzy after taking Percocet, move carefully when changing positions (like going from sitting down to standing). And clear your home of clutter that you could trip on. If your dizziness doesn’t improve, talk to your prescriber. Continued dizziness can be a sign of another issue, such as persistently low blood pressure or adrenal insufficiency (another possible Percocet side effect).

5. Dependence and misuse

Like all opioid medications, Percocet is a controlled substance that can cause dependence and misuse. Dependence is when your body relies on a medication to feel and function normally. Misuse is when you take a medication in a way that’s different from how it’s prescribed. 

With Percocet, misuse can lead to opioid use disorder and overdose. The risk for dependence and/or misuse is greater if you:

• Take high Percocet dosages

• Take Percocet for a long period of time

• Have a history of substance misuse, including alcohol use disorder

• Take other medications or substances have a risk of misuse, like benzodiazepines

Up to 1 in 5 people who take opioids long term develop opioid use disorder. Signs of opioid use disorder include having cravings for opioids, taking more than what’s prescribed, and continuing use despite experiencing negative consequences.

To minimize your risk for dependence and misuse, only take Percocet as prescribed, take it for the shortest amount of time possible, and take the lowest effective dosage. Percocet isn’t meant to be taken long term in most cases.

If you or someone you know struggles with substance use, help is available. Call SAMHSA’s National Helpline at 1-800-662-4357 to learn about resources in your area.

6. Overdose

Overdose is a severe potential side effect of Percocet. Both the acetaminophen and oxycodone components of Percocet can cause overdose. The main risk of acetaminophen overdose is liver damage. We’ll talk more about this in the next section. 

With an oxycodone overdose, your breathing could slow down or stop completely. This is life-threatening. If you or someone around you is experiencing an overdose, call 911 immediately. While you wait for help to arrive, administer naloxone (Narcan, Zimhi) if you have it on hand. 

Naloxone is a fast-acting medication that reverses the effects of an opioid overdose. If you or someone in your household takes an opioid, it’s best to carry naloxone on you at all times. You can get the medication OTC, but your insurance plan may cover the cost if you ask your healthcare professional for a prescription.

There are several things you can do to reduce your risk of a Percocet overdose, such as:

• Only take your medications as prescribed.

• Take the lowest effective dosage for the shortest amount of time possible.

• Share your medication list with your healthcare team to avoid interacting medications. Combining Percocet with other medications or substances that can affect your breathing, like benzodiazepines or alcohol, can increase your risk of overdose.

A Percocet overdose can be life-threatening. If you’ve taken a large amount of the medication or you’re experiencing symptoms of an overdose, seek immediate medical attention by calling 911 or going to the nearest emergency room.

7. Liver damage

Liver damage is a rare Percocet side effect that’s usually caused by an acetaminophen overdose. The liver is responsible for breaking down acetaminophen. But, if you take too much of it, your liver can’t keep up. When this happens, a toxic chemical can build up and cause liver failure. Possible symptoms of an acetaminophen overdose include pain in your upper-right stomach, vomiting, and confusion. 

Taking standard dosages of Percocet is unlikely to lead to liver problems. But it’s important not to take extra acetaminophen without checking with your provider first. Keep in mind that many OTC products contain acetaminophen. NyQuil Cold & Flu (acetaminophen / dextromethorphan / doxylamine) and Excedrin Migraine (acetaminophen / aspirin / caffeine) are two examples. If you’re not sure how to read medication labels to check for acetaminophen, ask your pharmacist for help. 

For most people, the maximum daily dose of acetaminophen is 4,000 mg. For some people, like those with existing liver disease, the recommended maximum daily dose is lower.

As mentioned, alcohol can interact with opioids. But it can also interact with acetaminophen, raising your risk of liver damage. This is another reason to avoid alcohol while taking Percocet.

Call your prescriber if you think you've taken too much acetaminophen. You can also call Poison Control at 1-800-222-1222. In cases of overdose, early medical treatment can prevent liver failure. 

8. Withdrawal

Stopping Percocet treatment suddenly can cause opioid withdrawal symptoms, such as nausea and vomiting, stomach cramps, and diarrhea. You may also experience increased sweating, heart palpitations, and muscle twitching.

While withdrawal symptoms can be uncomfortable, they’re not usually life-threatening. Still, it’s not a good idea to stop taking Percocet abruptly. Talk to your prescriber if you’re interested in decreasing your dosage or stopping Percocet altogether. They can help you gradually reduce your dosage to minimize withdrawal symptoms. 

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Written by:

Alex Evans, PharmD, MBA

Alex Evans, PharmD, MBA, has been a pharmacist for 12 years. His first job was floating in a community chain pharmacy.

Edited by:

Amy B. Gragnolati, PharmD, BCPS

Amy Gragnolati, PharmD, BCPS, is a pharmacy editor for GoodRx. Amy currently holds her pharmacist license in Georgia and California.

Reviewed by:

Daphne Berryhill, RPh

Daphne Berryhill, RPh, has two decades of experience as a clinical pharmacist. She spent most of her career in the Chicago area practicing in-home infusion.

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