Search Article Directory Nauru: Combunox

Generic Name: oxycodone and ibuprofen (Oral route)

eye-bue-PROE-fen, ox-i-KOE-done hye-droe-KLOR-ide

Oral route(Tablet)

NSAIDs may cause an increased risk of serious cardiovascular thrombotic events, myocardial infarction, and stroke, which can be fatal. This risk may be increased in patients with cardiovascular disease or risk factors for cardiovascular disease. Ibuprofen/oxycodone hydrochloride is contraindicated for the treatment of perioperative pain in the setting of coronary artery bypass graft (CABG) surgery. NSAIDs can also cause an increased risk of serious gastrointestinal adverse events especially in the elderly, including bleeding, ulceration, and perforation of the stomach or intestines, which can be fatal .

Commonly used brand name(s)

In the U.S.

Combunox

Available Dosage Forms:

Tablet

Therapeutic Class: Opioid/NSAID Combination

Pharmacologic Class: NSAID

Chemical Class: Propionic Acid (class)

Uses For Combunox

Ibuprofen and oxycodone combination is used to relieve acute, moderate to severe pain.

Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) used in this combination to relieve inflammation, swelling, and pain.

Oxycodone is a narcotic analgesic that acts in the central nervous system to relieve pain. If oxycodone is used for a long time, it may become habit-forming (causing mental or physical dependence). Physical dependence may lead to withdrawal side effects when you stop taking the medicine. Since ibuprofen and oxycodone combination is only used for short-term (7 days or less) relief of pain, physical dependence probably will not occur.

This medicine is available only with your doctor's prescription.

Before Using Combunox

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of ibuprofen and oxycodone combination in children below 14 years of age. Safety and efficacy have not been established.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of oxycodone and ibuprofen combination in the elderly. However, elderly patients who may be more sensitive than younger adults to the effects of ibuprofen and oxycodone combination, are more likely to have kidney, lung, or stomach problems, which may require caution in patients receiving oxycodone and ibuprofen combination.

Pregnancy

	Pregnancy Category	Explanation
1st Trimester	C	Animal studies have shown an adverse effect and there are no adequate studies in pregnant women OR no animal studies have been conducted and there are no adequate studies in pregnant women.
2nd Trimester	C	Animal studies have shown an adverse effect and there are no adequate studies in pregnant women OR no animal studies have been conducted and there are no adequate studies in pregnant women.
3rd Trimester	D	Studies in pregnant women have demonstrated a risk to the fetus. However, the benefits of therapy in a life threatening situation or a serious disease, may outweigh the potential risk.

Breast Feeding

Studies in women breastfeeding have demonstrated harmful infant effects. An alternative to this medication should be prescribed or you should stop breastfeeding while using this medicine.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

Ketorolac

Naltrexone

Pentoxifylline

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Abciximab

Acetophenazine

Adinazolam

Alfentanil

Alprazolam

Amobarbital

Anileridine

Aprobarbital

Ardeparin

Argatroban

Atazanavir

Beta Glucan

Bivalirudin

Brofaromine

Bromazepam

Brotizolam

Buprenorphine

Buspirone

Butabarbital

Butalbital

Butorphanol

Carisoprodol

Certoparin

Chloral Hydrate

Chlordiazepoxide

Chlorpromazine

Chlorzoxazone

Cilostazol

Citalopram

Clarithromycin

Clobazam

Clonazepam

Clopidogrel

Clorazepate

Clorgyline

Clovoxamine

Codeine

Dabigatran Etexilate

Dalteparin

Danaparoid

Dantrolene

Desflurane

Desirudin

Dexmedetomidine

Dezocine

Diazepam

Diphenhydramine

Dipyridamole

Doxylamine

Enflurane

Enoxaparin

Erythromycin

Escitalopram

Estazolam

Eszopiclone

Ethchlorvynol

Ethopropazine

Femoxetine

Fentanyl

Flesinoxan

Flumazenil

Flunitrazepam

Fluoxetine

Fluphenazine

Flurazepam

Fluvoxamine

Fondaparinux

Fospropofol

Furazolidone

Ginkgo

Halazepam

Halothane

Heparin

Hydrocodone

Hydromorphone

Hydroxyzine

Indinavir

Iproniazid

Isocarboxazid

Isoflurane

Itraconazole

Ketamine

Ketazolam

Ketoconazole

Lazabemide

Lepirudin

Levorphanol

Linezolid

Lorazepam

Lormetazepam

Medazepam

Meperidine

Mephenesin

Mephobarbital

Meprobamate

Mesoridazine

Metaxalone

Methdilazine

Methocarbamol

Methohexital

Methotrexate

Midazolam

Moclobemide

Morphine

Morphine Sulfate Liposome

Nadroparin

Nalbuphine

Nefazodone

Nelfinavir

Nialamide

Nitrazepam

Nitrous Oxide

Nordazepam

Opium

Oxazepam

Oxycodone

Oxymorphone

Pargyline

Parnaparin

Paroxetine

Pemetrexed

Pentazocine

Pentobarbital

Perphenazine

Phenelzine

Phenobarbital

Prazepam

Procarbazine

Prochlorperazine

Promazine

Promethazine

Propiomazine

Propofol

Propoxyphene

Protein C

Quazepam

Ramelteon

Rasagiline

Remifentanil

Reviparin

Ritonavir

Rivaroxaban

Saquinavir

Secobarbital

Selegiline

Sertraline

Sevoflurane

Sibutramine

Sodium Oxybate

Sufentanil

Tacrolimus

Tapentadol

Telithromycin

Temazepam

Thiethylperazine

Thiopental

Thioridazine

Ticlopidine

Tinzaparin

Tirofiban

Toloxatone

Tranylcypromine

Triazolam

Trifluoperazine

Triflupromazine

Trimeprazine

Vilazodone

Zaleplon

Zimeldine

Zolpidem

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Acebutolol

Acetohexamide

Alacepril

Alprenolol

Amikacin

Amiloride

Arotinolol

Aspirin

Atenolol

Azilsartan Medoxomil

Azosemide

Befunolol

Bemetizide

Benazepril

Bendroflumethiazide

Benzthiazide

Betaxolol

Bevantolol

Bisoprolol

Bopindolol

Bucindolol

Bumetanide

Bupranolol

Buthiazide

Candesartan Cilexetil

Canrenoate

Captopril

Carteolol

Carvedilol

Celiprolol

Chlorothiazide

Chlorpropamide

Chlorthalidone

Cilazapril

Clopamide

Cyclopenthiazide

Cyclosporine

Delapril

Desipramine

Desvenlafaxine

Dilevalol

Duloxetine

Enalaprilat

Enalapril Maleate

Eprosartan

Esmolol

Ethacrynic Acid

Fosinopril

Furosemide

Gliclazide

Glimepiride

Glipizide

Gliquidone

Glyburide

Hydrochlorothiazide

Hydroflumethiazide

Imidapril

Indapamide

Irbesartan

Labetalol

Landiolol

Levobetaxolol

Levobunolol

Lisinopril

Lithium

Losartan

Mepindolol

Methyclothiazide

Metipranolol

Metolazone

Metoprolol

Miconazole

Milnacipran

Moexipril

Nadolol

Nebivolol

Nipradilol

Olmesartan Medoxomil

Oxprenolol

Penbutolol

Pentopril

Perindopril

Phenytoin

Pindolol

Piretanide

Polythiazide

Propranolol

Quinapril

Ramipril

Rifampin

Sotalol

Spirapril

Spironolactone

St John's Wort

Tacrine

Talinolol

Tasosartan

Telmisartan

Temocapril

Tertatolol

Timolol

Tolazamide

Tolbutamide

Torsemide

Trandolapril

Triamterene

Trichlormethiazide

Valsartan

Venlafaxine

Voriconazole

Xipamide

Zofenopril

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following is usually not recommended, but may be unavoidable in some cases. If used together, your doctor may change the dose or how often you use this medicine, or give you special instructions about the use of food, alcohol, or tobacco.

Ethanol

Proper Use of Combunox

For safe and effective use of this medicine, do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered. Taking too much of this medicine may increase the chance of unwanted effects.

This medicine should come with a medication guide. Read and follow these instructions carefully. Ask your doctor if you have any questions.

Dosing

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

For oral dosage form (tablets):
- For pain:
  - Adults and teenagers 14 years of age and older—One tablet every 4 to 6 hours as needed. However, the dose is usually not more than 4 tablets per day, and should not be taken for longer than 7 days, unless directed by your doctor.
  - Children and teenagers younger than 14 years of age—Use and dose must be determined by your doctor.

Missed Dose

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Precautions While Using Combunox

It is very important that your doctor check your progress while you are taking this medicine. This will allow your doctor to see if the medicine is working properly and to decide if you should continue to take it.

Your doctor will want to check your blood pressure at the beginning of treatment and monitor it throughout treatment with this medicine. If high blood pressure occurs or worsens while taking this medicine, it may lead to serious heart problems.

This medicine may increase your risk of having a heart attack or stroke. This is more likely to occur in people who already have heart disease. People who use this medicine for a long time might also have a higher risk. Some signs of serious heart problems are chest pain, tightness in the chest, fast or irregular heartbeat, or unusual flushing or warmth of the skin. Stop taking this medicine and check with your doctor right away if you notice any of these warning signs.

Ibuprofen and oxycodone combination will add to the effects of alcohol and other central nervous system (CNS) depressants (medicines that make you drowsy or less alert). Some examples of CNS depressants are antihistamines or medicines for hay fever, allergies, or colds; sedatives, tranquilizers, sleeping medicine, or other prescription pain medicine or narcotics; medicine for seizures or barbiturates; muscle relaxants; or anesthetics, including some dental anesthetics. Do not drink alcoholic beverages, and check with your medical doctor or dentist before taking any of the medicines listed above, while you are using this medicine.

This medicine may cause bleeding in your stomach or intestines. This is more likely to occur if you have had a stomach ulcer in the past, if you smoke or drink alcohol regularly, are over 60 years of age, are in poor health, or are using certain other medicines (such as steroids or a blood thinner). These problems can occur at any time with or without warning, and can be fatal. You should contact your doctor immediately if any of the following symptoms occur including black, tarry stools; bloody stools; vomiting of blood or material that looks like coffee grounds; severe or continuing stomach pain, cramping, or burning; trouble breathing; severe or continuing nausea, heartburn and/or indigestion.

Liver problems may occur while you are using this medicine. Stop using this medicine and check with your doctor right away if you have more than one of these symptoms: abdominal pain or tenderness; clay-colored stools; dark urine; decreased appetite; fever; headache; itching; loss of appetite; nausea and vomiting; skin rash; swelling of the feet or lower legs; unusual tiredness or weakness; or yellow eyes or skin.

This medicine may cause a serious type of allergic reaction called anaphylaxis. Anaphylaxis can be life-threatening and requires immediate medical attention. Call your doctor right away if you have a rash; itching; hoarseness; trouble breathing; trouble swallowing; or any swelling of your hands, face, or mouth while you are using this medicine.

Serious skin reactions can occur with this medicine. Check with your doctor right away if you have blistering, peeling, or loosening of the skin; red skin lesions; a severe skin rash or acne; sores or ulcers on the skin; or fever or chills while you are using this medicine.

Using this medicine during late pregnancy can harm your unborn baby. If you think you have become pregnant while using the medicine, tell your doctor right away. Do not use this medicine during the later part of a pregnancy unless your doctor tells you to.

This medicine may cause some people to become drowsy, dizzy, lightheaded, or to feel a false sense of well-being. Make sure you know how you react to this medicine before you drive, use machines, or do anything else that could be dangerous if you are dizzy or are not alert and clearheaded. If these reactions are especially bothersome, check with your doctor.

Dizziness, lightheadedness, or fainting may occur, especially when getting up suddenly from a lying or sitting position. Getting up slowly may lessen this problem.

Before having any kind of surgery (including dental surgery) or emergency treatment, tell the medical doctor or dentist in charge that you are taking this medicine.

Ibuprofen and oxycodone combination may cause dryness of the mouth. For temporary relief, use sugarless candy or gum, melt bits of ice in your mouth, or use a saliva substitute. However, if dry mouth continues for more than 2 weeks, check with your dentist. Continuing dryness of the mouth may increase the chance of dental disease, including tooth decay, gum disease, and fungus infections.

Call your doctor right away if you have confusion, drowsiness, fever, a general feeling of illness, a headache, loss of appetite, nausea, a stiff neck or back, or vomiting. These could be symptoms of a serious condition called meningitis.

If you have heart disease or congestive heart failure (CHF), tell your doctor if you have unexplained weight gain or edema (fluid retention or body swelling) with this medicine.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

Combunox Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

Less common

Feeling faint, dizzy, or lightheaded

feeling of warmth or heat

flushing or redness of the skin, especially on the face and neck

headache

sweating

Rare

Abdominal or stomach pain

blurred vision

changes in skin color

chest pain

confusion

convulsions

decrease in frequency of urination

decreased urine

difficulty with breathing

difficulty in passing urine (dribbling)

dizziness

dizziness, faintness, or lightheadedness when getting up from a lying position

dry mouth

excessive muscle tone

fainting

fast heartbeat

fast, pounding, or irregular heartbeat or pulse

increased need to urinate

increased thirst

loss of appetite

mood changes

muscle pain or cramps

muscle stiffness

muscle tension or tightness

nausea or vomiting

numbness or tingling in the hands, feet, or lips

pain, tenderness, or swelling of the foot or leg

painful urination

pale skin

passing urine more often

severe constipation

severe vomiting

shortness of breath

troubled breathing with exertion

unusual bleeding or bruising

unusual tiredness or weakness

weakness

Get emergency help immediately if any of the following symptoms of overdose occur:

Symptoms of overdose

Change in consciousness

chest pain or discomfort

cold and clammy skin

constricted pupils

continuing ringing or buzzing or other unexplained noise in the ears

decreased awareness or responsiveness

difficult or troubled breathing

difficulty with sleeping

disorientation

drowsiness to profound coma

fainting

hallucination

hearing loss

irregular, fast or slow, or shallow breathing

lethargy

loss of bladder control

loss of consciousness

muscle spasm or jerking of all extremities

pale or blue lips, fingernails, or skin

severe sleepiness

skeletal muscle flaccidity

sleepiness or unusual drowsiness

sudden fainting

sudden loss of consciousness

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Less common

Acid or sour stomach

belching

bloated full feeling

diarrhea

difficulty having a bowel movement (stool)

excess air or gas in the stomach or intestines

fever

heartburn

indigestion

lack or loss of strength

passing gas

stomach discomfort, upset, or pain

Rare

Back pain

body aches or pain

bruising, large, flat, blue or purplish patches in the skin

changes in vision

chills

congestion

cough or hoarseness

delusions

dementia

difficult urination

difficulty with moving

dryness or soreness of the throat

enlarged abdomen or stomach

false or unusual sense of well-being

fear

hoarseness

impaired vision

increase in body movements

lower back or side pain

nervousness

pain, swelling, or redness in the joints

rash

runny nose

sleeplessness

swelling

taste perversion

tender, swollen glands in the neck

trouble with sleeping

trouble with swallowing

unable to sleep

voice changes

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

See also: Combunox side effects (in more detail)

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More Combunox resources

Combunox Side Effects (in more detail)
Combunox Dosage
Combunox Use in Pregnancy & Breastfeeding
Combunox Drug Interactions
Combunox Support Group
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Combunox Prescribing Information (FDA)

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Combunox Consumer Overview

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