Healthy Living

A333 Pill

A333 Pill

A333 Pill

It is a white and capsule-shaped pill. It has been identified as acetaminophen/oxycodone 325mg/10 mg. It is used for the treatment of chronic pain. This drug is supplied by Actavis Elizabeth.

It is a member of the drug class narcotic analgesic combination. During pregnancy, its risk cannot be ruled out. The FDA has put it in the category C. Under the Controlled Substances Act, it has been classified as schedule 2 controlled substance. It is available only by prescription.

Expert Answers

Does acupuncture help with fertility?

Have a question aboutAcetaminophen?Ask a doctor now

Uses

Acetaminophen and oxycodone are used to relieve moderate to severe pain. This drug is a combination of an opioid and a non-opioid pain reliever. Oxycodone changes the way how the body responds to pain while acetaminophen reduces fever.

How to use the medication?

Before you start taking acetaminophen and oxycodone, read the medication guide that is provided to you by your pharmacist. Talk with your doctor if you have any concerns.

You can take this medication orally as directed by your doctor. It can be taken with or without food. However, take it with food if you have nausea. The dosage prescribed by the doctor is based on the medical condition of the patient and the way the body responds to the treatment.

Do not increase the frequency of the medication or take it for a longer period of time. Follow your doctor's advice when it comes to stopping the medication. Since it is a pain medication, it is better to take it when you start feeling pain instead of taking it when you already have severe pain.

Your doctor may give you a long-acting opioid medication if you have ongoing pain. Along with this medication, other pain relievers may also be prescribed such as naproxen or ibuprofen. If this medication has been used for a long time or at higher doses, then it may cause withdrawal reactions such as:

These symptoms may be experienced if the medication is suddenly stopped. If the medication is used for a very long time, then it may not work effectively. Consult your doctor if the medication does not work.

This medication may cause addiction in some people. If a person already has a substance disorder, then the risk of addiction is even higher. Talk with your doctor about how to reduce the risk of addiction.

Precautions

Inform your doctor or pharmacist if you are allergic to opioids. If you are allergic to anything else, then inform your doctor as well. The inactive ingredients present in this drug may also cause an allergic reaction.

Inform your doctor if you have a medical history of the following conditions:

Include the following personal or family history:

  • Substance use disorder - overuse of alcohol, drugs, or other forms of substance abuse
  • Difficulty urinating - due to an enlarged prostate
  • Stomach or intestinal problems - constipation, blockage, diarrhea due to paralytic ileus, or infection
  • Pancreatitis
  • Gallbladder disease

Other side effects of this medication are dizziness and drowsiness, so avoid operating heavy machinery or driving a car after taking this medication. Avoid consuming alcoholic beverages as well.

Individuals should avoid the consumption of alcoholic drinks or take certain drugs that contain alcohol during oxycodone treatment. When prescribing oxycodone, a patient’s history of illicit drug use or alcoholism must be considered. If necessary, treatment should start at a lower dosage.

Patients must also be closely monitored for any signs or symptoms of hypotension (low blood pressure), hypoventilation (respiratory depression), and sedation. When it comes to grapefruit-drug interactions, it is recommended to completely avoid or limit grapefruit or grapefruit juice consumption during oxycodone treatment. 

Elderly individuals are more sensitive to the side effects of this drug, which include dizziness, confusion, slow or shallow breathing, and drowsiness.

During pregnancy, this medication should only be taken when needed. Acetaminophen passes into the breast milk. On the nursing infant, it may cause undesirable effects such as difficulty feeding, unusual sleepiness, or trouble breathing.

Extensive dialysis data is not available. 

Warning

People who take acetaminophen and oxycodone are at the risk of addiction and abuse, which can cause death due to overdose. It may also cause fatal breathing problems. A minimum effective dose should be prescribed by the doctor. Also, the medication should only be taken for a short period of time.

When you start taking the medication, there would be an increased risk of severe breathing. If this medication is taken along with alcohol or drugs, it may cause drowsiness or breathing problems. It may also cause serious side effects that may cause death.

Seek immediate medical help if you experience the following serious side effects:

  • Slow or shallow breathing
  • Difficulty waking up
  • Lightheadedness
  • Dizziness
  • Drowsiness

If you accidentally swallow this medicine, get medical help right away. Keep this drug in a safe place since there is a chance of it being abused by somebody else. This tablet contains acetaminophen, which may cause serious liver disease. In a day, adults should not exceed a dose of 4,000 mg of acetaminophen.

Children and people with liver disease should take the minimum effective dose. Talk with your doctor about a safe dosage for your condition. Do not use this drug with any other drug that contains acetaminophen. Many prescription and nonprescription medications contain acetaminophen. They include cough and cold products, pain relievers, or fever reducers. Thus, always check the drug's label.

If you think you have overdosed with acetaminophen, then seek medical help right away. The liver may get damaged if alcohol is daily taken, especially when the person is on this medication.

The risks and benefits should be discussed with the doctor if a woman of childbearing age is taking this medicine. Tell your doctor if you are pregnant or planning on becoming pregnant. This medicine should only be taken when needed during pregnancy since it may harm the unborn baby if it is used for a long time during pregnancy or if it is taken near the expected delivery date.

The risk can be reduced by prescribing the lowest effective dose. If a mother has been taking this drug for a very long time, the newborn baby may develop withdrawal symptoms such as:

  • Persistent crying
  • Irritability
  • Slow shallow breathing
  • Poor feeding
  • Vomiting
  • Diarrhea
  • Difficulty in gaining weight

The baby should be closely monitored for these symptoms. 

Side Effects

Along with some benefits, acetaminophen and oxycodone may also cause some undesirable side effects. If such side effects occur and persist or are severe, then immediate medical attention is needed. The common side effects associated with acetaminophen and oxycodone are:

  • Abdominal pain
  • Fever
  • Dizziness
  • Itching
  • Headache
  • Black tarry stools or light-colored stools
  • Chills
  • Dark-colored urine
  • Nausea
  • Skin rash
  • Loss of appetite
  • Vomiting of blood
  • Yellowing of the skin
  • Bad breath

Rare symptoms may also occur such as:

  • Fever (with or without chills)
  • Lower back pain
  • Side pain
  • Sore throat
  • Unusual bleeding or bruising
  • Difficulty urinating
  • Weakness
  • Tiredness
  • Cough or hoarseness
  • Sore throat
  • White spots, sores, or ulcers in the mouth or lips

If an overdose occurs, seek immediate medical help. The symptoms of overdose are:

  • Cold and clammy skin
  • Bluish lips or skin
  • Extreme sleepiness
  • Loss of consciousness
  • Slow breathing
  • Low blood pressure or low pulse rate
  • Unconsciousness
  • Illness
  • A general feeling of discomfort

Some side effects may not need medical attention since as the body adjusts to the medicine, these side effects may go away within a few days or weeks. Also, the various ways of reducing these side effects or preventing them can be suggested by the healthcare provider.

If any of the side effects continue to persist or causes discomfort, contact your doctor immediately. A relaxing or calming feeling is a very common experience after taking this drug.

General Side Effects

  • Lightheadedness
  • Nausea
  • Vomiting
  • Dizziness
  • Drowsiness
  • Sedation

Respiratory Side Effects

There have been reports of the following conditions:

Hepatic 

  • Hepatoxicity
  • Hepatic failure
  • Hepatitis
  • Hepatic disorder
  • Increased hepatic enzymes
  • An increase in the level of bilirubin
  • Jaundice

Dose-dependent hepatic necrosis can be due to high doses of acetaminophen. This condition is potentially fatal.

Hypersensitivity

There have been reports of allergic reactions, angioedema, and anaphylaxis.

Dermatologic 

  • Pruritis
  • Rash
  • Erythema
  • Blisters
  • Flushing
  • Urticaria
  • Increased sweating

Nervous System Side Effects

Opioid Side Effects

  • Mental impairment
  • Confusion
  • Anxiety
  • Nervousness
  • Hallucination
  • agitation
  • Drug dependence
  • Drug abuse
  • Nervousness
  • Depression
  • Suicidal thoughts

Gastrointestinal 

Hematologic 

  • Agranulocytosis is a very rare side effect associated with acetaminophen.

Renal Side Effects

  • Renal insufficiency and renal failure have been reported.

Cardiovascular

Metabolic

Musculoskeletal

There have been reports on myalgia and rhabdomyolysis.

Ocular

  • Visual disturbance
  • Miosis
  • Red eye

Genitourinary

Dysuria is a common side effect.

Endocrine

  • Adrenal insufficiency
  • Androgen deficiency

Other Side Effects

Drug Interactions

Acetaminophen/oxycodone is known to show 393 major drug interactions, 533 moderate drug interactions, and 34 minor drug interactions.

Keep a list of all the prescription, nonprescription drugs, vitamin supplements, and herbal products that you take and share it with your pharmacist and doctor. Without your doctor’s approval, do not start or change your medication. Some drugs may interact with acetaminophen and oxycodone. They include:

Pain Medications

  • Pentazocine
  • Butorphanol
  • Nalbuphine
  • Naltrexone

If this medication is taken with other drugs that cause drowsiness or breathing problems, then it may increase the risk of serious side effects such as severe drowsiness, slow or shallow breathing, and dizziness. You also need to inform your doctor if you are taking the following medications:

  • Cough relievers
  • Opioid pain medications such as hydrocodone or codeine
  • Drugs for sleep or anxiety such as zolpidem, alprazolam, lorazepam
  • Alcohol
  • Marijuana
  • Antihistamines such as diphenhydramine or cetirizine
  • Muscle relaxants such as cyclobenzaprine or carisoprodol

Check the labels of all medications that you are taking in case if they contain any ingredient that may cause drowsiness. Ask your doctor about the safety of those drugs.

Some medications may affect the working and removal of oxycodone. They include:

  • Azole antifungals - ketoconazole
  • HIV medications - ritonavir
  • Macrolide antibiotics - erythromycin
  • Seizure drugs – phenytoin, carbamazepine
  • Rifamycin

This medication tends to interfere with amylase or lipase test and show a false result. Drug interactions change the effectiveness of the medicine by changing the way the medicine works. Also, the risk for serious side effects may increase due to the interaction.

Missed Dose

If you miss a dose, then take it as soon as you remember it but if it is already time for the next dose then skip the missed one. Do not double dose yourself.   

Overdose

Naloxone is given in case of an overdose along with trouble breathing. If no symptoms occur at the moment, go to the nearest emergency room right away. The person may experience the following symptoms:

  • Loss of appetite
  • Slow heartbeat
  • Slow or shallow breathing
  • Coma
  • Nausea
  • Dark-colored urine
  • Yellowing of the skin or eyes
  • Sweating
  • Abdominal pain
  • Extreme tiredness

It is against the law to share this medication with anybody else since it for your current condition. Do not use this medication for any other condition. Use the medication as directed by the doctor. To treat an opioid overdose, ask the doctor or pharmacist for naloxone.

  • Life-Threatening Respiratory Depression: Dangerous, fatal or life-threatening respiratory depression may occur during initiation or when the dose is increased.
  • Accidental Ingestion: An accidental ingestion of as little as 1 dose, especially in children, can result in a life-threatening or fatal oxycodone overdose.

Storage

Store this medicine away from light and moisture. Keep it at room temperature. When no longer needed or expired, discard the medicine properly. 

Related Clinical Trials