Can you take Xanax and Oxycodone together?

What is Xanax? What are Xanax indications?

Xanax is a Brand name for a product manufactured by Pfizer that contains short-acting benzodiazepine drug named alprazolam as an active ingredient.

Alprazolam works by affecting chemicals in the brain known as neurotransmitters that may be unbalanced in patients with different types of anxiety disorder. Xanax indications are: panic disorders with or without agoraphobia, generalized anxiety disorder and anxiety linked with depression.

It is available on the market in the form of immediate release tablet in doses of: 0.25, 1, 2 and 5 mg and in form of extended release tablet, named as Xanax XR in doses of 3 and 5 mg.

What is Oxycodone? What are Oxycodone indications?

Oxycodone is a Generic name for a painkiller drug that is used to treat moderate to severe pain. The drug belongs to the class of opioid analgesics drugs that work by changing the way your brain and nervous system respond to pain. It is a controlled substance so it can only be used under a doctor’s close supervision. Oxycodone comes in a liquid, concentrated liquid, capsule, tablet and extended-release tablet form.

The extended-release tablets are used in patients who need round-the-clock pain relief. Oxycodone was approved for use by the FDA in 1976. Like all opioid analgesics, oxycodone has come under increased scrutiny by law enforcement officers, healthcare providers, and government officials due to its potential for abuse.

How Xanax and Oxycodone work in the body?

Alprazolam, the active ingredient of Xanax works by binding to benzodiazepine BNZ-1 receptors, which are responsible for induction of sleep and benzodiazepine BNZ-2 receptors which are responsible for anticonvulsant activity, motor coordination and memory functions.

BNZ1 and BNZ2 receptors are coupled with GABAA receptors, and when alprazolam binds to them it increases GABA neurotransmitter the inhibitory effects by increasing the affinity of GABA for its binding sites. When GABA binds to its receptors it opens the chloride channel, which results in a cell membrane hyperpolarization and prevention of further cell excitation.

Oxycodone is an opioid agonist drug. Oxycodone is chemically and functionally similar to a group of natural substances in the brain known as endorphins. Endorphins work by decreasing the pain messages that your body sends to the brain.

By mimicking these substances, oxycodone also decreases the amount of pain brain thinks you’re having. Oxycodone works as a weak agonist at mu, kappa, and delta opioid receptors in the brain. Oxycodone primarily affects mu-type opioid receptors, which are coupled with G-protein receptor.

Is it safe to take xanax and oxycodone together?

Oxycodone and Xanax Drug Interactions

Xanax and Oxycodone when used together may work additively and synergistically. Using Xanax together with Oxycodone may increase side effects such as dizziness, confusion, drowsiness, and difficulty concentrating. Some people, especially the elderly, may also experience impairment in judgment, thinking and motor coordination.

Patients should also avoid or limit the use of alcohol while being treated with these drugs. Also activities that require mental alertness such as driving or operating hazardous machinery should be avoided. During concomitant use of these drugs, patients should be monitored for potentially excessive or prolonged CNS and respiratory depression.

If these drugs are used together they may increase the risk of following side effects:

Xanax side effects:

  • Drowsiness (41%)
  • Depression (10-15%)
  • Headache (10-15%)
  • Constipation (10-15%)
  • Diarrhea (10-15%)
  • Dry mouth (10-15%)
  • Tachycardia (5-10%)
  • Confusion (5-10%)
  • Insomnia (5-10%)
  • Nausea/vomiting (5-10%)
  • Blurred vision (5-10%)
  • Nasal congestion (5-10%)
  • Hypotension (1-5%)
  • Syncope (1-5%)
  • Akathisia (1-5%)
  • Dizziness (1-5%)
  • Increased salivation (1-5%)
  • Nervousness (1-5%)
  • Tremor (1-5%)
  • Weight change (1-5%)

Oxycodone side effects:

  • Agitation
  • Angina pectoris
  • Anticholinergic effects (dry mouth, palpitation, tachycardia)
  • Bradycardia
  • Cardiac arrest
  • Coma
  • Constipation
  • Dizziness
  • Dysphoria
  • Euphoria
  • Faintness
  • Mental clouding/depression
  • Myocardial infarction
  • Nausea
  • Nervousness
  • Pruritus, urticaria
  • QT-interval prolongation
  • Respiratory arrest
  • Respiratory/circulatory depression
  • Restlessness
  • Sedation
  • Seizures
  • Severe cardiac arrhythmias
  • Shock
  • ST-segment elevation
  • Sweating, flushing, warmness of face/neck/upper thorax
  • Syncope
  • Urinary retention, oliguria
  • Ventricular tachycardia
  • Visual disturbances
  • Vomiting
  • Weakness

Oxycodone interactions with other drugs

Oxycodone should never be used with following drugs:

  • This drug can decrease the effect of oxycodone. Buprenorphine can also cause withdrawal symptoms.
  • Anesthetics such as butorphanol, pentazocine and nalbuphine. These drugs can decrease the effect of oxycodone. These drugs can also cause withdrawal symptoms.

Oxycodone should be avoided in combination with following drugs:

  • Monoamine oxidase inhibitors (MAOIs), a type of antidepressant, such as tranylcypromine, isocarboxazid, phenelzine, or selegiline
  • Antidepressants such as doxepin, fluvoxamine, duloxetine, or venlafaxine.
  • Muscle relaxants such as baclofen, cyclobenzaprine, or methocarbamol.
  • Hypnotics such as zolpidem, temazepam, or estazolam.
  • Nausea and vomiting drugs such as ondansetron or promethazine.
  • Psychotic drugs, such as chlorpromazine, prochlorperazine, or thioridazine.
  • Anticholinergic drugs, such as atropine, scopolamine, or benztropine.

Oxycodone may increase the risk of side effects of these drugs.

Following drugs may increase the risk of side effects of oxycodone:

  • Antifungal drugs such as voriconazole or ketoconazole.
  • Antibiotics such as erythromycin, clarithromycin, or telithromycin.
  • HIV drugs such as ritonavir, darunavir, or atazanavir.
  • Drugs such as bupropion, duloxetine, fluoxetine, paroxetine, or sertraline.
  • Anti-arrhythmia drugs such as amiodarone or quinidine.

Following drugs can make oxycodone less effective:

  • Antibiotics such as rifampin, rifabutin, or rifapentine
  • Anticonvulsants such as carbamazepine and phenytoin.

Oxycodone use during Pregnancy

Oxycodone use during pregnancy has not been studied in humans but this medication belongs to the FDA pregnancy category B, which indicates that it is probably safe for administration during the first trimester of pregnancy. Women who use oxycodone late during their pregnancy may see symptoms of withdrawal in the infant that may include excessive crying, fever, tremors, vomiting and increased stools.

Taking Oxycodone during pregnancy may also cause breathing problems in newborns. Despite a lack of data suggesting that oxycodone is harmful to pregnant women, there is always a risk of administrating this drug during pregnancy. If a doctor prescribes this drug to a pregnant woman, woman should inform the doctor of her pregnancy before beginning withe therapy.

Oxycodone and Breastfeeding

Oxycodone is excreted into breast milk, thus it can potentially cause serious side effects in nursing infants. There is one case of infant death that was possibly related to the breastfeeding mothers who used oxycodone. Doctor should be always consulted before using this drug during pregnancy.

If a doctor prescribes oxycodone to a nursing mother, mothers should watch for any changes in her infant, such as increased drowsiness or difficulty with breathing.

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