Taking Percocet (Oxycodone/APAP) With Goody's Headache Powder

In our latest question and answer, our pharmacist discusses whether or not it is safe to combine Percocet (oxycodone/acetaminophen) and Goody's Headache Powder.

Nov 17, 2017

Rick asked

I took a Percocet for a tooth ache 2 hours ago and now I have a headache. Can I take Goody's Headache Powder?


Both Percocet and Goody’s Headache Powder contain acetaminophen (Tylenol). It is therefore important to understand the maximum daily dosage of acetaminophen when considering this question. Additionally, the cause of the headache and alternative treatment options are important to consider.

How Percocet Works

Percocet contains oxycodone and acetaminophen which provides a complementary mechanism for treating a wide variety of pain. Oxycodone, as well as other opioids, activates the mu-opiate receptor and reduces perception of pain from the Central Nervous System (CNS). Opioids also change the way you respond to pain emotionally—giving the user a sense of euphoria and disinhibition. It is also important to note that Percocet may also cause headaches in some cases.

Acetaminophen inhibits cyclooxygenase (COX) in both COX-1 and COX-2 forms. Acetaminophen blocks COX in the CNS, which differs from nonsteroidal anti-inflammatory drugs (NSAIDs) that mostly work locally in the tissues. In order to avoid untoward effects like addiction, constipation, and respiratory depression, the lowest dose for the shortest duration is recommended when taking Percocet and other opioids.


How Goody’s Works

Goody’s Headache Powder contains aspirin, acetaminophen, and caffeine. The amount of each ingredient varies based on the particular type of Goody’s Powder, but the Extra Strength contains 260 mg of acetaminophen, 520 mg of aspirin, and 32.5 mg of caffeine. Aspirin and acetaminophen have similar mechanisms that block COX-mediated pain. Caffeine causes constriction of blood vessels surrounding your brain which decreases blood flow and therefore headache related tension.


What Happens When You Take Both

Because both of these products contain acetaminophen, it is important to know the amount in each dose. For Percocet, each tablet generally consists of 325 mg of acetaminophen and between 2.5 and 10 mg of oxycodone. Previously, higher acetaminophen doses were found in combination products such as Percocet and Lortab (hydrocodone/acetaminophen). However, the FDA recently moved to limit the amount of acetaminophen to 325 mg in each tablet. The max daily dose of acetaminophen is recommended to be 4000 mg due to the potential for liver damage. This is caused by a build-up of the toxic metabolite N-acetyl-para-benzoquinoneimine (NAPQI).

It would generally not be recommended to take two products with acetaminophen together (even within two hours), but in this case the combined dose would be estimated to be 585 mg—well under the maximum daily dose. Assuming the maximum daily dose was not exceeded and this is not a routine occurrence, it would not be expected to cause harm in most patients.


Other Options For Headache

If you want to avoid the risk of taking two acetaminophen products together, there are other options to treat headache. Over-the-counter NSAIDs, such as ibuprofen (Advil, Motrin) and Aleve (naproxen) may help. Before taking NSAIDs, caution should be taken in patients with GI or cardiac conditions, including hypertension. In addition, understanding the trigger of the headache can help resolve and/or prevent the headache. Avoiding bright lights and loud noises, ensuring plenty of rest and hydration, and alleviating stress can also mitigate headaches.

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