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Every medicine must have its generic name and its brand-name. Generic name is an international name used to label particular pharmacologically active substance. If a pharmaceutical company wants to manufacture certain drug, it can assign a different brand-name to it, but it is obligated to design the drug according to protocol established for that particular drug recognized by its generic name. For example:

Percocet and Roxicet are brand names for the same drug - combination of two pain relievers: acetaminophen and oxycodone (generic names).

Analgesics Classification

Medications used to treat pain are called analgesics. There are generally two types of analgesics used to treat different types of pains - opioid and non-opioid. Non-opioid analgesics are intended for the treatment of mild and moderate pain, while opioids are much more potent and are reserved for patients with severe and chronic pain. Non-opioid analgesics include Non-steroidal anti-inflammatory drugs (NSAIDs), Acetaminophen, and corticosteroid drugs. Opioid analgesics, such as morphine, oxycodone, and codeine are very potent and they can eliminate even the most severe pains (there is no upper limit). However, they can produce significant side effects in large doses.

Combinations of Analgesics

Sometimes, there is a need to combine non-opioid and opioid drugs with the aim to achieve the best outcome of pain management. One of the basic rules of pain pharmacology is that the lowest efficient dose should be used in order to avoid side effects and interactions with other drugs. That is one of the reasons why opioid and non-opioid analgesics are often combined, such as with Percocet/Roxicet. As said above, it contains oxycodone, which is a potent opioid analgesic and acetaminophen which is the least efficient but the safest non-opioid analgesic. That way, the dose of oxycodone is reduced thanks to the combination with acetaminophen.

Percocet/Roxicet Use and Side Effects

This drug is intended for patients with moderate to severe, acute or chronic pain. It is taken orally, strictly according to doctor's prescription. Do not use this drug without consulting your doctor. It can be taken with or without food, but some patients may experience nausea if taken without food. Nausea and vomiting, dizziness, sedation, and obstipation are the most common side effects. In cases of overdose, patients may experience respiratory depression, decreased blood pressure and even shock.

Withdrawal symptoms can also be severe, so the withdrawal should be gradual and according to doctor's instructions.

As Percocet/Roxicet contains an opioid drug, it can produce drug addiction - need and desire to take the drug in increasing doses in order to achieve same satisfying effects. Although the fear of drug addiction is real in prolonged use, it should not overcome the need to manage the pain properly, especially in patients with terminal stage of disease. Studies have shown that cancer patients with good pain management live significantly longer than those with poor pain management.

Pain Management during Pregnancy and Breastfeeding

It is certainly not recommended to use any drugs during pregnancy (excluding folic acid and some vitamins), but pain management is sometimes unavoidable. In fact, there are many drugs that are considered safe if used according to instructions and that can be used to relief pain during pregnancy. Although there were not many studies, Acetaminophen was not associated with any birth defects so far and is most commonly prescribed analgesic in pregnancy. Aspirin is often prescribed, but some studies suggest that it should not be used during the first trimester. NSAIDs are also not recommended during pregnancy, and they are even contraindicated during the third trimester. Opioid analgesics used for moderate and severe pain did not show significant association with birth defects and so far, the interference with embryonic and fetal development was not found.

As well as during pregnancy, acetaminophen is also considered the safest drug during breastfeeding. Aspirin should not be used during breastfeeding due to high concentrations in breast milk and side effects noticed in infants. NSAIDs can be used, but only in recommended doses and according to doctor's instructions. Use of opioid analgesics during breastfeeding is controversial due to some new data suggesting adverse effects in newborns.

In conclusion, acetaminophen is the safest drug to use during pregnancy and breastfeeding. The lack of scientific evidence about safety issues is a real problem and it comes from very strict regulations regarding clinical trials on pregnant women.

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