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Opiate Combinations

DrugOpiate combinations with acetaminophen or ibuprofen

May 2014

Generic products containing 325mg APAP are preferred products

Brand name Generic ingredients Strengths
Magnacet
Alcet
Xolox
oxycodone/acetaminophen 2.5/400 mg, 5mg/400 mg, 10 mg/400 mg, 7.5/400 mg
Primlev 5/300 mg, 7.5/300 mg, 10/300 mg
Xodol Hydrocodone/Acetaminophen 5/300 mg, 7.5/300 mg, 10/300 mg
Combunox Oxycodone/Ibuprofen 5/400 mg
Ibudone Hydrocodone/Ibuprofen 5/200 mg, 10/200 mg
Reprexain
2.5/200 mg, 5/200 mg, 10/200 mg

Criteria

Combunox, generic oxycodone/ibuprofen, Ibudone, Reprexain and generic hydrocodone/ibuprofen

  • Patient is greater than 14 years of age and has acute, moderate-to-severe pain
  • Patient has not had adequate pain relief from ibuprofen plus any IR opioid analgesic used concomitantly and prescriber states why a combination product must be used

One fill allowed. Intended use per label is for short term, acute pain of 7 to 10 days.

Magnacet, Primlev, Alcet, Xolox (oxycodone/acetaminophen)

  • Patient is being treated for moderate to moderately severe pain and has not had adequate pain relief from any of the following:
    • generic oxycodone/acetaminophen products (e.g., generic product with 325 mg APAP)
    • generic hydrocodone products (e.g., generic product with 325 mg APAP) 
  • and prescriber has a reason why a combination product must be used

Xodol tablet (hydrocodone bit/acetaminophen)  

  • Patient is being treated for moderate to moderately severe pain and has not had adequate pain relief from all of the following at equipotent dosing:
    • generic oxycodone/acetaminophen products (e.g., generic Percocet)
    • generic hydrocodone/acetaminophen products (e.g., generic product with 325 mg APAP) 
  • and prescriber has a reason why a combination product must be used

Questions?

MHCP Provider Call Center 651-431-2700 or 800-366-5411

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