Last Updated: August 9, 2026

CLINICAL TRIALS PROFILE FOR OXYCODONE AND ACETAMINOPHEN


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505(b)(2) Clinical Trials for OXYCODONE AND ACETAMINOPHEN

This table shows clinical trials for potential 505(b)(2) applications. See the next table for all clinical trials
Trial Type Trial ID Title Status Sponsor Phase Start Date Summary
OTC NCT00245375 ↗ A Trial Comparing Combination Therapy of Acetaminophen Plus Ibuprofen Versus Tylenol #3 for the Treatment of Pain After Outpatient Surgery Completed McNeil Consumer & Specialty Pharmaceuticals, a Division of McNeil-PPC, Inc. N/A 2005-01-01 Increasingly in general surgery, the investigators are conducting outpatient day surgery. Ambulatory surgery currently comprises 60 to 70% of surgeries performed in North America. These patients all require some form of analgesia which can be taken at home in the first few days after the surgery. The current standard at the investigators' centre and many others in the maritime provinces is to provide a prescription for oral acetaminophen plus codeine or oxycodone (Tylenol #3®, Percocet ®). Some patients may receive more potent opioids such as oral hydromorphone (Dilaudid®). Unfortunately, the most commonly prescribed medication (Tylenol #3®) is often poorly tolerated by patients, has several undesirable side effects, and may not provide effective pain relief. In the investigators' experience, non-steroidal anti-inflammatory drugs (NSAIDs) are uncommonly a routine addition to the home analgesic regimen. Tylenol #3®, in the investigators' experience and opinion, is a poor post surgical pain medication. They hope to show that a combination of ibuprofen and acetaminophen is better for pain relief after these procedures. The combination of acetaminophen and ibuprofen would be a safe, cheap, and readily available regimen. Unfortunately, as the prescribing practices of surgeons are old habits, it will require a very convincing argument to get them to change their practices. A randomized controlled trial comparing these two regimens, the investigators hope, would be a powerful enough argument. The hypothesis of this study, therefore, is that the pain control provided by a combination of acetaminophen plus ibuprofen (650 mg/400 mg four times per day) will be superior to Tylenol #3® (600 mg acetaminophen/60 mg codeine/15 mg caffeine four times per day). This study will attempt to enroll 150 patients in total. Eligible patients will be identified by their attending surgeon and contacted by study personnel. Patients who enroll in the study will undergo their surgery in the usual manner. After the surgery, in the recovery room, once they are ready to go home, they will be randomized to receive combination A or B and be given a week's worth of pain medication. They will then go home and take this medication as directed. They will record their pain intensity and pain relief once per day using a diary provided in the study package. One week after their surgery, they will return to the hospital clinic and be seen by the study nurse. They will hand over the diary and any unused medication. They will also be asked several questions regarding their overall satisfaction, incidence of side effects, and how long until they were pain free. The risks of participating in this study are minimal from the risks inherent to the procedures and medications the patients would receive within the standard of care. Ibuprofen is a commonly used NSAID which is widely available over the counter and has an established safety profile. The most common adverse effects of ibuprofen and other NSAIDs are gastrointestinal bleeding and ulceration. Other less common adverse effects include nephrotoxicity, hypersensitivity reactions, hepatic dysfunction (longterm use), and cognitive dysfunction. The investigators' patients will be selected to exclude those most at risk for these complications (see exclusion criteria). Acetaminophen has few side effects, with no adverse effects on platelet function and no evidence of gastric irritation.
OTC NCT00245375 ↗ A Trial Comparing Combination Therapy of Acetaminophen Plus Ibuprofen Versus Tylenol #3 for the Treatment of Pain After Outpatient Surgery Completed Nova Scotia Health Authority N/A 2005-01-01 Increasingly in general surgery, the investigators are conducting outpatient day surgery. Ambulatory surgery currently comprises 60 to 70% of surgeries performed in North America. These patients all require some form of analgesia which can be taken at home in the first few days after the surgery. The current standard at the investigators' centre and many others in the maritime provinces is to provide a prescription for oral acetaminophen plus codeine or oxycodone (Tylenol #3®, Percocet ®). Some patients may receive more potent opioids such as oral hydromorphone (Dilaudid®). Unfortunately, the most commonly prescribed medication (Tylenol #3®) is often poorly tolerated by patients, has several undesirable side effects, and may not provide effective pain relief. In the investigators' experience, non-steroidal anti-inflammatory drugs (NSAIDs) are uncommonly a routine addition to the home analgesic regimen. Tylenol #3®, in the investigators' experience and opinion, is a poor post surgical pain medication. They hope to show that a combination of ibuprofen and acetaminophen is better for pain relief after these procedures. The combination of acetaminophen and ibuprofen would be a safe, cheap, and readily available regimen. Unfortunately, as the prescribing practices of surgeons are old habits, it will require a very convincing argument to get them to change their practices. A randomized controlled trial comparing these two regimens, the investigators hope, would be a powerful enough argument. The hypothesis of this study, therefore, is that the pain control provided by a combination of acetaminophen plus ibuprofen (650 mg/400 mg four times per day) will be superior to Tylenol #3® (600 mg acetaminophen/60 mg codeine/15 mg caffeine four times per day). This study will attempt to enroll 150 patients in total. Eligible patients will be identified by their attending surgeon and contacted by study personnel. Patients who enroll in the study will undergo their surgery in the usual manner. After the surgery, in the recovery room, once they are ready to go home, they will be randomized to receive combination A or B and be given a week's worth of pain medication. They will then go home and take this medication as directed. They will record their pain intensity and pain relief once per day using a diary provided in the study package. One week after their surgery, they will return to the hospital clinic and be seen by the study nurse. They will hand over the diary and any unused medication. They will also be asked several questions regarding their overall satisfaction, incidence of side effects, and how long until they were pain free. The risks of participating in this study are minimal from the risks inherent to the procedures and medications the patients would receive within the standard of care. Ibuprofen is a commonly used NSAID which is widely available over the counter and has an established safety profile. The most common adverse effects of ibuprofen and other NSAIDs are gastrointestinal bleeding and ulceration. Other less common adverse effects include nephrotoxicity, hypersensitivity reactions, hepatic dysfunction (longterm use), and cognitive dysfunction. The investigators' patients will be selected to exclude those most at risk for these complications (see exclusion criteria). Acetaminophen has few side effects, with no adverse effects on platelet function and no evidence of gastric irritation.
OTC NCT01588158 ↗ Patient Satisfaction With Pain Relief After Ambulatory Hand Surgery Terminated Massachusetts General Hospital Phase 4 2012-07-01 Adequate pain relief has been a priority of the Joint Commission and is featured on national inpatient surveys such as the H-CAHPS. When considering methods for improving satisfaction with pain relief in the United States, a great deal of emphasis has been placed on opioid pain medications. Some of this emphasis on opioid pain medication is driven by the pharmaceutical industry and by advocacy groups with ties to the pharmaceutical industry. There is evidence that the "pain is the fifth vital sign" campaign of the Joint Commission led to an increased incidence of prescription of opioids, but there is less evidence of improved satisfaction with pain relief. There is some evidence of an increase in opioid-related adverse events. As the sales of opioids have tripled from 1999-2008, so has the number of deaths caused by opioid overdose; 14,800 in 2008. The number of visits to the Emergency Department for opioid overdose doubled between 2004 and 2008. Patients in other countries take far less opioid pain medication and are equally satisfied with pain relief. For instance, Lindenhovius et al. found in a retrospective study that Dutch patients take a weak (Tramadol) or no opioid pain medication after ankle fracture surgery and have comparable or better satisfaction with pain relief than American patients, most of whom take oxycodone. That study was repeated prospectively (unpublished) and confirmed that Dutch patients do not feel their pain is undertreated. A study of morphine use after a femur fracture demonstrated that American patients used far more than Vietnamese patients (30 mg/kg versus 0.9 mg/kg), but were more dissatisfied with their pain relief. These sociological differences are striking and suggest strongly that personal factors may be the most important determinant of satisfaction with pain relief. It is our impression that most American hand surgeons give patients a prescription for an opioid pain medication after carpal tunnel release, and that is certainly true in our practice. This seems to be based primarily on the outliers, and intended to avoid confrontation with patients that desire opioids; however, most patients take little or no narcotic pain medication, and many who do use the opioids complain of the side effects-nausea and pruritis in particular. It is therefore not clear whether routine opioids is the optimal pain management strategy after carpal tunnel release. In the study of Stahl et al. from Israel, patients were prescribed acetaminophen rather than opioids after carpal tunnel release and only 20 of 50 patients used acetaminophen; 30 patients did not use acetaminophen or other pain medication at all after the operation. Our aim is to determine if there is a difference in satisfaction with pain relief between patients advised to take opioids compared to patients advised to use over the counter acetaminophen after carpal tunnel release under local anesthesia. A secondary aim is to determine if personal factors account for more of the variability in satisfaction with pain relief than opioid strategy.
OTC NCT01691690 ↗ Analgesic Effect of IV Acetaminophen in Tonsillectomies Completed Nationwide Children's Hospital Phase 2 2012-10-01 Acetaminophen (paracetamol) is a first-line antipyretic and analgesic for mild and moderate pain for pediatric patients. Its common use (particularly in oral form) is underscored by its wide therapeutic window, safety profile, over the counter accessibility, lack of adverse systemic effects (as compared with NSAIDS and opioids) when given in appropriate doses. Although the exact anti-nociceptive mechanisms of acetaminophen continue to be elucidated, these mechanisms appear to be multi-factorial and include central inhibition of the cyclo-oxygenase (COX) enzyme leading to decreased production of prostaglandins from arachidonic acid, interference with serotonergic descending pain pathways, indirect activation of cannabinoid 1 (CB1) receptors and inhibition of nitric oxide pathways through N-methyl-D-aspartate (NMDA) or substance P. Of the above mechanisms, the most commonly known is that of central inhibition of COX enzymes by which the decreased production of prostaglandins diminish the release of excitatory transmitters of substance P and glutamate which are both involved in nociceptive transmission (Anderson, 2008; Smith, 2011). To date, several studies have shown acetaminophen's opioid sparing effect in the pediatric population when given by the rectal or intravenous routes (Korpela et al, 1999; Dashti et al, 2009; Hong et al, 2010).
OTC NCT02929589 ↗ Ibuprofen to Decrease Opioid Use and Post-operative Pain Following Unilateral Inguinal Herniorrhaphy Suspended Mike O'Callaghan Federal Hospital Phase 3 2018-07-05 This is a prospective, randomized, double-blinded, and placebo-controlled trial comparing oxycodone/acetaminophen prescribed with or without ibuprofen for pain control following open unilateral inguinal hernia repair, with allowed exception of any currently prescribed opioid (codeine, hydrocodone, hydromorphone, morphine, methadone, oxymorphone, transdermal fentanyl), which can be continued. The patients will not be allowed to continue any over-the-counter pain medications, such as ibuprofen, naproxen, or acetaminophen containing medications, that were not prescribed by the investigators during this study. Patients not receiving Ibuprofen will be given a placebo pill composed of corn starch. The placebo pill will be formulated into the same shape, size and color as the ibuprofen capsule. Neither the investigators nor the research subjects will know if the subject is receiving a placebo versus Ibuprofen. The subjects will complete pain level and medication diaries, and will be followed for 2 months after their surgery. The research aims to discover the appropriate amount of opioid medication to prescribe to patients undergoing an elective open inguinal hernia repair, and reduce the total opioid dose needed by utilizing ibuprofen in combination. The investigators expect that the subjects who take ibuprofen will use less oxycodone/acetaminophen, and have comparable or lower mean pain levels. This could contribute to reducing the surplus opioids prescribed by physicians after surgery, which can lead to opioid use disorders. This particular procedure is common in men, and the findings have the potential to decrease the symptoms and pain of Active Duty members and DoD beneficiaries who undergo an inguinal hernia repair, and are at risk for prescription drug abuse or dependence.
OTC NCT02929589 ↗ Ibuprofen to Decrease Opioid Use and Post-operative Pain Following Unilateral Inguinal Herniorrhaphy Suspended Mike O'Callaghan Military Hospital Phase 3 2018-07-05 This is a prospective, randomized, double-blinded, and placebo-controlled trial comparing oxycodone/acetaminophen prescribed with or without ibuprofen for pain control following open unilateral inguinal hernia repair, with allowed exception of any currently prescribed opioid (codeine, hydrocodone, hydromorphone, morphine, methadone, oxymorphone, transdermal fentanyl), which can be continued. The patients will not be allowed to continue any over-the-counter pain medications, such as ibuprofen, naproxen, or acetaminophen containing medications, that were not prescribed by the investigators during this study. Patients not receiving Ibuprofen will be given a placebo pill composed of corn starch. The placebo pill will be formulated into the same shape, size and color as the ibuprofen capsule. Neither the investigators nor the research subjects will know if the subject is receiving a placebo versus Ibuprofen. The subjects will complete pain level and medication diaries, and will be followed for 2 months after their surgery. The research aims to discover the appropriate amount of opioid medication to prescribe to patients undergoing an elective open inguinal hernia repair, and reduce the total opioid dose needed by utilizing ibuprofen in combination. The investigators expect that the subjects who take ibuprofen will use less oxycodone/acetaminophen, and have comparable or lower mean pain levels. This could contribute to reducing the surplus opioids prescribed by physicians after surgery, which can lead to opioid use disorders. This particular procedure is common in men, and the findings have the potential to decrease the symptoms and pain of Active Duty members and DoD beneficiaries who undergo an inguinal hernia repair, and are at risk for prescription drug abuse or dependence.
>Trial Type >Trial ID >Title >Status >Phase >Start Date >Summary

All Clinical Trials for OXYCODONE AND ACETAMINOPHEN

Trial ID Title Status Sponsor Phase Start Date Summary
NCT00092313 ↗ A Study of Two Approved Drugs in the Treatment of Postoperative Dental Pain (0966-182) Completed Merck Sharp & Dohme Corp. Phase 3 2002-06-01 The purpose of this study is to compare the safety and effectiveness of two approved drugs in the treatment of pain following dental surgery.
NCT00092326 ↗ A Study of Two Approved Drugs in the Treatment of Postoperative Dental Pain (0966-183) Completed Merck Sharp & Dohme Corp. Phase 3 2002-06-01 The purpose of this study is to compare the safety and effectiveness of two approved drugs in the treatment of pain following dental surgery.
NCT00245375 ↗ A Trial Comparing Combination Therapy of Acetaminophen Plus Ibuprofen Versus Tylenol #3 for the Treatment of Pain After Outpatient Surgery Completed McNeil Consumer & Specialty Pharmaceuticals, a Division of McNeil-PPC, Inc. N/A 2005-01-01 Increasingly in general surgery, the investigators are conducting outpatient day surgery. Ambulatory surgery currently comprises 60 to 70% of surgeries performed in North America. These patients all require some form of analgesia which can be taken at home in the first few days after the surgery. The current standard at the investigators' centre and many others in the maritime provinces is to provide a prescription for oral acetaminophen plus codeine or oxycodone (Tylenol #3®, Percocet ®). Some patients may receive more potent opioids such as oral hydromorphone (Dilaudid®). Unfortunately, the most commonly prescribed medication (Tylenol #3®) is often poorly tolerated by patients, has several undesirable side effects, and may not provide effective pain relief. In the investigators' experience, non-steroidal anti-inflammatory drugs (NSAIDs) are uncommonly a routine addition to the home analgesic regimen. Tylenol #3®, in the investigators' experience and opinion, is a poor post surgical pain medication. They hope to show that a combination of ibuprofen and acetaminophen is better for pain relief after these procedures. The combination of acetaminophen and ibuprofen would be a safe, cheap, and readily available regimen. Unfortunately, as the prescribing practices of surgeons are old habits, it will require a very convincing argument to get them to change their practices. A randomized controlled trial comparing these two regimens, the investigators hope, would be a powerful enough argument. The hypothesis of this study, therefore, is that the pain control provided by a combination of acetaminophen plus ibuprofen (650 mg/400 mg four times per day) will be superior to Tylenol #3® (600 mg acetaminophen/60 mg codeine/15 mg caffeine four times per day). This study will attempt to enroll 150 patients in total. Eligible patients will be identified by their attending surgeon and contacted by study personnel. Patients who enroll in the study will undergo their surgery in the usual manner. After the surgery, in the recovery room, once they are ready to go home, they will be randomized to receive combination A or B and be given a week's worth of pain medication. They will then go home and take this medication as directed. They will record their pain intensity and pain relief once per day using a diary provided in the study package. One week after their surgery, they will return to the hospital clinic and be seen by the study nurse. They will hand over the diary and any unused medication. They will also be asked several questions regarding their overall satisfaction, incidence of side effects, and how long until they were pain free. The risks of participating in this study are minimal from the risks inherent to the procedures and medications the patients would receive within the standard of care. Ibuprofen is a commonly used NSAID which is widely available over the counter and has an established safety profile. The most common adverse effects of ibuprofen and other NSAIDs are gastrointestinal bleeding and ulceration. Other less common adverse effects include nephrotoxicity, hypersensitivity reactions, hepatic dysfunction (longterm use), and cognitive dysfunction. The investigators' patients will be selected to exclude those most at risk for these complications (see exclusion criteria). Acetaminophen has few side effects, with no adverse effects on platelet function and no evidence of gastric irritation.
NCT00245375 ↗ A Trial Comparing Combination Therapy of Acetaminophen Plus Ibuprofen Versus Tylenol #3 for the Treatment of Pain After Outpatient Surgery Completed Nova Scotia Health Authority N/A 2005-01-01 Increasingly in general surgery, the investigators are conducting outpatient day surgery. Ambulatory surgery currently comprises 60 to 70% of surgeries performed in North America. These patients all require some form of analgesia which can be taken at home in the first few days after the surgery. The current standard at the investigators' centre and many others in the maritime provinces is to provide a prescription for oral acetaminophen plus codeine or oxycodone (Tylenol #3®, Percocet ®). Some patients may receive more potent opioids such as oral hydromorphone (Dilaudid®). Unfortunately, the most commonly prescribed medication (Tylenol #3®) is often poorly tolerated by patients, has several undesirable side effects, and may not provide effective pain relief. In the investigators' experience, non-steroidal anti-inflammatory drugs (NSAIDs) are uncommonly a routine addition to the home analgesic regimen. Tylenol #3®, in the investigators' experience and opinion, is a poor post surgical pain medication. They hope to show that a combination of ibuprofen and acetaminophen is better for pain relief after these procedures. The combination of acetaminophen and ibuprofen would be a safe, cheap, and readily available regimen. Unfortunately, as the prescribing practices of surgeons are old habits, it will require a very convincing argument to get them to change their practices. A randomized controlled trial comparing these two regimens, the investigators hope, would be a powerful enough argument. The hypothesis of this study, therefore, is that the pain control provided by a combination of acetaminophen plus ibuprofen (650 mg/400 mg four times per day) will be superior to Tylenol #3® (600 mg acetaminophen/60 mg codeine/15 mg caffeine four times per day). This study will attempt to enroll 150 patients in total. Eligible patients will be identified by their attending surgeon and contacted by study personnel. Patients who enroll in the study will undergo their surgery in the usual manner. After the surgery, in the recovery room, once they are ready to go home, they will be randomized to receive combination A or B and be given a week's worth of pain medication. They will then go home and take this medication as directed. They will record their pain intensity and pain relief once per day using a diary provided in the study package. One week after their surgery, they will return to the hospital clinic and be seen by the study nurse. They will hand over the diary and any unused medication. They will also be asked several questions regarding their overall satisfaction, incidence of side effects, and how long until they were pain free. The risks of participating in this study are minimal from the risks inherent to the procedures and medications the patients would receive within the standard of care. Ibuprofen is a commonly used NSAID which is widely available over the counter and has an established safety profile. The most common adverse effects of ibuprofen and other NSAIDs are gastrointestinal bleeding and ulceration. Other less common adverse effects include nephrotoxicity, hypersensitivity reactions, hepatic dysfunction (longterm use), and cognitive dysfunction. The investigators' patients will be selected to exclude those most at risk for these complications (see exclusion criteria). Acetaminophen has few side effects, with no adverse effects on platelet function and no evidence of gastric irritation.
NCT00290589 ↗ A Trial of Corticosteroids for Low Back Pain Completed Montefiore Medical Center Phase 3 2003-06-01 Low back pain is a common symptom that functionally disables many people. When the low back pain is accompanied by pain that shoots down the leg, it is felt to be caused by a herniated disc. We are conducting this study to determine if a powerful anti-inflammatory agent will decrease the pain and functional impairment that is associated with this illness.
NCT00312221 ↗ Safety and Efficacy of Buprenorphine Transdermal System (BTDS) in Subjects With Moderate to Severe Osteoarthritis Pain Terminated Purdue Pharma LP Phase 3 2004-04-01 The objective of this study is to demonstrate the effectiveness and tolerability of the buprenorphine transdermal system (20 mg) in comparison to the buprenorphine transdermal system (5 mg) and oxycodone immediate release in subjects with moderate to severe osteoarthritis pain currently treated with oral opioids. The double-blind treatment intervention duration is 12 weeks during which time supplemental analgesic medication (acetaminophen, ibuprofen, immediate release oxycodone) will be provided to all subjects in addition to study drug.
NCT00313014 ↗ Safety and Efficacy of Buprenorphine Transdermal System (BTDS) in Subjects With Moderate to Severe Low Back Pain Terminated Purdue Pharma LP Phase 3 2004-02-01 The objective of this study is to demonstrate the effectiveness and tolerability of the buprenorphine transdermal system (BTDS) 20 in comparison to the buprenorphine transdermal system (BTDS) 5 and oxycodone immediate-release in subjects with moderate to severe low back pain currently treated with oral opioids. The double-blind treatment intervention duration is 12 weeks during which time supplemental analgesic medication (acetaminophen, ibuprofen) will be provided to all subjects in addition to study drug.
>Trial ID >Title >Status >Phase >Start Date >Summary

Clinical Trial Conditions for OXYCODONE AND ACETAMINOPHEN

Condition Name

Condition Name for OXYCODONE AND ACETAMINOPHEN
Intervention Trials
Pain, Postoperative 25
Pain 18
Postoperative Pain 15
Opioid Use 9
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Condition MeSH

Condition MeSH for OXYCODONE AND ACETAMINOPHEN
Intervention Trials
Pain, Postoperative 64
Acute Pain 13
Osteoarthritis 9
Fractures, Bone 8
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Clinical Trial Locations for OXYCODONE AND ACETAMINOPHEN

Trials by Country

Trials by Country for OXYCODONE AND ACETAMINOPHEN
Location Trials
United States 282
Canada 16
China 2
Puerto Rico 2
Norway 1
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Trials by US State

Trials by US State for OXYCODONE AND ACETAMINOPHEN
Location Trials
New York 32
California 27
Pennsylvania 18
Texas 14
North Carolina 12
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Clinical Trial Progress for OXYCODONE AND ACETAMINOPHEN

Clinical Trial Phase

Clinical Trial Phase for OXYCODONE AND ACETAMINOPHEN
Clinical Trial Phase Trials
PHASE4 4
PHASE3 5
PHASE2 3
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Clinical Trial Status

Clinical Trial Status for OXYCODONE AND ACETAMINOPHEN
Clinical Trial Phase Trials
Completed 60
Recruiting 31
Terminated 19
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Clinical Trial Sponsors for OXYCODONE AND ACETAMINOPHEN

Sponsor Name

Sponsor Name for OXYCODONE AND ACETAMINOPHEN
Sponsor Trials
Montefiore Medical Center 9
Purdue Pharma LP 7
University of California, Los Angeles 7
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Sponsor Type

Sponsor Type for OXYCODONE AND ACETAMINOPHEN
Sponsor Trials
Other 168
Industry 38
U.S. Fed 3
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Clinical trials update, market analysis and projection for oxycodone and acetaminophen (combination immediate-release vs extended-release risks)

Last updated: July 28, 2026

Executive summary: Oxycodone plus acetaminophen is a mature, high-volume opioid combination with a shrinking addressable market in the U.S. driven by opioid-safety contracting and tighter prescribing patterns. Near-term growth is constrained; upside comes primarily from share shifts among current branded and generic formulations and from any re-expansion in hospital and post-acute prescribing in specific subsegments. Patent and exclusivity are mostly expired for legacy immediate-release combinations, so competition is predominantly generic, with pricing pressure as the primary variable. The main execution risk for market participants is regulatory and litigation exposure tied to opioid distribution and marketing practices rather than clinical differentiation.


What is the current clinical trials landscape for oxycodone and acetaminophen?

Oxycodone/acetaminophen (often marketed as immediate-release combination products) has limited meaningful late-stage clinical development relative to reformulated opioids and non-opioid alternatives. Most active clinical work in recent years has focused on:

  • Comparative effectiveness and real-world outcomes versus other opioid regimens (including dose-titration and switching strategies).
  • Safety outcomes tied to co-administration patterns (sedation, respiratory depression signals, overdose risk).
  • Protocols designed to reduce total opioid exposure and manage chronic pain outcomes.

Featured snippet answer: Clinical trials for oxycodone/acetaminophen increasingly emphasize safety, prescribing strategy, and comparative outcomes rather than new chemical entities.

Are there any phase 3 trials for oxycodone/acetaminophen right now?

No definitive, globally consolidated phase 3 signal can be provided here without a specific trial registry snapshot (ClinicalTrials.gov) and sponsor-level confirmation. The combination is generally not where sponsors place late-stage investment anymore, given generic saturation and regulatory scrutiny.

What kinds of trial endpoints are being used?

The dominant endpoint set across opioid-related studies includes:

  • Pain intensity and functional improvement (short-term).
  • Responder rates and time-to-analgesic effect.
  • Safety endpoints: adverse events, sedation scores, respiratory function measures, misuse risk proxies.
  • Prescription and utilization outcomes: duration of therapy, discontinuation rates, and conversion to other analgesics.

What investigational directions compete with oxycodone/acetaminophen in clinical development?

Growth areas in acute and chronic pain programs that siphon attention and volume include:

  • Abuse-deterrent opioid formulations (where they are still relevant under payer constraints).
  • Buprenorphine-based analgesics.
  • Non-opioid combinations and adjuvant strategies.
  • Multimodal perioperative pathways (reducing opioid duration rather than dose).

How big is the oxycodone plus acetaminophen market, and what’s driving demand?

Featured snippet answer: Demand is driven by acute pain utilization patterns (post-surgery, injury, ED discharge) and payer and provider prescribing behavior. Growth is mainly substitution among opioid brands and generics rather than new patient expansion.

Core demand drivers

  • Post-acute pain management protocols in hospitals and outpatient surgery centers.
  • Familiarity and established prescribing workflows among clinicians.
  • Availability of multiple strengths and dosing schedules (immediate-release formulations).

Key demand dampeners

  • Opioid prescribing restrictions tied to state policies and payer utilization management.
  • Greater use of opioid-sparing regimens and multi-modal analgesia pathways.
  • Litigation and regulatory pressure impacting distribution and marketing practices for the broader opioid class.

What market segments matter most?

  • Acute musculoskeletal and post-procedural pain.
  • Short-course prescriptions (duration tends to matter more than total volume).
  • Claims-based utilization from commercial insurance, Medicare Part D, and Medicaid managed care.

What is the forecast outlook for oxycodone and acetaminophen through 2030?

Featured snippet answer: Total industry volume is likely to be flat to modestly down in mature markets with price erosion from generic competition. Any growth is expected to come from share gains within existing opioid combinations, not from category expansion.

Projection framework used for credible market modeling

For a mature, largely generically commoditized product, the forecast hinges on:

  • Unit volume trends: new prescriptions, refill intensity, and duration of therapy.
  • Price per unit: driven by generic mix and payer negotiated discounts.
  • Net revenue adjustments: wholesaler/distributor channel mix, rebates, and chargebacks (market-level direction).
  • Policy effects: state-level prescribing controls, PDMP utilization requirements, prior authorization.

Likely trajectory

  • U.S.: declining or stable volume; pricing pressure remains the dominant factor.
  • International: depends on country-specific opioid regulation, reimbursement, and enforcement intensity; category may be smaller but still impacted by policy tightening.

Which oxycodone/acetaminophen products dominate the market and how does share shift under generic entry?

Featured snippet answer: Branded share is limited versus generic options; market outcomes are primarily driven by generic penetration, payer formulary placement, and contract pharmacy dynamics.

Brand-to-generic dynamics

  • Branded products typically lose volume after exclusivity windows end.
  • Generics compete on price, availability, and pharmacy stocking.
  • Payer policies determine “effective” utilization via formulary tiers and prior authorization rules.

How do formulary restrictions affect utilization?

Common payer tactics include:

  • Limiting strengths or quantities per fill.
  • Requiring step edits between opioid products.
  • Enforcing opioid duration caps tied to guideline-concordant prescribing.

What patents protect oxycodone and acetaminophen combinations in the U.S.?

Featured snippet answer: Legacy oxycodone/acetaminophen immediate-release combinations are largely in generic territory; the active patent estate, if any, tends to be tied to specific formulations, processes, or use claims rather than new base-drug composition.

Why patent relevance is lower for this combination

  • The active ingredient combination is widely established.
  • Multiple generic entrants exist across strengths and dosing forms.
  • Many foundational patents expired long ago for classic immediate-release tablets.

Formulation patents vs process patents

If present, protection typically falls into:

  • Specific excipient systems and granulation/compaction approaches.
  • Stability and dissolution profiles.
  • Methods of making tablets to meet critical quality attributes.

Method-of-use and abuse-deterrent adjuncts

If any newer entrant attempts differentiation, it is usually via:

  • Abuse-deterrent or tamper-resistant characteristics.
  • Specific dosing regimens intended to reduce misuse.

When do oxycodone/acetaminophen lose exclusivity, and are Paragraph IV filings relevant?

Featured snippet answer: For most legacy oxycodone/acetaminophen immediate-release products, exclusivity windows and listed patents are largely expired, so the current competitive pattern is less about Paragraph IV and more about routine generic approvals and formulary contracting.

Paragraph IV playbook for this category

Paragraph IV challenges still matter when:

  • A specific combination strength or dosage form has a still-listed patent.
  • A company seeks entry ahead of a real patent barrier tied to formulation or manufacturing.

Practical implication for market participants

  • Generic entry risk is mostly about whether any remaining listed patents block a specific dosage form, strength, or label.
  • Settlement outcomes, if any, usually influence short-term supply and pricing rather than driving multi-year market shifts.

What is the Orange Book status of oxycodone and acetaminophen products?

Featured snippet answer: Most oxycodone/acetaminophen immediate-release combinations have extensive generic coverage; the Orange Book typically shows limited remaining patent protection, with any active listings concentrated in specific formulations, strengths, or manufacturing methods.

Orange Book entries to watch

  • Listed patents with “expires” dates.
  • Patent use codes indicating whether composition, method of use, or formulation is implicated.
  • Whether patents remain “active” or have been rendered irrelevant by litigation outcomes.

No Orange Book table is provided here because the prompt requires current, product-specific listing data that is not included in the supplied material.


How strong is the patent estate for oxycodone/acetaminophen versus reformulated opioids?

Featured snippet answer: The estate strength for classic immediate-release oxycodone/acetaminophen is generally low for exclusivity defense because generics dominate the category. Reformulated opioids can have stronger differentiation narratives, but oxycodone/acetaminophen is not where most durable new IP is being created.

Key strength metrics to model

  • Number of active Orange Book patents by dosage form.
  • Claim scope and enforceability (formulation vs process vs use).
  • Litigation history and settlement patterns for the same IP.

What patent litigation affects oxycodone/acetaminophen generic entry risk?

Featured snippet answer: Litigation risk exists, but it is typically localized to specific dosage forms and listed patents rather than sweeping barriers across the entire drug combination category.

How litigation impacts pricing

  • If a patent blocks entry, price holds higher for longer until generic launch.
  • If settlement permits “at-risk” or delayed entry, pricing steps down only at settlement-defined points.
  • Injunction risk tends to be short-term in a category with many generic options.

How does oxycodone and acetaminophen compare with alternative analgesic strategies on market access?

Featured snippet answer: Market access depends less on analgesic efficacy differentiation and more on payer opioid-safety posture and prescribing rules. Alternatives that reduce opioid duration can win formulary and utilization.

Competitive set

  • Other opioid combinations (hydrocodone/acetaminophen, oxycodone alone).
  • Tramadol and other centrally acting agents.
  • NSAID-based and acetaminophen-only regimens.
  • Multimodal perioperative pain protocols.

Commercial implication

Oxycodone/acetaminophen tends to persist where:

  • Clinicians prefer established regimens.
  • Patients have contraindications to alternative classes.
  • Short-course prescribing is still clinically justified and permitted.

What manufacturing and supply risks exist for oxycodone/acetaminophen tablets?

Featured snippet answer: Supply risk is primarily tied to regulatory compliance, controlled-substance handling, and manufacturing yields rather than technical barriers unique to this combination.

Common operational constraints

  • GMP compliance for tablets across multiple strengths.
  • Controlled-substance procurement and distribution compliance.
  • Batch release timelines and stability testing.

Key takeaways

  • Oxycodone/acetaminophen is a mature, generic-dominated opioid combination with limited new clinical differentiation.
  • Forecast outlook is stable-to-declining on volume in the U.S., with pricing pressure the primary driver of net revenue decline.
  • Any growth is likely share-based within the opioid combination segment rather than category expansion.
  • Patent and exclusivity barriers are typically low for classic immediate-release strengths, so generic competition remains the baseline scenario.
  • The biggest commercial risk centers on opioid regulatory enforcement and litigation tail risk across the broader category.

FAQs

1) Are there any new abuse-deterrent or reformulated oxycodone/acetaminophen products in late-stage trials?
Late-stage investment is generally concentrated in other opioid reformulations and non-opioid strategies rather than classic oxycodone/acetaminophen immediate-release combinations.

2) Does FDA approval for oxycodone/acetaminophen depend on REMS or other opioid-specific restrictions?
Opioid class controls influence prescribing and distribution patterns; product-specific regulatory requirements depend on the individual NDA/labeling and current FDA actions.

3) How do opioid-safety payer policies affect oxycodone/acetaminophen utilization?
Formulary tiering, quantity limits, prior authorization, and step edits reduce total and incremental utilization.

4) What is the typical generic entry timeline for oxycodone/acetaminophen strengths?
It varies by the presence of any remaining listed patents for a specific strength and formulation and by litigation and settlement outcomes; in general, many strengths are already widely generic.

5) What is the highest-value subsegment for oxycodone/acetaminophen market modeling?
Acute, short-course post-procedural pain where opioid duration controls still allow initial fills.


References

  1. ClinicalTrials.gov. (n.d.). Studies on oxycodone combinations and pain management. https://clinicaltrials.gov
  2. FDA. (n.d.). Opioid-related regulatory and safety information. https://www.fda.gov/drugs/information-drug-class/opioids
  3. FDA. (n.d.). Drugs@FDA (search: oxycodone; acetaminophen; combination products). https://www.accessdata.fda.gov/scripts/cder/daf/
  4. FDA. (n.d.). Orange Book: Approved Drug Products with Therapeutic Equivalence Evaluations. https://www.accessdata.fda.gov/scripts/cder/daf/index.cfm

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