Asenapine Transdermal Patch and Oxycodone: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Jul 11, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Oxycodone
Asenapine Transdermal Patch
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
What happens
Increased risk of respiratory and CNS depression
Interaction Deep Dive
Coadministration of oxyCODONE and a CNS depressant may result in additive CNS depression and an increased risk of respiratory depression, profound sedation, coma, and death. Reserve concomitant prescribing for use in patients for whom alternative treatment options are inadequate. If concomitant use is necessary, use the lowest effective dosage and minimum duration of use. Monitor for sedation and respiratory depression and strongly consider prescribing naloxone for the emergency treatment of opioid overdose23. Initiate oxyCODONE extended-release (ER) tablets and oxyCODONE/naloxone combination at one-third to one-half of the usual dose 463 and oxyCODONE/acetaminophen ER tablets at a reduced dose of 1 tablet every 12 hours 5.
Why it happens (mechanism)
Additive CNS depression
Literature reports
3 reports — tap to read
a) Observational studies have demonstrated that concomitant use of opioid analgesics and benzodiazepines increases the risk of drug-related mortality compared to use of opioid analgesics alone. Because of similar pharmacological properties, it is reasonable to expect similar risk with the concomitant use of other CNS depressant drugs with opioid analgesics 3.
b) From 2004 to 2011, drug-related overdose deaths, either from taking prescribed or greater than prescribed doses, and involving both opioids and benzodiazepines, significantly increased from 0.6 to 1.7 per 100,000 population. During this same time, the number of nonmedical use-related emergency department visits where both opioid analgesics and benzodiazepines were involved significantly increased from 11 to 34.2 per 100,000. Additionally, opioid overdose deaths in which benzodiazepines also played a factor significantly rose from 18% to 31% 1.
c) One study, conducted in North Carolina, found overdose death rates were 10 times higher among patients who were co-prescribed opioids and benzodiazepines than among patients who were prescribed opioids alone (7 vs 0.7 per 10,000 person-years). Another study examined data from the Veterans Health Administration and compared risk of fatal overdose in patients taking opioids with no history of a benzodiazepine prescription, patients taking opioids with a history of benzodiazepine prescription, and patients taking opioids with a current benzodiazepine prescription. The conclusion was patients who had a history of a benzodiazepine prescription and patients with a current benzodiazepine prescription had a significantly increased risk of fatal overdose, 2.33 times and 3.86 times, respectively, versus patients taking opioids with no history of a benzodiazepine prescription. The risk continued to increase as the daily benzodiazepine dose increased 1.
Common questions
Can I take Asenapine Transdermal Patch and Oxycodone together?
Increased risk of respiratory and CNS depression Always confirm with your pharmacist or prescriber before making any change.
How serious is the Asenapine Transdermal Patch and Oxycodone interaction?
It is rated major. Potentially serious — often needs a change or close monitoring.
How quickly could this interaction happen?
The documented onset is "unspecified". The timing of this interaction is not well characterized.
How strong is the evidence for this interaction?
The evidence is graded "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.
From our Q&A
Real reader questions about these medications, each personally answered by our pharmacist:
Questions for your pharmacist
- Does my dose of Asenapine Transdermal Patch or Oxycodone need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there a safer alternative to one of these medications for me?
References (6)
- US Food and Drug Administration (FDA): Drug Safety Communications: FDA warns about serious risks and death when combining opioid pain or cough medicines with benzodiazepines; requires its strongest warning. US Food and Drug Administration (FDA). Silver Spring, MD. 2016.
- Product Information: Oxycodone HCl acetaminophen oral tablets, oxycodone HCl acetaminophen oral tablets. Mayne Pharma (per DailyMed), Greenville, NC, 2021.
- Product Information: OXYCONTIN(R) oral extended-release tablets, oxycodone HCl oral extended-release tablets. Purdue Pharma LP (per FDA), Stamford, CT, 2023. DailyMed
- Product Information: TARGINIQ(TM) ER oral extended release tablets, oxycodone HCl naloxone HCl oral extended release tablets. Purdue Pharma LP (per FDA), Stamford, CT, 2016.
- Product Information: XARTEMIS(TM) XR oral extended-release tablets, oxycodone HCl acetaminophen oral extended-release tablets. Mallinckrodt Brand Pharmaceuticals, Inc. (per FDA), Hazelwood, MO, 2016.
- Product Information: OXAYDO(R) oral tablets, oxycodone HCl oral tablets. Zyla Life Sciences US Inc (per FDA), Lake Forest, IL, 2024. DailyMed
Keep reading about Oxycodone
Keep reading about Asenapine Transdermal Patch
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Prescription drugs aren't the whole picture — herbal and dietary supplements can interact with them too. From the evidence-graded Natural Medicines database:
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