A yellow, round tablet stamped with the imprint “230” (often accompanied by a stylized “XC” logo) is Oxycodone Hydrochloride 10 mg and Acetaminophen 325 mg, manufactured by Alvogen, Inc. It is a strong prescription narcotic analgesic equivalent to Percocet 10/325. Classified as a Schedule II controlled substance, it is prescribed for managing moderate-to-severe pain.
Pill Identification
When identifying a tablet with a “230” imprint, verify all physical characteristics:
Visual Feature – Physical Description
- Imprint Code –
230on one side; stylizedCor manufacturer logo on the reverse - Active Ingredients – Oxycodone Hydrochloride (10 mg) + Acetaminophen (325 mg)
- Color & Shape – Yellow, round tablet
- Manufacturer – Alvogen, Inc.
- Drug Class – Opioid Analgesic / Non-Opioid Analgesic Combination
- Controlled Status – DEA Schedule II (high potential for abuse and dependence)
- Counterfeit Warning: Fake or “pressed” illicit tablets resembling the yellow “230” pill are frequently produced illegally and may contain lethal doses of synthetic opioids like fentanyl. Never consume an unverified, loose, or second-hand tablet.
Mechanism of Action
The 230 pill combines two distinct pain-relieving agents that work synergistically:
- Oxycodone (Opioid Agonist): Binds primarily to opioid receptors in the central nervous system (CNS). This inhibits ascending pain pathways, alters the perception of pain, and stimulates dopamine pathways in the brain’s reward center.
- Acetaminophen (Non-Opioid Analgesic & Antipyretic): Inhibits prostaglandin synthesis in the central nervous system and elevates the pain threshold.
- Synergistic Analgesia: The dual-action mechanism delivers stronger pain relief at lower individual opioid doses than taking either medication alone.
Indications & Dosage
Approved Medical Indications
Prescribed for the management of acute, moderate-to-severe pain when alternative, non-opioid pain management strategies are ineffective, tolerated poorly, or inadequate.
Typical Dosage Guidelines
- Adult Administration: Usually taken orally every 4 to 6 hours as needed for severe pain.
- Daily Maximum Limits:
- Oxycodone: Dosed based on medical evaluation and patient opioid tolerance.
- Acetaminophen Ceiling: Total daily consumption of acetaminophen from all sources (including over-the-counter flu/cold remedies) must not exceed 4,000 mg per day to prevent severe, irreversible liver failure.
- Duration: Prescribed for the shortest duration possible to mitigate risks of tolerance, dependency, and addiction.
Side Effects
Common Side Effects
- Drowsiness, fatigue, or sedation
- Dizziness or lightheadedness
- Nausea, vomiting, or stomach discomfort
- Constipation (often requires a stool softener or proactive fluid/fiber intake)
- Dry mouth, sweating, or mild itching
Serious Side Effects (Seek Emergency Medical Help)
- Severe Respiratory Depression: Slowed, shallow, or irregular breathing.
- Hepatotoxicity (Liver Failure): Jaundice (yellowing of eyes/skin), severe upper-right abdominal pain, or dark urine.
- Extreme Sedation: Inability to stay awake, severe confusion, or loss of consciousness.
- Hypotension: Sudden drop in blood pressure causing fainting or severe dizziness.
- Serotonin Syndrome: Agitation, fever, rapid heart rate, muscle twitching, or rigidity when combined with serotonergic medications.
Boxed Warnings & Precautions
The FDA applies several severe Boxed Warnings to combination opioid medications:
FDA Boxed Warnings
- Addiction, Abuse, and Misuse: Oxycodone exposes users to the risks of opioid addiction, abuse, and overdose, which can be fatal.
- Life-Threatening Respiratory Depression: Serious or fatal hypoventilation can occur, especially during initiation or following a dose increase.
- Accidental Ingestion: Ingestion of even one dose by children or non-tolerant individuals can result in a fatal overdose.
- Neonatal Opioid Withdrawal Syndrome (NOWS): Prolonged use during pregnancy can cause life-threatening withdrawal in the newborn.
- Hepatotoxicity Risk: Acetaminophen has been associated with cases of acute liver failure, sometimes resulting in liver transplant or death.
- Concomitant Use with Benzodiazepines or CNS Depressants: Co-ingestion with benzodiazepines, alcohol, or other depressants can result in profound sedation, respiratory depression, coma, and death.
Key Precautions
- Avoid Alcohol: Never combine alcohol with this medication – doing so exacerbates CNS depression and drastically raises the risk of liver damage and fatal overdose.
- Physical Dependence & Tapering: Abruptly stopping after prolonged use causes severe physical withdrawal symptoms (e.g., tremors, fever, sweating, muscle aches, vomiting). Discontinuation must be managed via a medical tapering plan.
- Naloxone Availability: Patients prescribed Schedule II opioids should consider keeping Naloxone (Narcan) accessible to quickly reverse accidental opioid overdose in emergencies.