The quick answer is yes, depending on if your physician is aware of your overall health condition and feels that mixing these drugs is the best option for you. Both of these commonly used drugs are utilized for pain.

The apparent difference is that oxycodone is a controlled substance opioid pain reliever, while ibuprofen belongs to a group of medications called Non-Steroidal Anti Inflammatory Drugs (NSAIDS). Oxycodone has a high potential for future abuse, addiction, and diversion, but ibuprofen also comes with risks, and certain patients should not be given NSAIDS.

Since these drugs have distinctly different pharmacological mechanisms, in some cases it is very appropriate to alternate with both pain medications, where there is a need for an anti-inflammatory drug and a stronger pain killer to mitigate the symptoms.  

What is the mechanism of opioids?

Oxycodone is a narcotic pain medication that acts in the central nervous system to alleviate pain. Opioid medications activate specific receptors in the body known as mu, delta, and kappa receptors. Oxycodone activates these receptors throughout the body, including the gut, central nervous, and limbic systems, which explains opioid-induced constipation, pain alleviation, and the effects of euphoria.

As the central nervous system is responsible for respiration, using higher amounts of oxycodone can lead to respiratory depression, which is the main etiology of overdose deaths from this subset of medications. 

What is the mechanism of ibuprofen? 

Ibuprofen is a Nonsteroidal Anti-inflammatory Drug, commonly known as NSAIDs.  Due to its anti-inflammatory properties, these drugs are used for minor headaches, muscle injuries, low back pain, joint pain, and dysmenorrhea (painful menstrual periods). In addition, NSAIDs work to reduce fever and are used in children and adults. Cyclooxygenase (COX) is an enzyme involved in the inflammatory process. NSAIDs inhibit this pathway, making these drugs quite effective anytime the pain is secondary to inflammation.  

What are some of the side effects of opioids?

• Constipation
• Nausea and vomiting 
• Sedation and dizziness
• Breathing difficulties
• Shortness of breath
• Dependence and addiction
  

What are some of the common side effects of ibuprofen?

Some common side effects of ibuprofen include...

• Heartburn and indigestion
• Bleeding and bruising 
• Nausea
• Bloating and gas 
• Difficulty breathing 
• Changes in urine output and color

When should I NOT take oxycodone?

Oxycodone is a controlled substance and there are certain circumstances where your doctor may not recommend oxycodone or use them sparingly if the benefits outweigh the risks.  Below is a list of some of the top reasons your doctor may want to either refrain from or minimize the use of oxycodone. 

• Lung problems including COPD, sleep apnea, uncontrolled asthma
• History of drug abuse or battles with addiction
• Adrenal gland problems
• Acute head injury
• Respiratory depression
• Uncontrolled psychosis 
• Swallowing difficulties
• Increased intracranial pressure

When should I NOT take ibuprofen?

Ibuprofen is available over the counter, leaving many the assumption that these are safe for everyone. However, there are certain circumstances where your doctor may not recommend using ibuprofen or to use them sparingly. Below is a list of some of the top reasons your doctor may want to either refrain from or minimize the use of ibuprofen.

• Severe heart disease 
• Allergies or hypersensitivity to NSAIDs and Aspirin 
• Uncontrolled stomach ulcer
• Kidney disease
• Uncontrolled hypertension
• While on Plavix, coumadin, and other blood-thinning medications
• In certain types of strokes
• Bleeding disorders
• Liver cirrhosis
• Uncontrolled asthma
• Patients who have had coronary artery bypass
• Pregnancy, particularly in the third trimester

How do I know if I should take these medications together?

It is important to reiterate that no matter how comfortable you may feel that combining these medications is the right thing to do; always ask your healthcare provider. Because ibuprofen and oxycodone work in different ways and pathways, they are commonly used to minimize pain. Just as with any medication, the longer you are on these drugs, the more you expose yourself to chronic complications and side effects. A form of medicine that combines oxycodone with ibuprofen is available, but it is also just as easy to take each one independently and alternate.