ConZip vs. Percocet: Similarities and Differences
Medically reviewed by Lindsay Cook, PharmD
ConZip (tramadol) and Percocet (oxycodone/acetaminophen) are Food and Drug Administration (FDA)-approved prescription opioids used for the management of moderate to severe, persistent pain in adults.
While these drugs are similar, they carry notable differences that potential users should be aware of.
The significant difference between ConZip and Percocet is their drug classes and active ingredients: ConZip is an opioid agonist and contains a single active ingredient.
Meanwhile, Percocet contains oxycodone, a narcotic pain reliever, and acetaminophen, an analgesic pain reliever.
This article will provide an overview of ConZip and Percocet, highlighting their similarities and differences, guidance on using them safely, potential side effects, storage requirements, and more.
Getty Images / Maca and Naca
Opioids for Pain Management
The following will outline and provide context regarding the use of opioids in the treatment of pain management.
Understanding Opioids
Opioids are a group of medications used to treat and manage pain.
This group of medications earned their name as "opioids" because they attach to opioid receptors in the body, which are found in the nervous system and gastrointestinal (GI) tract.
Some opioids are produced naturally by the opium poppy plant, and some are synthetic and produced in a lab using an identical chemical structure.
Healthcare providers use opioids to manage pain because they are effective at providing pain relief for people experiencing pain-related conditions.
Many providers must assess the risks versus benefits of using opioids for pain management due to the risks associated with their use.
Appropriate opioid prescribing by healthcare providers should provide pain control and minimize harm. Providers should implement preventive measures to reduce drug diversion or misuse.
How Healthcare Providers Assess Pain
Healthcare providers usually use a pain scale to recognize and assess moderate to severe pain. There are several different scales used to rate and classify pain.
Using a pain scale helps providers quantify an individual's pain levels.
Other factors to consider when assessing pain include the source of the pain, whether or not it interrupts daily activities and functioning, and whether or not other health conditions also exist.
Defining pain can be difficult as pain levels vary from person to person. Pain that is mild for one person may be severe for another.
How Opioids Work
Opioids work to manage pain by reducing the body’s perception of pain and decreasing the release of pain signals.
Prevalence of Use
Data from a 2021 report indicated that nearly 22% of adults with chronic pain used an opioid in the past three months.
Commonly Prescribed Opioids: Examples
Some other notable examples of opioids used for pain management include:
Opana (oxymorphone)
Codeine
Prescription Requirements
Opioids are classified as controlled substances due to the potential for abuse, misuse, and diversion.
Controlled substances are medications that have a high risk of being used differently than their intended use, resulting in a high risk of substance use disorder.
Federal regulations require the following components to be included on any prescription for a controlled substance:
Prescription date
Personal information (name and address)
Prescriber information (name, address, and DEA number)
Drug-specific information (name, strength, dosage form, quantity, and directions for use)
Number of refills
Manual prescriber signature
Individual state laws may have stricter requirements.
Conditions Requiring ConZip vs. Percocet
Some common conditions that may require the use of ConZip or Percocet include:
Pain related to a fall or accident
Controlled Substance Status: ConZip vs. Percocet
ConZip and Percocet are controlled substances, meaning they are regulated by the United States Drug Enforcement Administration (DEA).
ConZip is classified as a Schedule IV drug, which means it has a low potential for abuse and a low risk of dependence.
Percocet is classified as a Schedule II drug and has a high potential for abuse, with the potential to lead to dependence.
Opioids like ConZip and Percocet are considered controlled substances because of their potential to be misused and their risk of potential abuse and addiction.
What Is ConZip?
ConZip is a brand-name opioid agonist. It is an ER formulation of the active ingredient tramadol.
This medication is used for the management of moderate to severe, persistent pain that requires long-term treatment with a daily opioid when other treatment options have failed.
ConZip should not be used on children 12 years old or younger. It should not be used in children under 18 years of age following medical procedures to remove the tonsils or the adenoids.
Accidental ingestion of ConZip by children can result in a deadly overdose. Life-threatening respiratory depression and death can also occur in children who take tramadol.
ConZip prescriptions may be written, called into the pharmacy, or faxed, and they may be refilled up to five times in six months.
Available Strengths
ConZip is orally administered and available as a capsule and generic medication.
ConZip is available at the following strengths:
100 mg
200 mg
300 mg
Boxed Warning
ConZip carries a boxed warning regarding the potential risk of opioid addiction, abuse, and misuse, which can result in overdose or death.
Other boxed warnings for ConZip include:
Life-threatening respiratory depression
Accidental ingestion may result in overdose, especially by children
Risks of use in combination with benzodiazepines or other nervous system depressants
Cytochrome P450 (CYP) interactions
Off-Label Uses
A medication is used off-label when it is prescribed for a purpose or at a dose other than its FDA-approved use.
The active ingredient in ConZip (tramadol) has been used off-label as an antidepressant and for the treatment of male sexual dysfunction.
Tramadol is also available in combination with acetaminophen (brand name: Ultracet) and celecoxib (seglentis) for the treatment of pain in adults.
How It Works
Similar to other opioids, Conzip works by selectively binding to various opioid receptors in the nervous system.
It does not bind to specific receptors in the same way more potent opioids can.
ConZip works differently than other opioids because it inhibits the reabsorption of norepinephrine and serotonin, which contributes to its ability to relieve pain.
ConZip is designed to provide sustained pain relief over an extended time as an ER formulation.
What Is Percocet?
Percocet, a full opioid agonist, is an IR medication containing a combination of two medications: oxycodone (a narcotic pain reliever) and acetaminophen (an analgesic pain reliever).
Like ConZip, it is also FDA-approved for the management of severe and persistent pain that requires treatment with an opioid medication when other treatment options have failed.
Percocet prescriptions have stricter requirements than ConZip prescriptions. Percocet prescriptions can be written or faxed. They can only be called into the pharmacy under particular circumstances.
Percocet prescriptions cannot be refilled.
However, multiple prescriptions may be issued for a total supply of at most 90 days under certain conditions.
Available Strengths
Brand-name Percocet is orally administered and is available in tablet or liquid form.
As a combination of oxycodone and acetaminophen, g as a generic medication.
Percocet is available at the following strengths of oxycodone and acetaminophen, respectively:
2.5 mg/325 mg
5 mg/325 mg
7.5 mg/325 mg
10 mg/325 mg
Percocet use in the pediatric population has not been established.
However, oxycodone use in people 11 years and older who are opioid-tolerant may be appropriate.
Boxed Warning
This medication should not be used in people with notable respiratory depression, acute or severe asthma, or GI obstruction.
Percocet carries the following boxed warnings:
Potential for medication addiction, abuse, and misuse
Life-threatening respiratory depression
Neonatal abstinence syndrome
Cytochrome P450 (CYP) interactions
Risks of use in combination with benzodiazepines or other nervous system depressants
Off-Label Uses
Percocet may be used off-label for fibromyalgia syndrome and other pain-related diagnoses.
How It Works
Oxycodone and acetaminophen work together to create the desired effect of pain relief.
Oxycodone is an opioid agonist and works to disrupt the transmission of pain signals and the perception of pain.
Conversely, acetaminophen more directly impacts the central nervous system by inhibiting cyclooxygenase (COX) and reducing the production of chemicals called prostaglandins that influence pain.
Dosing Guidelines
The following provides general dosing guidelines for using ConZip and Percocet for pain management (note that your healthcare provider may decide to titrate your dose to achieve optimal pain relief):
Taking tramadol?: | Dose: | Frequency: |
• Not currently | • 100 mg | • Once daily |
• Yes. IR | • Calculate the 24-hour IR dose and round down to the nearest 100 mg increment | • Once daily |
Strength: | Usual Dose: | Frequency: | Daily Maximum: |
• 2.5 mg/325 mg | • One to two tablets | • Every 6 hours as needed | • 12 tablets |
• 5 mg/325 mg | • One tablet | • Every 6 hours as needed | • 12 tablets |
• 7.5 mg/325 mg | • One tablet | • Every 6 hours as needed | • Eight tablets |
• 10 mg/325 mg | • One tablet | • Every 6 hours as needed | • Six tablets |
How Quickly Does Each Drug Work?
Generally, how long the effects of ConZip or Percocet last in the body depends on factors such as how much of the medication was taken and the time it was taken.
However, users will typically begin to feel the effects of Percocet for pain relief within 10 to 30 minutes of consumption.
In comparison, because ConZip is an ER medication, users may need several hours to feel its pain-relieving effects.
Based on the half-lives of the medications (the time it takes for a drug's active substance to be reduced by half within the body), ConZip may stay in the body for up to three days, and Percocet may stay in the body for several hours.
Both medications are expelled (the method by which a drug's active substance exists from the body) through the kidneys.
Side Effects and Precautions
ConZip and Percocet carry the potential for side effects of varying severities.
Therefore, if using either drug, be sure to monitor yourself or a loved one closely for the emergence of side effects that fail to dissipate or worsen over time.
If you believe you are experiencing a medical emergency, dial 911 immediately.
Common Side Effects
The most common side effects associated with the use of ConZip and Percocet include the following:
Severe Side Effects
Severe side effects associated with the use of ConZip include:
Increased risk of seizure
Respiratory depression
Severe side effects associated with the use of Percocet include:
Respiratory depression
Adrenal insufficiency
Liver toxicity
Increased risk of seizure
Safely Taking ConZip vs. Percocet
ConZip should be taken at most once daily, while Percocet may be taken throughout the day as directed or prescribed.
If prescribed ConZip or Percocet, you should never double your dose, but you may take a missed dose as soon as you remember. If it's almost time for your next dose, skip the missed dose and continue your usual schedule.
Use of either medication is not recommended in pregnant or breastfeeding people and has the potential to result in fetal harm.
ConZip capsules should be swallowed whole. Avoid breaking, chewing, or splitting the capsules.
These medications should be titrated or discontinued under the supervision of your provider. Do not abruptly discontinue the use of either medication.
Potential for Interaction
Avoid taking ConZip with the following medications due to their potential to affect absorption and effectiveness:
Some antidepressant medications, such as Prozac (fluoxetine) and Wellbutrin (bupropion)
Macrolide antibiotics, such as erythromycin
Azole-antifungal agents, such as ketoconazole
Protease inhibitors, such as Norvir (ritonavir)
Benzodiazepines and other nervous system depressants, such as anxiety medications, muscle relaxants, antipsychotics, and other opioids, should be avoided due to the potentially harmful effects that may occur when taken together.
Finally, avoid alcohol intake when taking either drug.
Review of Efficacy
Opioids are seen as effective treatment options for pain management when used short-term (less than three months).
However, overall, more research is needed to assess the long-term efficacy of opioids.
Head-to-Head Review
Tramadol was found to be just as effective as oxycodone when used for pain relief following various types of surgery.
Alternative Treatment Options
Some non-drug therapies for pain management include:
Exercise
Weight loss
Massage
Acupuncture
Mind-body practices such as yoga
Summary
Opioids are a group of medications used to treat and manage pain.
Opioids work to manage pain by reducing the body’s perception of pain and decreasing the release of pain signals.
Conzip (tramadol) and Percocet (oxycodone/acetaminophen) are both prescription-only medications that are FDA-approved for the management of severe and persistent pain.
The significant difference between ConZip and Percocet is their drug classes and active ingredients.
ConZip is an opioid agonist and contains a single active ingredient. Percocet contains oxycodone, which is a narcotic pain reliever, and acetaminophen, which is an analgesic pain reliever.
Understanding the differences between these drugs is essential to appropriately assess the pain management strategies you may be presented with.
These medications should be prescribed, titrated, and discontinued under the supervision of your provider to prevent medication tolerance or abuse. Do not abruptly discontinue the use of either medication.
Frequently Asked Questions
How do I store ConZip or Percocet?
ConZip and Percocet should be stored in a secure, dry area at room temperature (68–77 degrees F).
Do not store either medication in bathrooms or other areas susceptible to high heat, light, or moisture.
They should be kept out of the sight and reach of children and pets.
Can Tylenol be taken alongside ConZip or Percocet?
Tylenol can be taken alongside ConZip. Use caution when taking additional Tylenol with Percocet as it already contains the active ingredient in Tylenol (acetaminophen).
Liver injury is associated with doses of acetaminophen exceeding 4 grams (g) per day, especially if taking more than one medication containing acetaminophen.
How likely is opioid tolerance? How can this risk be mitigated?
Tolerance occurs when more medication is required over time to experience the same pain-relief effect. The risk of developing opioid tolerance increases with repeat opioid use.
Opioid tolerance risk can be mitigated by considering alternatives to opioids for pain management and following the recommendations of your healthcare provider.
Read the original article on Verywell Health.
