In 2022, 8.3 million people aged 12 or older reported misusing prescription pain relievers like oxycodone in the past year. Oxycodone products, including pills like M523, are among the most commonly misused prescription opioids in the U.S.
For many, opioid misuse begins unintentionally. They take an extra dose for pain relief or tell themselves they’re going to use someone else’s prescription just one time. However, because of oxycodone’s powerful effects, that “one time” can quickly turn into a pattern of dependence. M523 pills, though medically useful, carry real risks when not used exactly as directed.
In this article, you will learn how to identify an M523 pill, the common uses for it, side effects, risks of abuse, and more.
To speak with an addiction specialist or get answers about starting treatment, don’t hesitate to reach out to our team at First Step Behavioral Health today.
What is a White Oval Pill Marked M523?
A white, oval pill with the imprint M523 is a prescription medication that contains oxycodone hydrochloride 10 mg and acetaminophen 325 mg. It’s a generic version of Percocet, a combination pain reliever that is typically prescribed to treat moderate to severe pain.
The pill is manufactured by Mallinckrodt Pharmaceuticals, and the imprint “M523” helps identify it. One side of the pill is marked, and the other is scored to make it easier to split if needed. The “M” stands for Mallinckrodt, the manufacturer, while “523” is a unique marker to accurately identify acetaminophen-oxycodone. Unique markers like these are essential in order for prescribers and patients to identify medications properly.
Oxycodone is a strong opioid that activates opioid receptors in the brain and changes the way the brain responds to pain by reducing pain signals. It’s a Schedule II controlled substance due to its strong potential for misuse and dependence.
Acetaminophen (often known by the brand name Tylenol) is a non opioid pain reliever and fever reducer that helps boost the effectiveness of the oxycodone. Because this pill contains an opioid, it has a high potential for misuse, addiction, and dependence, especially when taken in larger amounts or for longer than prescribed.
If you find a pill marked M523 and it wasn’t prescribed to you, or if you’re unsure about its use, it’s important to contact a pharmacist or healthcare provider before taking it. Misuse of this medication can lead to serious health risks, including overdose.
Common Uses for M523 Pills
M523 pills, which contain oxycodone 10 mg and acetaminophen 325 mg, are prescribed to manage moderate to severe pain that doesn’t respond well to over-the-counter medications. This includes both short-term and longer-lasting pain conditions, depending on the patient’s needs and history.
A medical professional may prescribe M523 for:
- Post-surgical pain – An M523 pill can provide significant pain relief, especially after procedures where pain is expected to be intense during recovery.
- Injury-related pain – It’s often used to treat pain due to injuries, such as fractures, sprains, or severe muscle strains.
- Chronic pain conditions – When patients can’t get the same pain relieving effects from non-opioid drugs, oxycodone may be prescribed for chronic pain, including lower back pain, arthritis, or pain from nerve damage.
- Cancer-related pain – Opioids are frequently used to help improve comfort and quality of life during cancer treatment.
The M523 pill is usually taken every 4 to 6 hours as needed for pain relief. Because it contains an opioid, it’s typically prescribed for short-term use. Long-term use is generally avoided unless no other options are effective, due to the risk of tolerance, physical dependence, and addiction.
Always follow a doctor’s instructions carefully when using the M523 white pill. Taking more than prescribed or mixing it with alcohol or other substances can increase the risk of serious side effects, including respiratory depression and opioid overdose.
Side Effects
Like other medications that contain oxycodone and acetaminophen, the M523 pill can cause a range of side effects, some of which are relatively mild and others are more serious. Side effects often depend on the dosage, how long the person has been taking it, and individual sensitivity to opioids.
Common side effects include:
- Drowsiness or sedation
- Dizziness or lightheadedness
- Nausea or vomiting
- Constipation
- Headache
- Dry mouth
- Mood swings
These symptoms are typical, especially when starting the medication or after a dose increase. They may improve as your body adjusts to the drug. If they don’t improve or get worse, speak with your doctor immediately, or seek medical attention in the event of an emergency.
Serious side effects may include:
- Shallow or slowed breathing
- Severe drowsiness or trouble staying awake
- Confusion or difficulty thinking clearly
- Low blood pressure
- Liver damage (especially if taken in high doses due to the acetaminophen content)
- Allergic reactions like rash, itching, or swelling
Long-term use or misuse of M523 pills increases the risk of tolerance, dependence, and addiction as well as respiratory depression. Taking too much, either on purpose or by accident, can lead to overdose, which can be life-threatening. Signs of overdose include blue lips or fingernails, unconsciousness, and extremely slow breathing.
The Risks of Misusing Acetaminophen and Oxycodone
If you had Percocet prescribed to you, be sure to take it exactly as directed. Misusing a pill like M523, which combines acetaminophen and oxycodone, can be extremely dangerous and can lead to a range of negative consequences. Each ingredient carries its own set of serious risks when not taken as prescribed.
Risk of Addiction and Dependence
Oxycodone is a powerful opioid. Taking more than prescribed, taking it too often, or using it without a prescription can quickly lead to tolerance (needing more for the same effect), dependence, and eventually addiction. Once dependence sets in, stopping the drug suddenly can cause painful withdrawal symptoms like chills, nausea, anxiety, and muscle aches.
Risk of Overdose
High doses of oxycodone can slow down or stop breathing. This is the most life-threatening effect of opioid misuse. Overdoses can happen when people take too much at once, combine it with alcohol or other drugs, or take it in a way it wasn’t meant to be used (like crushing and snorting).
Liver Damage from Acetaminophen
Acetaminophen is generally safe in recommended doses, but too much can severely damage the liver. Taking just a few extra pills can lead to acute liver failure, especially if combined with alcohol or other medications that strain the liver. Overdosing on acetaminophen can be fatal and may not cause symptoms right away.
Accidental Misuse
Some people may misuse M523 pills unintentionally by taking more for extra pain relief or mixing them with other substances without realizing the risks. Even seemingly small changes in how it’s used can have serious consequences.
In short, while the M523 white pill can be an effective pain reliever when used correctly, misusing it, whether recreationally or by accident, puts you and your health at serious risk. If you or someone you know is struggling to use it safely, it’s important to reach out for help from a doctor or treatment center.
How Long Does the M523 Pill Stay in Your System?
Oxycodone is a fast-acting opioid. On average, a single dose can provide pain relief for 4 to 6 hours, but traces of the drug can remain in your body much longer, depending on factors like your metabolism, body fat, liver function, and how often you’ve been taking it.
Here’s a general breakdown of how long oxycodone (the main active ingredient) stays detectable:
- Blood: up to 24 hours
- Urine: 3 to 4 days after the last dose
- Saliva: up to 2 days
- Hair: up to 90 days
Acetaminophen, the second ingredient, leaves the body more quickly, usually within 24 hours, and is not commonly tested for in drug screenings.
Keep in mind that if you’ve been taking M523 pills regularly or in high doses, it may take longer to fully clear from your system. Extended use can also lead to drug buildup in the body, especially in people with slower metabolism or liver issues.
If you’re taking this medication and are concerned about drug testing, or if you’re trying to stop after long-term use, it’s best to talk to a healthcare provider. Quitting suddenly can lead to physical and psychological withdrawal symptoms, and medical guidance can help make the process safer.
Signs of Prescription Pill Addiction
Addiction to prescription pills like the M523 (oxycodone/acetaminophen) can develop gradually and isn’t always easy to spot, especially when the medication started as a legitimate way to manage pain. Over time, the need to feel relief or avoid withdrawal can take over, leading to behaviors that signal a deeper issue.
Here are some common signs of prescription pill addiction:
- Taking more than prescribed, or using the medication more often than directed
- Running out of pills early or visiting multiple doctors to try to obtain additional prescriptions (doctor shopping)
- Thinking about the pill constantly, including how to get more or when the next dose is
- Changes in mood or behavior, such as irritability, anxiety, or unusual secrecy
- Neglecting responsibilities at work, home, or school because of pill use
- Lying to friends or family about how much or how often the medication is being used
- Loss of interest in hobbies or activities that used to matter
- Using the pills to cope with emotions, stress, or mental health struggles
- Withdrawal symptoms (like nausea, chills, sweating, or restlessness) if you try to stop
If you or your loved one is struggling with opioid addiction, early intervention is key, and it’s never too late to ask for help from a trusted healthcare professional. Seek professional treatment as soon as you identify the signs of addiction.
Can You Overdose on M523 Pills?
Oxycodone is a strong opioid, and when it’s taken in amounts beyond the recommended dosage or mixed with other central nervous system depressants, it can have serious adverse effects, one of which is overdose.
Too much oxycodone can slow down your breathing to the point that it stops completely. This is the most serious and immediate danger. Signs of an opioid overdose include:
- Slow or shallow breathing
- Blue or gray lips and fingernails
- Extreme drowsiness or loss of consciousness
- Cold or clammy skin
- Pinpoint pupils
If someone shows these signs, call 911 right away and administer naloxone (Narcan) if available. Every second counts, so it’s important to act immediately.
Even though acetaminophen is available over the counter, it can cause severe liver damage if taken in high doses. Acetaminophen overdose symptoms may not appear right away, but can include:
- Nausea or vomiting
- Loss of appetite
- Pain in the upper right side of the abdomen
- Yellowing of the skin or eyes (jaundice)
- Confusion or unusual tiredness
Liver damage from acetaminophen can be permanent or fatal if not treated quickly.
Overdoses often happen when M523 pills are taken with alcohol, benzodiazepines (like Xanax or Valium), or other drugs that depress the central nervous system. This combination makes it even more likely for breathing to slow or even stop completely.
Find Opioid Addiction Treatment Today
M523 white oval shaped pills carry significant risks when abused, but there are effective treatment programs available.
Treatment for opioid addiction often includes:
- Medical detox to manage withdrawal safely and comfortably
- Medication-assisted treatment (MAT) like buprenorphine or methadone to reduce cravings
- Therapy and counseling to address underlying mental health concerns and build coping skills
- Support groups and aftercare planning to maintain long-term recovery
At First Step Behavioral Health, we offer comprehensive opioid addiction treatment programs, complete with detox under medical supervision, all-day care through our partial care program, and intensive outpatient treatment programs that help you maintain sobriety and ongoing support.
Don’t wait any longer for the help you need–contact us today to get started.
References:
- Daily Med: oxycodone hydrochloride and acetaminophen tablet
- U.S. Drug Enforcement Administration (DEA): Oxycodone
- American Heart Association (AHA) Journals: Acetaminophen, Nonsteroidal Anti-Inflammatory Drugs, and Hypertension
- JAMA Network: Effectiveness of Oxycodone Hydrochloride (Strong Opioid) vs Combination Acetaminophen and Codeine (Mild Opioid) for Subacute Pain After Fractures Managed Surgically
- Oxford Academic: Effectiveness and Safety of New Oxycodone/Acetaminophen Formulations With Reduced Acetaminophen for the Treatment of Low Back Pain
