Pharmacy Author: Omudhome Ogbru, PharmD
Medical and Pharmacy Editor: Jay W. Marks, MD

GENERIC NAME: oxycodone

BRAND NAMES: OxyContin, Roxicodone, M-oxy, ETH-Oxydose, Oxyfast, OxyIR

DRUG CLASS AND MECHANISM: Oxycodone is a strong narcotic pain-reliever and cough suppressant similar to morphine, codeine and hydrocodone. The precise mechanism of action is not known but may involve stimulation of opioid receptors in the brain. Oxycodone increases pain tolerance and decreases discomfort, but the presence of pain is still apparent. In addition to pain reduction, oxycodone also causes sedation and respiratory depression. The FDA approved oxycodone in 1976.

GENERIC AVAILABLE: Yes

PRESCRIPTION: Yes

PREPARATIONS: Tablets: 5, 10, 15, 20, and 30 mg. Controlled release tablets: 10, 20, 40, and 80 mg. Capsules: 5 mg. Solution: 5 mg/5 ml, 20 mg/ml

STORAGE: Oxycodone should be stored between 15° to 30°C (59° to 86°F). Open bottles of oral solution should be discarded after 90 days.

PRESCRIBED FOR: Oxycodone is prescribed for the relief of moderate to severe pain.

DOSING: The usual starting dose using immediate release tablets is 10 to 30 mg every 4 hours. Patients who have never received opioids should receive 5-15 mg every 4 to 6 hours. Some patients may require 30 mg or more every 4 hours. The starting dose using immediate release capsules is 5 mg every 6 hours.

Continuous release tablets are administered every 12 hours and are used when around the clock treatment is required for an extended time period. Continuous release tablets should not be broken, crushed or chewed; tablets should be swallowed whole. Broken, crushed or chewed tablets may lead to increased absorption and dangerous levels of oxycodone.

The 80 mg and 160 mg tablets should only be used by patients that require daily doses of at least 160-320 mg and are tolerant of opioid therapy. Administration of large doses to opioid naive patients may lead to profound respiratory depression and even death.

The usual adult dose of oral solution (20 mg/ml) is 5 mg every 6 hours. The usual adult dose for the oral solution (5 mg/ml) is 10-30 mg every 4 hours.

DRUG INTERACTIONS: Oxycodone, like other narcotic pain-relievers, increases the effect of drugs that slow brain function, such as alcohol, barbiturates, skeletal muscle relaxants such as carisoprodol (Soma) and cyclobenzaprine (Flexeril), and benzodiazepines such as lorazepam (Ativan). Combined use of muscle relaxants and oxycodone may lead to increased respiratory depression.

Since oxycodone causes constipation, the use of antidiarrheals such as, diphenoxylate (Lomotil) and loperamide (Imodium) in persons taking oxycodone can lead to severe constipation.

Drugs which stimulate and also block opioid receptors [for example, pentazocine, nalbuphine, butorphanol (Stadol), buprenorphine (Subutex)] may reduce the effect of oxycodone and may precipitate withdrawal symptoms.

A fatty meal may increase the absorption of oxycodone by 27% and increase the toxicity of oxycodone..

PREGNANCY: Safety during pregnancy has not been established. Children born to mothers who were taking oxycodone for a prolonged period may exhibit respiratory depression or withdrawal symptoms.

NURSING MOTHERS: Small amounts of oxycodone are secreted in breast milk and may cause adverse events in the newborn infant.

SIDE EFFECTS: The most frequent adverse reactions of oxycodone include lightheadedness, dizziness, sedation, nausea, vomiting, headache, rash, constipation, dry mouth, and sweating.

• Oxycodone can depress breathing, and is used with caution in elderly, debilitated patients and in patients with serious lung disease.
  
  
• Oxycodone can impair thinking and the physical abilities required for driving or operating machinery.
  
  
• Oxycodone is habit forming.
  
  
• Mental and physical dependence can occur, but are unlikely when used for short-term pain relief. If oxycodone is suddenly withdrawn after prolonged use withdrawal symptoms may develop.
  
  
• The dose of oxycodone should be gradually reduced in order to avoid withdrawal symptoms.

From the Doctors at MedicineNet.com

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