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 does not eliminate the sensation of pain but decreases
discomfort by increasing tolerance to pain. In addition to tolerance to pain,
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 destroyed after 90 days.
PRESCRIBED FOR: Oxycodone is prescribed for the relief of moderate to
severe pain.
DOSING: The usual starting dose using immediate release oxycodone
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;
swallow tablets whole. Broken, crushed or chewed continuous release tablets may
lead to increased absorption and dangerous levels of oxycodone.
The 80 mg and
160 mg tablets should only be used by patients who require daily doses of at
least 160-320 mg and are tolerant to opioid therapy. Administration of large
doses to opioid-naïve patients may lead to profound depression of breathing.
The
usual adult dose of oral concentrate 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, for example,
carisoprodol (Soma),
cyclobenzaprine (Flexeril), and
benzodiazepines, for example,
lorazepam (Ativan). Combined use of muscle relaxants and oxycodone
may lead to increased respiratory depression.
Since oxycodone causes constipation, the use of antidiarrheals,
for example,
diphenoxylate (Lomotil) and loperamide (Imodium), in persons taking oxycodone,
can lead to severe constipation.
Drugs which stimulate and also block opioid receptors [or example,
pentazocine,
nalbuphine (Nubain),
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%.
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 side effects in the newborn.
SIDE EFFECTS: The most frequent side effects 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, symptoms of withdrawal may develop. The dose of
oxycodone should be gradually reduced in order to avoid withdrawal symptoms.
Last Editorial Review: 12/10/2008
Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.
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