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Medications and Drugs

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.

Reference: FDA Prescribing Information


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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