Oxycodone

Oxycodone: Complete Guide with FAQs

Introduction

  • Oxycodone is a semi-synthetic opioid analgesic used to manage moderate to severe pain.
  • It is available as an immediate-release (IR) or extended-release (ER) formulation, providing flexibility in managing acute and chronic pain.
  • Oxycodone is highly effective but carries a significant risk of dependency, abuse, and overdose.

Class and Mechanism of Action

  • Drug Class: Opioid analgesic.
  • Mechanism: Binds to mu-opioid receptors in the central nervous system (CNS), inhibiting pain signals and altering the brain’s perception of pain.

Indications

  • Moderate to severe acute pain (e.g., post-surgical pain, injury).
  • Chronic pain conditions requiring around-the-clock pain management.
  • Cancer-related pain.

Dosage and Administration

  • Forms Available:
    • Immediate-release tablets.
    • Extended-release tablets.
    • Oral solutions.
    • Capsules.
    • Combination formulations (e.g., with acetaminophen or ibuprofen).

Typical Dosages

  • Immediate-Release (IR):
    • Adults: 5–15 mg every 4–6 hours as needed.
  • Extended-Release (ER):
    • Adults: 10 mg every 12 hours, titrated based on pain response.
  • Combination Formulations:
    • Doses vary based on the secondary ingredient (e.g., acetaminophen).
  • Administration Guidelines:
    • Take ER formulations whole; do not crush, break, or chew.
    • Adjust dosing for opioid-naïve versus opioid-tolerant patients.

Forms, Brand Names, Manufacturers, and Prices

  • Immediate-Release Tablets:
    • Brand Names: Roxicodone (Mallinckrodt).
    • Price: ~$5–$10 per tablet.
  • Extended-Release Tablets:
    • Brand Names: OxyContin (Purdue Pharma).
    • Price: ~$15–$30 per tablet depending on dosage.
  • Oral Solutions:
    • Brand Names: Oxycodone Hydrochloride Oral Solution (generic).
    • Price: ~$20–$50 per bottle.
  • Combination Formulations:
    • Brand Names: Percocet (Endo Pharmaceuticals), Combunox.
    • Price: ~$10–$20 per tablet.

Contraindications and Precautions

  • Contraindications:
    • Severe respiratory depression.
    • Acute or severe asthma.
    • Paralytic ileus.
    • Hypersensitivity to oxycodone or its components.
  • Precautions:
    • Monitor for signs of misuse, dependency, and overdose.
    • Use cautiously in patients with respiratory conditions, liver or kidney impairment, or a history of substance abuse.
    • Avoid alcohol and other CNS depressants to reduce overdose risk.

Side Effects

Common Side Effects

  • Nausea and vomiting.
  • Constipation.
  • Drowsiness.
  • Dizziness.
  • Dry mouth.

Less Common Side Effects

  • Hypotension.
  • Sweating.
  • Headache.
  • Urinary retention.

Rare but Serious Side Effects

  • Respiratory depression.
  • Dependency and withdrawal symptoms with long-term use.
  • Overdose: Symptoms include pinpoint pupils, unconsciousness, and respiratory failure.

Drug Interactions

  • CNS Depressants: Enhanced sedation and respiratory depression (e.g., benzodiazepines, alcohol).
  • MAO Inhibitors: Risk of severe CNS toxicity; avoid concurrent use.
  • Cytochrome P450 Inhibitors (CYP3A4): Increased oxycodone levels (e.g., ketoconazole, erythromycin).
  • Cytochrome P450 Inducers (CYP3A4): Reduced efficacy (e.g., rifampin, carbamazepine).

Monitoring Parameters

  • Assess pain relief and control.
  • Monitor for respiratory rate, oxygen saturation, and sedation levels.
  • Evaluate signs of misuse, dependency, or withdrawal.
  • Regular liver and kidney function tests for long-term users.

Patient Counseling Points

  • Take oxycodone exactly as prescribed; do not share it with others.
  • Avoid alcohol and other sedatives unless approved by a doctor.
  • Store securely and out of reach of children to prevent accidental ingestion or misuse.
  • Report symptoms like confusion, extreme drowsiness, or difficulty breathing immediately.
  • Use a stool softener or laxative to prevent constipation.

Use in Children

  • Not typically recommended; use is limited to specific cases under strict medical supervision.

Use in Pregnancy

  • Category C: May cause fetal harm; use only if benefits outweigh risks.
  • Prolonged use during pregnancy can lead to neonatal opioid withdrawal syndrome.

Use in Elderly

  • Start at lower doses due to increased sensitivity to side effects like sedation and respiratory depression.

FAQs About Oxycodone

Q1: What is oxycodone used for?

  • It is used to manage moderate to severe pain, particularly in chronic or cancer-related conditions.

Q2: Is oxycodone addictive?

  • Yes, it has a high potential for addiction and dependency.

Q3: How long does oxycodone stay in your system?

  • Immediate-release forms last 4–6 hours; extended-release forms last 12 hours.

Q4: Can I take oxycodone with food?

  • Yes, taking it with food can reduce nausea.

Q5: What are the signs of an oxycodone overdose?

  • Symptoms include slow or shallow breathing, pinpoint pupils, and unconsciousness.

Q6: Can I stop taking oxycodone abruptly?

  • No, stopping suddenly can cause withdrawal symptoms. Taper off under medical supervision.

Q7: What should I do if I miss a dose?

  • Take it as soon as you remember unless it’s close to the next dose. Do not double up doses.

Q8: Is oxycodone safe for long-term use?

  • Long-term use is possible but requires close monitoring to manage risks like tolerance and dependency.

Q9: How does oxycodone compare to hydrocodone?

  • Oxycodone is generally more potent than hydrocodone and may have different side effect profiles.

Q10: Can I drink alcohol while taking oxycodone?

  • No, alcohol increases the risk of sedation and respiratory depression.

Q11: How should I dispose of unused oxycodone?

  • Follow local regulations or use a drug take-back program; avoid flushing unless specifically advised.

Q12: Can I use oxycodone during breastfeeding?

  • Not recommended as it passes into breast milk and may cause sedation or respiratory depression in the baby.

Q13: What are the alternatives to oxycodone for pain management?

  • Alternatives include morphine, hydromorphone, and non-opioid options like NSAIDs or acetaminophen for less severe pain.

Q14: What is the difference between oxycodone and OxyContin?

  • OxyContin is the extended-release form of oxycodone, designed for long-lasting pain control.

Q15: What should I do in case of an overdose?

  • Seek emergency medical help immediately and administer naloxone if available.

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