Oxycodone


Generic Medicine Info
Indications and Dosage
Intravenous
Moderate to severe pain
Adult: As inj: 1-10 mg over 1-2 min, repeated not more often than 4 hrly. As infusion: Initially, 2 mg/hr, increased as necessary. Patient-controlled analgesia (PCA): 0.03 mg/kg, admin w/ a minimum lock-out time of 5 min.
Elderly: Give the lowest dose w/ careful titration to pain control.

Oral
Moderate to severe pain
Adult: Initially, 5 mg 4-6 hrly may increase as necessary. Extended-release tab: 5-10 mg 12 hrly. Max: 400 mg/day.

Subcutaneous
Moderate to severe pain
Adult: As inj: Initially, 5 mg 4 hrly. As infusion: Initially, 7.5 mg daily adjusted according to response.
Elderly: Give the lowest dose w/ careful titration to pain control.
Renal Impairment
Oral:
Mild to moderate: Initial: 2.5 mg 6 hrly. Severe: Contraindicated.
Intravenous/Subcutaneous:
Mild to moderate: Give the lowest dose w/ careful titration to pain control. Severe: Contraindicated.
Hepatic Impairment
Oral:
Mild: Initial: 2.5 mg 6 hrly. Moderate to severe: Contraindicated.
Intravenous/Subcutaneous:
Mild: Give the lowest dose w/ careful titration to pain control. Moderate to severe: Contraindicated.
Administration
Prolonged-Release: May be taken with or without food. 160 mg tab must be taken on an empty stomach. Do not take w/ high fat meals. All strengths: Swallow whole, do not break/chew/crush. Taking broken, chewed or crushed tab leads to rapid release & absorption of a potentially fatal dose of oxycodone.
Reconstitution
Dilute to 1 mg/mL in 0.9% saline, 5% dextrose or water for inj.
Incompatibility
Prochlorperazine, cyclizine in concentrations greater than 3 mg/mL or when diluted in 0.9% saline.
Contraindications
Resp depression, known or suspected paralytic ileus, acute abdomen, delayed gastric emptying, COPD, cor pulmonale, acute or chronic bronchial asthma, hypercarbia, chronic constipation. Concurrent admin of MAOIs or w/in 2 wk of discontinuation of use. Moderate to severe hepatic and severe renal impairment. Lactation.
Special Precautions
Patient w/ raised intracranial pressure, hypotension, hypovolaemia, toxic psychosis, biliary tract diseases, pancreatitis, inflammatory bowel disorders, prostatic hypertrophy, adrenocortical insufficiency, history of drug abuse or acute alcoholism, delirium tremens, thyroid dysfunction. Mild to moderate renal and mild hepatic impairment. Pregnancy.
Adverse Reactions
Nausea, constipation, vomiting, resp depression, headache, pruritus, insomnia, dizziness, asthenia, somnolence, abdominal pain, chills and fever, hypotension, anorexia, diarrhoea, dyspepsia, dysphagia, anxiety, nervousness, tremor, vasodilation, cough, dyspnoea, rash.
PO: B (Prolonged use may cause neonatal opioid withdrawal syndrome (NOWS).)
Patient Counseling Information
May impair ability to drive or operate machinery.
MonitoringParameters
Monitor pain relief, resp and mental status, BP; signs of misuse, abuse, and addiction; signs or symptoms of hypogonadism or hypoadrenalism.
Overdosage
Symptoms: Pin-point pupils, resp depression, hypotension. Circulatory failure and somnolence progressing to stupor or deepening coma, skeletal muscle flaccidity, bradycardia and death may occur in more severe cases. Management: Maintain adequate respiration and employ supportive measures (including oxygen and vasopressors) in the management of circulatory shock and pulmonary oedema. Cardiac arrest or arrhythmias may require cardiac massage or defibrillation. Naloxone may be used as an antidote.
Drug Interactions
Potentiates the effects of tranquilisers, anaesth, hypnotics, anti-depressants, sedatives, phenothiazines, neuroleptic drugs, other opioids, muscle relaxants and antihypertensives. Concurrent admin of quinidine, a CYP2D6 inhibitor may cause an increase in serum levels and elimination half-life of oxycodone. Cimetidine and CYP3A inhibitors (e.g. ketoconazole, erythromycin) may inhibit the metabolism of oxycodone.
Potentially Fatal: Concurrent admin of MAOIs may result to CNS excitation or depression w/ hypertensive or hypotensive crisis.
Food Interaction
May potentiate the CNS depressant effect of alcohol.
Action
Description: Oxycodone is a synthetic phenanthrene-derivative opiate agonist. It binds to opiate receptors in the CNS, causing inhibition of ascending pain pathways, altering the perception of and response to pain. It produces generalised CNS depression.
Onset: 10-15 min (immediate-release).
Duration: 3-6 hr (immediate-release); ≤12 hr (extended-release).
Pharmacokinetics:
Absorption: Absorbed from the GI tract. Bioavailability: Approx 60-87%.
Distribution: Crosses the placenta and enters breast milk. Volume of distribution: 2.6 L/kg. Plasma protein binding: Approx 45%.
Metabolism: Metabolised via glucuronidation to noroxycodone by CYP3A isoenzymes and to a lesser extent, to oxymorphone by CYP2D6.
Excretion: Via urine as unchanged drug. Elimination half-life: 2-4 hr.
Storage
Store between 15-30°C. Protect from light.
MIMS Class
References
Anon. Oxycodone. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 30/07/2014.

Buckingham R (ed). Oxycodone. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 30/07/2014.

Joint Formulary Committee. Oxycodone Hydrochloride. British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 30/07/2014.

McEvoy GK, Snow EK, Miller J et al (eds). Oxycodone, Oxycodone HCl, Oxycodone Terephthalate. AHFS Drug Information (AHFS DI) [online]. American Society of Health-System Pharmacists (ASHP). https://www.medicinescomplete.com. Accessed 30/07/2014.

Oxecta Tablet (Pfizer Laboratories Div Pfizer Inc). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 30/07/2014.

Disclaimer: This information is independently developed by MIMS based on Oxycodone from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to MIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, MIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2021 MIMS. All rights reserved. Powered by MIMS.com
  • Oxyneo
  • Oxynorm
  • Oxynorm Injection
Register or sign in to continue
Asia's one-stop resource for medical news, clinical reference and education
Sign up for free
Already a member? Sign in