Drug reference

Oxycodone

Opioid Analgesic · Pain Management

Also known as OxyContin, OxyNorm, oxycodone hydrochloride

Opioid AnalgesicPain ManagementATC N02AA05

CDSCO approvedSchedule XATC N02AA05

EXCRETION

—

not curated

INTERACTIONS

12 major

SEVERE in our sources

PREGNANCY

—

not curated

Top interactionssee all 12 →

BarbituratesSevereTextbookKDT 7e · p401
BenzodiazepinesSevereTextbookKDT 7e · p383
Chlordiazepoxide HydrochlorideSevereTextbookG&G 14e
ClomethiazoleSevereTextbookG&G 14e

Mechanism

Oxycodone is a strong agonist at the mu-opioid receptors. As an opioid analgesic, it binds to these receptors in the central nervous system and other tissues, modulating pain perception.

Indications

Treatment of moderate to severe pain in patients with cancer who have difficulty in tolerating morphine or diamorphineTreatment of severe non-malignant pain in patients in whom controlled release morphine sulphate is ineffective or not toleratedanalgesiaAnalgesicPain control (in fixed combination with naloxone for opioid-induced constipation)

Dosing

Adult: Oral: 5 mg/3–4 h
Pediatric: Oral: 0.1 mg/kg/3–4 h
Renal adjustment: Avoid if eGFR less than 10 mL/minute/1.73 m2. Max. initial dose 2.5 mg every 6 hours in patients not currently treated with an opioid with mild to moderate impairment.
Hepatic adjustment: Caution in mild impairment; avoid in moderate to severe impairment. Initial dose reduction of 50% in mild impairment; adjust according to response.
Max dose: 40 mg oxycodone/20 mg naloxone every 12 h (fixed combination for pain control)

Pharmacokinetics

Onset

much faster uptake into the brain than morphine

Duration

3-4 hours

Bioavailability

3 (Kp,uu,brain)

Protein binding

45%

Metabolism

Hepatic metabolism to oxymorphone

Excretion

—

Contraindications

Combined with CNS depressants

Side effects

Common

InfectionInjuryLacrimation disorderMigraineOral disordersVoice alterationFever (with parenteral use)EuphoriaConstipationNauseaDrowsinessHypotensionRespiratory depressionVomitingDiarrhea

Serious

SIADH
Hypogonadism (with parenteral use)
Ureteral spasm (with parenteral use)
Haemorrhage (with oral use)
Lymphadenopathy (with oral use)
Muscle spasms (with oral use)
Photosensitivity reaction (with oral use)
Tooth discolouration (with oral use)
Weight changes (with oral use)
Dental caries (with parenteral use, frequency not known)
Hyperalgesia (with parenteral use, frequency not known)
Withdrawal syndrome neonatal (with parenteral use, frequency not known)
Toxicity from dose dumping
Addiction
Respiratory depression

Pregnancy & lactation

Lactation

Present in milk—avoid.

Drug interactions

Barbiturates

Severe

Textbook

Exaggerated CNS depression.

Source: KDT 7e · p401

Benzodiazepines

Severe

Textbook

Marked depression of respiration, cardiac contractility, and blood pressure.

Carefully monitor respiratory and cardiovascular functions when co-administering benzodiazepines with opioids due to increased risk of severe depression of vital signs.

Source: KDT 7e · p383

Chlordiazepoxide Hydrochloride

Severe

Textbook

Increased rates of accidental overdose and death.

Caution is advised, especially for patients with a history of drug abuse.

Source: G&G 14e

Clomethiazole

Severe

Textbook

Increased rates of accidental overdose and death.

Caution is advised, especially for patients with a history of drug abuse.