What is oxycodone, and how does it work (mechanism of action)?
- Oxycodone is a strong narcotic pain-reliever and cough suppressant similar to morphine, codeine, and hydrocodone. The precise mechanism of action (how it works) is not known, but it may involve stimulation of opioid receptors in the brain. Oxycodone does not eliminate the sensation of pain but decreases discomfort by increasing the tolerance to pain. In addition to tolerance to pain, oxycodone also causes sedation and depression of respiration.
- The FDA approved oxycodone in 1976.
What are the uses for oxycodone?
- Oxycodone is prescribed for the management of pain severe enough to require daily, around-the-clock, long-term treatment with a narcotic, and for which alternative treatment options are inadequate for the relief of moderate to severe pain.
What are the side effects of oxycodone?
The most frequent side effects of oxycodone include:
Other side effects of oxycodone include:
- Heart attack
- Abnormal heartbeats
- Urinary retention
Oxycodone is used with caution in the elderly, debilitated patients, and in patients with serious lung disease because it can depress breathing.
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 If oxycodone is suddenly withdrawn after prolonged use, symptoms of withdrawal may develop.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.
What is the dosage for oxycodone?
- The usual starting dose using immediate release oxycodone tablets is 5 to 30 mg every 4 to 6 hours. Patients who have never received opioids should start with 5-15 mg every 4 to 6 hours. Some patients may require 30 mg or more every 4 hours.
- The usual starting dose using extended release tablets is 10 mg every 12 hours. Extended release tablets are used when around-the-clock treatment is required for an extended period. Extended release tablets should be swallowed whole, broken, crushed, or chewed. Breaking, crushing, or chewing extended release tablets may lead to rapid absorption of the drug and dangerous levels of oxycodone.
- Patients who have been using opioids and have become tolerant to opioid therapy should only use the 60 and 80 tablets or single doses greater than 40 mg. Administration of large doses to opioid-naïve patients may lead to profound depressed breathing. The usual adult dose for the oral solution (5 mg/5 ml) is 10-30 mg every 4 hours.
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Which drugs or supplements interact with oxycodone?
- Oxycodone, like other narcotic pain-relievers, increases the effects of drugs that slow brain function, such as:
- Combined use of the above drugs and oxycodone may lead to increased respiratory depression.
- Oxycodone should not be taken with any of the monoamine oxidase inhibitor (MAOI) class of antidepressants, for example, isocarboxazid (Marplan), phenelzine (Nardil), tranylcypromine (Parnate), selegiline (Eldepryl), and procarbazine (Matulane) or other drugs that inhibit monoamine oxidase, for example, linezolid (Zyvox). Such combinations may lead to confusion, high blood pressure, tremor, hyperactivity, coma, and death. Oxycodone should not be administered within 14 days of stopping an MAOI.
- Since oxycodone causes constipation, the use of antidiarrheals, for example, diphenoxylate and atropine (Lomotil) and loperamide (Imodium), in persons taking oxycodone, can lead to severe constipation.
- Drugs that stimulate and block opioid receptors for example, pentazocine, nalbuphine (Nubain), butorphanol (Stadol), and buprenorphine (Subutex) may reduce the effect of oxycodone and may precipitate withdrawal symptoms.
- Combining oxycodone with drugs that affect activity of certain liver enzymes or discontinuing such drugs may result in fatal oxycodone overdose.
- A fatty meal may increase the absorption of oxycodone by 27%.
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Is oxycodone safe to take if I’m pregnant or breastfeeding?
- 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.
- Small amounts of oxycodone are secreted in breast milk, which may cause side effects in the newborn.
What else should I know about oxycodone?
- Oxycodone is available as:
- Tablets (Immediate Release): 5, 7.5, 10, 15, 20, and 30 mg.
- Capsules (Immediate Release): 5 mg.
- Tablets (Extended Release): 10, 15, 20, 30, 40, 60, and 80.
- Oral Concentrate: 20 mg/ml.
- Oral Solution: 5 mg/5 ml
- Oxycodone should be stored between 15 C and 30 C (59 F and 86 F). Open bottles of oral solution should be destroyed after 90 days.
- Brand names available in the US for oxycodone are OxyContin, Roxicodone, Oxecta, Oxaydo, Xtampza ER, and Roxybond.
- Oxycodone is available in generic form.
- Oxocodone is a controlled narcotic in the US, and can only be obtained by a visit to your doctor.