Analgesic

Oxycodone

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Oxycodone, Percocet, Roxicodone, Oxycontin, Endocet, Roxicet

  • Indications
  1. Strong oral Opioid Analgesic for moderate to severe pain
  • Precautions
  1. Risk of serious respiratory depression
  2. Among the most abused and diverted prescription medications
  • Preparations
  • Immediate Release
  1. Oxycodone immediate release
    1. Adults (and over age 12 years) 5-10 mg every 4-6 hours as needed
    2. Child
      1. Moderate dose: 0.05 to 0.15 mg/kg/dose (up to 5 mg/dose) every 4-6 hours as needed
      2. High dose: 0.15 to 0.3 mg/kg/dose (up to 10 mg/dose) every 4-6 hours as needed
    3. Tabs: 5 mg (scored), 15, 30 mg
    4. Solution: 5 mg/ml
    5. Concentrate 20 mg/ml (dissolves sublingually)
  2. Acetaminophen and Oxycodone
    1. Percocet (Oxycodone 5 mg with Acetaminophen 325 mg)
      1. Dose: 1-2 orally every 6 hours as needed (adults or age over 12 years)
    2. Roxicet Solution (Oxycodone 5 mg and Acetaminophen 325 mg per 5 ml)
      1. Dose: Base on Oxycodone dose of 0.05 to 0.15 mg/kg/dose every 4-6 hours up to 5 mg/dose
  • Preparations
  • Controlled-Release (Extended Release)
  1. Oxycontin 10 mg every 12 hours
    1. Available in 10 mg, 15 mg, 20 mg, 30 mg, 40, 60 mg, 80 mg sustained release formulations
    2. Generic in U.S. as of 2016
  2. Precautions
    1. Start with short acting Oxycodone and convert to long acting based on pattern of requirements
    2. Titrate slowly: 80 mg is very high dose and only for Opioid tolerant patients
    3. Do not break or chew sustained release product (risk of Overdose)
    4. Sustained release product is intended only for scheduled use (not prn)
    5. Oxycontin true duration of action approaches 6 hours (instead of 12 hours) in many patients
      1. Oxycontin may offer no duration benefit over other formulations
      2. Oxycontin was released as MS Contin (8 hour duration) patent was expiring
      3. The exaggerated duration may add to misuse and abuse of Opioids
      4. Art Van Zee (2009) Am J Public Health 99(2): 221–7 +PMID:18799767 [PubMed]
  • Adverse Effects
  1. Respiratory depression or arrest
    1. Reversal: Naloxone
  2. Nausea or Vomiting
  3. Constipation
  4. Sedation
  • References
  1. Hamilton (2012) Tarascon Pharmacopeia, Jones and Bartlett, Burlington
  2. Robertson (2005) Harriet Lane Handbook, Mosby, Philadelphia p. 911