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Usual Adult Dose for:
Additional dosage information:
Usual Adult Dose for Pain
The following dosing recommendations can only be considered suggested approaches to what is actually a series of clinical decisions over time in the management of the pain of each individual patient.
-Immediate Release (IR): 5 to 15 mg orally every 4 to 6 hours
-Controlled Release (CR): 10 mg orally every 12 hours
-Solution 5 mg per 5 mL: 5 to 15 mg every 4 to 6 hours
-Solution Concentrate 100 mg/5 mL (20 mg/mL): For patients that have already been titrated to a stable analgesic regimen using lower strengths of oxycodone and who can benefit from use of a smaller volume of oral solution.
-Titrate dose based upon the individual patient response to their initial dose.
-Adjust dose to an acceptable level of analgesia taking into account the improvement in pain intensity and the tolerability.
-Administration of supplemental analgesia for breakthrough pain and titration of the total daily dose may be necessary, especially in patients with rapidly changing disease states.
-When converting from other narcotic pain relievers to oxycodone, the manufacturer product information and/or local protocol should be consulted.
-Doses should be swallowed whole with enough water to ensure complete swallowing immediately after placing in the mouth. Doses should not be crushed or administered via nasogastric, gastric or other feeding tubes as it may cause obstruction.
Renal Dose Adjustments
CrCl less than 60 mL/minute: Start conservatively and titrate dosage carefully to desired effect
Liver Dose Adjustments
Initial: Give one-third to one-half of the usual dose; titrate dosage carefully to desired effect.
Treatment may require cautious initiation and adjustment according to the severity of pain, history of opioid tolerance, patient response, and tolerance of side effects. Parenteral therapy may also require adjustments according to additional monitoring of respiratory rate and sedation score.
Dosage reductions may be required with concomitant CNS depressant therapy.
As needed "rescue doses" of immediate release oral oxycodone may be needed for patients with cancer pain. The need for more than 2 rescue doses per day may require a review of the controlled release dose.
Oxycodone should not be ceased abruptly; the daily dose should be gradually tapered to minimize or prevent withdrawal symptoms.
The US FDA requires a Risk Evaluation and Mitigation Strategy (REMS) for extended-release and long-acting opioid analgesics. The REMS consists of a medication guide and elements to assure safe use. Additional information is available at www.fda.gov/Drugs/DrugSafety/postmarketDrugSafetyInformationforPatientsandProviders/ucm111350.htm.
-ABUSE AND ADDICTION: Oxycodone has an abuse liability similar to morphine. This should be considered when prescribing or dispensing oxycodone in situations where the physician or pharmacist is concerned about an increased risk of misuse, abuse, or diversion.
-RESPIRATORY: Opioid agonists frequently cause respiratory depression which, if not immediately recognized and treated, may lead to respiratory arrest and death. Respiratory depression from opioids is manifested by a reduced urge to breathe and a decreased rate of respiration, often associated with a "sighing" pattern of breathing. Carbon dioxide (CO2) retention from opioid-induced respiratory depression can exacerbate the sedating effects of opioids. Management of respiratory depression may include close observation, supportive measures, and use of opioid antagonists, depending on patient status. The risk is greatest during the initiation of therapy or following a dose increase. Patients should be monitored for respiratory depression.
-OVERDOSE: Accidental ingestion can result in fatal overdose of oxycodone, especially in children.
-NEONATE WITHDRAWAL SYNDROME: Prolonged use during pregnancy can result in neonatal opioid withdrawal syndrome, which may be life-threatening if not treated, and requires management according to protocols developed by neonatology experts. If opioid use is required for a prolonged period in a pregnant woman, the patient should be advised of the risk of neonatal opioid withdrawal syndrome and appropriate treatment should be available.
-ALCOHOL: patients should not drink alcoholic beverages or use prescription or nonprescription products that contain alcohol while taking this drug. The co-ingestion of alcohol may result in increased plasma levels and a potentially fatal overdose of oxycodone.
-GENERAL: Oxycodone, like other narcotic analgesics, should be administered with caution to patients with head injuries, increased intracranial pressure, acute undiagnosed abdominal pain, circulatory shock, respiratory depression, hypothyroidism, severe renal and/or liver disease, Addison's disease, prostatic hypertrophy, urethral stricture, acute alcoholism, delirium tremens, seizure risk, biliary tract disease, and general debilitation.
Safety and efficacy have not been established in patients younger than 18 years. Established local clinical guidelines should be consulted before initiating use in these patients.
Consult WARNINGS section for additional precautions.
US Controlled Substance: Schedule II
Data not available
This drug is not for use:
-As an as needed (prn) analgesic
-For mild pain or pain that is not expected to persist for an extended period of time
-For acute pain
-In the immediate postoperative period (the first 24 hours following surgery) for patients not previously taking the drug.
-For postoperative pain unless the patient is already receiving chronic opioid therapy prior to surgery, or if the postoperative pain is expected to be moderate to severe and persist for an extended period of time.
-Side effects associated with opioids, apart from constipation, generally reduce with time. Anticipation and management of these effects may improve tolerability.
-Controlled release forms should not be used in opioid naive patients.
-Oxycodone tablets should be taken one tablet at a time with enough water to ensure complete swallowing immediately after placing in the mouth.
-The controlled-release form of oxycodone should not be broken, chewed, or crushed as this could lead to a faster release and absorption of oxycodone, potentiating toxicity.
-High fat meals may increase absorption of oxycodone.
-Oxycodone conventional release preparations are generally used for a 4 to 6 week trial period prior to transferring to longer acting, controlled release preparations.
More about oxycodone
- Oxycodone capsules
- Oxycodone concentrate
- Oxycodone solution
- Oxycodone sustained-release tablets
- Oxycodone (Advanced Reading)