Oxycodone

Pronunciation

Class: Opiate Agonists
VA Class: CN101
CAS Number: 76-42-6
Brands: Combunox, Endocet, Endodan, Endocodone, OxyContin, Oxydose, OxyFast, OxyIR, Percocet, Percodan, Percolone, Roxicet, Roxicodone, Roxiprin, Tylox

Warning(s)

  • Abuse Potential
  • Schedule II controlled substance with abuse liability similar to morphine.b

  • Potential for abuse in a manner similar to other legal or illicit opiates.b Consider abuse potential when prescribing or dispensing oxycodone extended-release tablets (e.g., OxyContin) in situations where the clinician or pharmacist is concerned about increased risk of misuse, abuse, or diversion.b

  • Intended Uses of Extended-release Tablets (e.g., OxyContin)
  • Oxycodone hydrochloride extended-release tablets (e.g., OxyContin) are a controlled-release oral formulation indicated for the management of moderate to severe pain when a continuous, around-the-clock analgesic is needed for an extended period of time.b

  • Oxycodone hydrochloride extended-release tablets (e.g., OxyContin) are not intended for use as a prn analgesic.b

  • Only use the 80-mg formulation in opiate-tolerant patients.b This strength may cause fatal respiratory depression when administered to patients not previously exposed to opiates.b (See Dosage and Administration.)

  • Overdose Risk with Improper Administration of Extended-release Tablets (e.g., OxyContin)
  • Oxycodone hydrochloride extended-release tablets are to be swallowed whole and are not to be broken.b

  • Chewing, crushing, or dissolving the extended-release tablets could result in rapid release and absorption of a potentially fatal dose of oxycodone hydrochloride.b

REMS:

FDA approved a REMS for oxycodone to ensure that the benefits of a drug outweigh the risks. The REMS may apply to one or more preparations of oxycodone and consists of the following: medication guide and elements to assure safe use. See the FDA REMS page () or the ASHP REMS Resource Center ().

Introduction

Opiate agonist; phenanthrene-derivative.a

Uses for Oxycodone

Acute Pain

Relief of moderate to moderately severe pain.f g h i

Usually, temporary relief of moderate to moderately severe pain such as that associated with acute and some chronic medical disorders including renal or biliary colic, acute trauma, postoperative pain, and cancer.e

Additive analgesic effects with combinations of oxycodone and NSAIAs or acetaminophen because of differing mechanisms of action.c

Consider around-the-clock dosing of analgesics in the initial stages of acute pain to avoid wide swings in pain and sedation often associated with as-needed dosing regimens.e

Slideshow: Are You at Risk of Prescription Drug Addiction?

Extended-release tablets are not intended for use on an as-needed (“prn”) basis, but when a continuous, around-the-clock analgesic is needed for an extended period of time.

Chronic Pain

For relief of malignant (cancer) pain and chronic nonmalignant pain.e f g h

In the management of chronic pain associated with a terminal illness such as cancer, the principal goal of analgesic therapy is to make the patient relatively pain-free while maintaining as good a quality of life as possible.e

Analgesic therapy must be individualized and titrated according to patient response and tolerance.e f g h i

When opiate therapy is indicated, usually initiate with a mild, oral opiate like oxycodone.e f g h i

Although consideration of the dependence potential of opiate agonists has often limited their effective use by many clinicians in terminally ill patients with severe, chronic pain, such consideration is irrelevant in the context of terminal illness.e

Treatment of continuous or frequently recurring pain is best accomplished by the use of “around-the-clock” dosing regimens designed to prevent pain and minimize fluctuations in serum analgesic concentrations.e f g h

If pain severity increases, switching to more potent analgesics may be necessary; also consider alternative analgesic adjuncts such as tricyclic antidepressants or anticonvulsants (e.g., in the treatment of chronic nonmalignant pain such as neurogenic pain).e f g h

Oxycodone Dosage and Administration

General

Extended-release Tablets

  • Adjust dosage according to patient tolerance and response; provide supplemental analgesia in the form of conventional preparations or another suitable short-acting analgesic for breakthrough pain or to prevent pain that occurs predictably (e.g., incident pain associated with certain activities).

  • Only use the 80-mg formulation in opiate-tolerant patients whose opiate requirement is equivalent to a daily oxycodone dosage of 160 mg or more.

  • Supplemental analgesia may be necessary during therapy with extended-release tablets for breakthrough pain; discontinue any other existing around-the-clock opiate regimens when extended-release oxycodone therapy is initiated.

  • When therapy with oxycodone extended-release tablets is discontinued, it should be done gradually to avoid precipitation of withdrawal symptoms.

Administration

Oral Administration

Administer orally.a

Extended-release Tablets

Swallow tablets whole; do not divide, crush, or chew. (See Boxed Warning.)

Food does not substantially affect the extent of oral absorption from extended-release tablets.

Rectal Administration

Suppositories are not commercially available in the US.a

When rectal administration was preferred, conventional oral tablets or solution have been administered rectally.g

If administered rectally, insert the dosage form just inside the rectal sphincter for optimal systemic absorption of unmetabolized drug.h g Administration high in the rectal vault can result in rapid first-pass hepatic metabolism, with greatly diminished efficacy.h g

Not usually suitable for long-term administration due to rectal irritation from repeated dosing.g

Although the manufacturer states that extended-release tablets should not be administered rectally, rectal administration of extended-release formulations are used widely for opiate delivery in palliative care.h

Dosage

Available as oxycodone hydrochloride and oxycodone terephthalate; dosage expressed in terms of the respective salt.b d

Pediatric Patients

Conventional Preparations
Oral

Children <50 kg: Usually, initiate with 0.1–0.2 mg/kg every 3–4 hours as needed.f g h i Adjust according to response and tolerance.f g h

Children ≥50 kg: Usually, initiate with 5–10 mg every 3–4 hours as needed.f g h i Adjust according to response and tolerance.f g h

Children 6–12 Years of Age: 0.61 mg of the combined salts every 6 hours.

Children ≥12 Years of Age: 1.22 mg of the combined salts every 6 hours.

Adults

Conventional Preparations
Oral

Usually, initiate with 5–15 mg every 4–6 hours as needed.a c Adjust according to response and tolerance.c f g h

4.88 mg every 6 hours as the combined salts.a

Nonopiate-containing analgesic fixed combinations: Nonopiate component may limit dosage of opiate component.117 119 120 121 Nonopiate analgesics are available in various fixed ratios with oxycodone and also are available in many other prescription and OTC preparations; ensure that therapy is not duplicated and that nonopiate dosage does not exceed maximum recommended dosages.117 118 119 121

Extended-release Tablets
Initial Therapy with Extended-release Tablets
Oral

Initially, 10 mg every 12 hours.a Patients previously receiving nonopiate analgesics may continue these drugs as dosage of the extended-release tablets is titrated to provide adequate analgesia.

Switching from Conventional Oxycodone Preparations to Extended-release Tablets
Oral

Calculate the total daily dosage of the conventional preparation and give as extended-release tablets in 2 divided doses at 12-hour intervals.

Switching from Other Opiates to Extended-release Tablets
Oral

The equivalent total daily dosage of oxycodone hydrochloride should be calculated based on standard conversion factors suggested by the manufacturer (table below) and administered as extended-release tablets in 2 divided doses at 12-hour intervals. Round down to the nearest whole tablet any calculated doses that do not correspond to an available tablet strength.

Converting Daily Opiate Dosages to Oxycodone (mg/day prior opiate × factor = mg/day oral oxycodone)b

Prior Opiate

Factor Oral

Factor Parenteral

Oxycodone

1

Codeine

0.15

Hydrocodone

0.9

Hydromorphone

4

20

Levorphanol

7.5

15

Meperidine

0.1

0.4

Methadone

1.5

3

Morphine

0.5

3

Table to be used only for conversion to oral oxycodone.b

More conservative conversion for patients receiving high-dose parenteral opiates (e.g., use 0.5 instead of 3 as multiplication factor for high-dose parenteral morphine).b

Patients receiving fentanyl transdermal systems may receive extended-release tablets beginning 18 hours after removal of the transdermal system. Initially, dosage of approximately 10 mg every 12 hours as extended-release tablets can be substituted for each 25-mcg/hour increment in fentanyl transdermal system dosage. Monitor patient closely as clinical experience with this dosage conversion ratio is limited.

Switching from Extended-release Tablets
Oral

When patients are switched from extended-release tablets to a parenteral opiate, conservative dose conversion ratios should be used to avoid toxicity.

Special Populations

Hepatic Impairment

Extended-release Tablets

Initially, 33–50% of the usual dosage; titrate dosage carefully.

Renal Impairment

Extended-release Tablets

Consider reduction of the initial dosage and adjust according to the clinical situation in impaired renal function (Clcr <60 mL/minute).

Geriatric Patients

Consider dosage reduction.a

Cautions for Oxycodone

Contraindications

  • Known hypersensitivity to oxycodone or any ingredient in the formulation.c d

  • Extended-release tablets in significant respiratory depression (in unmonitored settings or the absence of resuscitative equipment), acute or severe bronchial asthma or hypercarbia, or with known or suspected paralytic ileus.b

Warnings/Precautions

Warnings

Abuse Potential

Possible tolerance, psychologic dependence, and physical dependence following prolonged administration.b c d Use only with careful surveillance in patients with a history of drug or alcohol dependence or abuse.b d

OxyContin has been intentionally abused by crushing extended-release tablets and “snorting” the powder or dissolving the contents in water and injecting the solution IV. The risk of toxicity is increased when used concomitantly with alcohol or other CNS depressants, including other opiates.

Abuse by chewing OxyContin extended-release tablets also reported.

Breaking, chewing, or crushing of extended-release tablets (e.g., OxyContin) results in immediate release of the opiate and the risk of a potentially fatal overdose.

Extended-release tablets (e.g., OxyContin) are subject to diversion and abuse.

Patients should be instructed to keep extended-release tablets (e.g., OxyContin) in a secure place to prevent theft.

Health-care professionals should contact the professional licensing board, or controlled substance authority in their states for information about prevention and detection of abuse or diversion.

Sensitivity Reactions

Sulfite Sensitivity

Some formulations contain sulfites, which may cause allergic-type reactions (including anaphylaxis and life-threatening or less severe asthmatic episodes) in certain susceptible individuals.a

General Precautions

Increased Intracranial Pressure or Head Trauma

Potential for increased respiratory depressant effects and elevation of CSF pressure in patients with increased intracranial pressure, head trauma, or other intracranial lesions.b c d

Adverse effects of opiates may obscure the existence, extent, or course of intracranial pathology.b c d

Acute Abdominal Conditions

Administration may complicate assessment of patients with acute abdominal conditions.b d

Respiratory Depression

Possible dose-related respiratory depression.b c d

Use with extreme caution in patients with significant chronic obstructive respiratory disease or cor pulmonale, and in patients with substantially decreased respiratory reserve as in patients with hypoxia, hypercapnia, or preexisting respiratory depression.a c b

Hypotension

Possible severe hypotension with extended-release tablets; especially in patients with depleted blood volume or in combination with other hypotensive agents.b (See Drug Interactions.)

Ambulatory Surgery and Postoperative Use

Extended-release tablets (e.g., OxyContin) are not indicated for preoperative (preemptive) analgesia, or for the relief of pain in the immediate (initial 12–24 hours) postoperative period in patients not already receiving the drug or in those whose pain is mild or not expected to persist for an extended period of time.

Extended-release tablets (e.g., OxyContin) are indicated for postoperative use only in patients receiving the drug prior to surgery or if the postoperative pain is expected to be moderate to severe and to persist for an extended period of time.

Pancreatic/Biliary Tract Disease

Possible spasm of the sphincter of Oddi; use with caution in patients with biliary tract disease, including acute pancreatitis.b c

May increase serum amylase concentrations.b c

Debilitated and Special Risk Patients

Use with caution in debilitated patients and in those with hypothyroidism, Addison’s disease, and prostatic hypertrophy or urethral stricture.b c d

Fixed-Combination Preparations

When used in fixed-combination with other drugs, consider the cautions, precautions, and contraindications applicable to each ingredient.b d

Specific Populations

Pregnancy

Category Bc j k or C.b d

Most experts state category B, with category D applying if used for prolonged periods or in high doses at term.k

Lactation

Distributed into milk.c k

Avoid use in nursing women.c If used, observe infant for GI effects, sedation, and changes in feeding patterns.k

Pediatric Use

Safety and efficacy of the extended-release tablets (e.g., OxyContin) not established in children <18 years of age.b

Safety and efficacy of other preparations not established in children;c d j however, the drug is recommended for use in pediatric patients.a f g h i (See Pediatric Dosage under Dosage and Administration.)

Geriatric Use

Possibility of reduced clearance in geriatric patients; adjust dosage.b (See Geriatric Patients under Dosage and Administration.)

Hepatic Impairment

Decreased clearance.b c Use with caution and consider initial dosage adjustment.b c (See Hepatic Impairment under Dosage and Administration.)

Renal Impairment

Decreased clearance.b Use with caution and consider initial dosage adjustment.b c (See Hepatic Impairment under Dosage and Administration.)

Common Adverse Effects

With conventional preparations: lightheadedness, dizziness, sedation, nausea, vomiting.d With extended-release tablets: constipation, nausea, somnolence, dizziness, vomiting, pruritus, headache, dry mouth, sweating, asthenia.b

Interactions for Oxycodone

Metabolized by CYP2D6.b

Specific Drugs

Drug

Interaction

Comments

Anticholinergic agents

Possible paralytic ileusd

CNS depressants (e.g., opiate agonists, general anesthetics, tranquilizers, phenothiazines, sedatives/hypnotics, alcohol)

Additive CNS effectsb c d

Reduce dosage of one or both agents with conventional preparations;d initiate therapy with oxycodone extended-release tablets using 33–50% the usual dosageb

Hypotensive agents

Possible additive hypotensive effects with extended-release tabletsb

MAO inhibitors

Potentiation of antidepressant effect with other opiatesb e

Use with cautionb

Skeletal muscle relaxants

Possible enhanced neuromuscular blocking effect resulting in increased respiratory depressionb

Oxycodone Pharmacokinetics

Absorption

Bioavailability

Following oral administration, about 60–87% of an oral dose reaches the systemic circulation.b c g

Relative oral bioavailability of extended-release tablets to conventional oral dosage forms is the same.b

Peak plasma concentrations occur within 1.4–2.6 hours for conventional oral dosage forms.c

Onset

Conventional preparations: analgesia within 10–15 minutes; peak at about 1 hour.a g

Extended-release tablets (e.g., OxyContin): analgesia within 1 hour; peak effect also may occur at this time but persists.g

Extended-release tablets (e.g., OxyContin): biphasic absorption; half-lives of 0.6 (initial release) and 6.9 (extended release) hours.a b

Duration

Conventional preparations: analgesia effect persists for 3–6 hours.a

Food

Oral solution with a high-fat meal: extent of absorption increases 27%; rate of absorption is not affected.c

Distribution

Extent

Distributed to skeletal muscle, liver, intestinal tract, lungs, spleen, and brain.b

Readily crosses the placenta.e k

Distributes into milk.b c k

Plasma Protein Binding

About 45%.b c g

Elimination

Metabolism

Extensively metabolized in the liver to noroxycodone and oxymorphone and their glucuronide conjugates.

Oxymorphone formation mediated by CYP2D6;g approximately 10 times as potent as morphine parenterally and likely contributes to oxycodone’s effects.g

Elimination Route

Oxycodone and its metabolites excreted principally in urine.

Half-life

Conventional preparations: 3.2–5 hours.b g

Extended-release tablets (e.g., OxyContin): apparent half-life 4.5–8 hours.g

Special Populations

Renal impairment: elimination half-life increased by 1 hour compared with normal renal function.g Peak plasma concentrations and AUCs for oxycodone and noroxycodone increased substantially.g

Mild to moderate hepatic impairment: the elimination half-life was increased by 2.3 hours compared with normal hepatic function.g Peak plasma concentrations and AUCs for oxycodone and noroxycodone increased but less substantially than with hepatic impairment.g

Stability

Storage

Oral

Conventional Preparations

Tight, light-resistant containers at 15–30°C.a c d

Extended-release Tablets

Tight, light-resistant containers at 25°C (may be exposed to 15–30°C).a d

Actions

  • Principal pharmacologic effects are on CNS and intestines.e

  • Acts at several sites within the CNS involving several systems of neurotransmitters to produce analgesia; precise mechanism of action not fully elucidated.e

Advice to Patients

  • Potential for drug to impair mental alertness or physical coordination; use caution when driving or operating machinery until effects on individual are known.b c d e

  • Importance of not breaking, crushing, or chewing extended-release tablets (e.g., OxyContin); potentially fatal overdose can occur.b (See Abuse Potential under Cautions.)

  • Importance of informing clinicians of breakthrough pain or adverse effects.b c

  • Importance of taking only as prescribed; do not increase dosage or abruptly discontinue without consulting a clinician.b c

  • Importance of protecting the drug from theft; do not give to anyone other than the individual for whom it was prescribed.b c

  • Importance of advising patients that the matrix core of Oxycontin extended-release tablet does not completely dissolve and may be passed in the stool.

  • Importance of informing clinicians of existing or contemplated concomitant therapy, including prescription and OTC drugs as well as any concomitant illnesses.b c

  • Importance of women informing clinicians if they are or plan to become pregnant or plan to breast-feed.b c

  • Importance of informing patients of other important precautionary information.b c (See Cautions.)

Preparations

Excipients in commercially available drug preparations may have clinically important effects in some individuals; consult specific product labeling for details.

Oxycodone preparations are subject to control under the Federal Controlled Substances Act of 1970 as schedule II (C-II) drugs.

* available from one or more manufacturer, distributor, and/or repackager by generic (nonproprietary) name

Oxycodone Hydrochloride

Routes

Dosage Forms

Strengths

Brand Names

Manufacturer

Oral

Capsules

5 mg*

Oxycodone Hydrochloride Capsules (C-II)

OxyIR (C-II)

Purdue Pharma

Solution

5 mg/5 mL*

Oxycodone Hydrochloride Oral Solution (C-II)

Roxicodone (C-II)

Xanodyne

20 mg/mL*

Oxycodone Hydrochloride Oral Concentrate Solution (C-II)

Oxydose (C-II)

Ethex

OxyFast (C-II)

Purdue Pharma

Roxicodone (C-II)

Xanodyne

Tablets

5 mg*

Endocodone (C-II; scored)

Endo

Oxycodone Hydrochloride Tablets (C-II)

Percolone (C-II; scored)

Endo

Roxicodone (C-II; scored)

Xanodyne

15 mg

Roxicodone (C-II; scored)

Xanodyne

30 mg

Roxicodone (C-II)

Xanodyne

Tablets, extended-release

10 mg*

OxyContin (C-II)

Purdue Pharma

20 mg*

OxyContin (C-II)

Purdue Pharma

40 mg*

OxyContin (C-II)

Purdue Pharma

80 mg*

OxyContin (C-II)

Purdue Pharma

* available from one or more manufacturer, distributor, and/or repackager by generic (nonproprietary) name

Oxycodone and Acetaminophen

Routes

Dosage Forms

Strengths

Brand Names

Manufacturer

Oral

Capsules

5 mg Oxycodone Hydrochloride and Acetaminophen 500 mg*

Tylox (C-II)

Ortho-McNeil

Solution

5 mg/5 mL Oxycodone Hydrochloride and Acetaminophen 325 mg/5 mL

Roxicet (C-II)

Roxane

Tablets

2.5 mg Oxycodone Hydrochloride and Acetaminophen 325 mg

Percocet (C-II)

Endo

5 mg Oxycodone Hydrochloride and Acetaminophen 325 mg*

Endocet (C-II; scored)

Endo

Oxycodone Hydrochloride and Acetaminophen Tablets (C-II)

Percocet (C-II; scored)

Endo

Roxicet (C-II; scored)

Roxane

5 mg Oxycodone Hydrochloride and Acetaminophen 500 mg

Roxicet Caplets (C-II; scored)

Roxane

7.5 mg Oxycodone Hydrochloride and Acetaminophen 325 mg*

Oxycodone Hydrochloride and Acetaminophen Tablets (C-II)

Percocet (C-II)

Endo

7.5 mg Oxycodone Hydrochloride and Acetaminophen 500 mg*

Endocet (C-II)

Endo

Oxycodone Hydrochloride and Acetaminophen Tablets (C-II)

Percocet (C-II)

Endo

10 mg Oxycodone Hydrochloride and Acetaminophen 325 mg*

Oxycodone Hydrochloride and Acetaminophen Tablets (C-II)

Percocet (C-II)

Endo

10 mg Oxycodone Hydrochloride and Acetaminophen 650 mg*

Endocet (C-II)

Endo

Oxycodone Hydrochloride and Acetaminophen Tablets (C-II)

Percocet (C-II)

Endo

* available from one or more manufacturer, distributor, and/or repackager by generic (nonproprietary) name

Oxycodone and Aspirin

Routes

Dosage Forms

Strengths

Brand Names

Manufacturer

Oral

Tablets

4.5 mg Oxycodone Hydrochloride, Oxycodone Terephthalate 0.38 mg, and Aspirin 325 mg*

Endodan (C-II; scored)

Endo

Oxycodone Hydrochloride and Aspirin Tablets (C-II)

Percodan (C-II; scored)

Endo

Roxiprin (C-II)

Roxane

Other Oxycodone Combinations

Routes

Dosage Forms

Strengths

Brand Names

Manufacturer

Oral

Tablets, film-coated

5 mg with Ibuprofen 400 mg

Combunox (C-II)

Forest

Comparative Pricing

This pricing information is subject to change at the sole discretion of DS Pharmacy. This pricing information was updated 02/2013. Actual costs to patients will vary depending on the use of specific retail or mail-order locations and health insurance copays.

Endocet 10-325MG Tablets (ENDO PHARMACEUTICALS): 20/$34.99 or 30/$52.48

Endocet 10-650MG Tablets (ENDO PHARMACEUTICALS): 20/$35.99 or 30/$48.97

Endocet 5-325MG Tablets (ENDO PHARMACEUTICALS): 30/$17.99 or 90/$53.97

OxyCODONE HCl 10MG Tablets (KVK TECH): 10/$12.99 or 20/$15.99

OxyCODONE HCl 15MG Tablets (ACTAVIS ELIZABETH): 20/$20.78 or 30/$31.16

OxyCODONE HCl 30MG Tablets (MYLAN): 20/$28.99 or 30/$43.49

OxyCODONE HCl 5MG Tablets (QUALITEST): 20/$22.76 or 30/$34.14

Oxycodone-Acetaminophen 10-325MG Tablets (MALLINCKRODT PHARM): 20/$40.66 or 30/$60.99

Oxycodone-Acetaminophen 10-650MG Tablets (WATSON LABS): 20/$33.33 or 30/$49.99

Oxycodone-Acetaminophen 5-325MG Tablets (MALLINCKRODT PHARM): 20/$11.99 or 30/$17.99

Oxycodone-Acetaminophen 5-500MG Capsules (MALLINCKRODT PHARM): 20/$15.99 or 30/$23.99

Oxycodone-Acetaminophen 7.5-325MG Tablets (MALLINCKRODT PHARM): 20/$31.99 or 30/$47.99

Oxycodone-Acetaminophen 7.5-500MG Tablets (WATSON LABS): 20/$25.99 or 30/$38.99

Oxycodone-Ibuprofen 5-400MG Tablets (WATSON LABS): 20/$33.33 or 30/$49.99

OxyCONTIN 10MG 12-hr Tablets (PURDUE PHARMA L.P.): 20/$49.99 or 30/$74.99

OxyCONTIN 15MG 12-hr Tablets (PURDUE PHARMA L.P.): 20/$72.99 or 30/$109.49

OxyCONTIN 20MG 12-hr Tablets (PURDUE PHARMA L.P.): 20/$86.99 or 30/$129.96

OxyCONTIN 30MG 12-hr Tablets (PURDUE PHARMA L.P.): 20/$125.99 or 30/$188.96

OxyCONTIN 40MG 12-hr Tablets (PURDUE PHARMA L.P.): 20/$154.99 or 30/$231.97

OxyCONTIN 60MG 12-hr Tablets (PURDUE PHARMA L.P.): 20/$215.00 or 30/$320.96

OxyCONTIN 80MG 12-hr Tablets (PURDUE PHARMA L.P.): 20/$290.99 or 30/$436.49

Percocet 10-325MG Tablets (ENDO PHARMACEUTICALS): 20/$127.99 or 30/$191.99

Percocet 10-650MG Tablets (ENDO PHARMACEUTICALS): 20/$130.99 or 30/$195.97

Percocet 2.5-325MG Tablets (ENDO PHARMACEUTICALS): 30/$90.99 or 60/$180.98

Percocet 5-325MG Tablets (ENDO PHARMACEUTICALS): 20/$94.99 or 30/$141.97

Percocet 7.5-325MG Tablets (ENDO PHARMACEUTICALS): 20/$90.99 or 30/$135.98

Percocet 7.5-500MG Tablets (ENDO PHARMACEUTICALS): 20/$100.99 or 30/$150.98

Percodan 4.5-0.38-325MG Tablets (ENDO PHARMACEUTICALS): 20/$39.59 or 30/$52.77

Roxicet 5-325MG/5ML Solution (ROXANE): 500/$49.99 or 1500/$135.96

Roxicet 5-325MG Tablets (ROXANE): 20/$12.99 or 30/$14.99

Roxicodone 15MG Tablets (XANODYNE PHARMACEUTICALS): 20/$38.37 or 30/$55.86

Roxicodone 30MG Tablets (XANODYNE PHARMACEUTICALS): 20/$73.36 or 30/$97.06

Tylox 5-500MG Capsules (MCNEIL): 20/$49.54 or 30/$74.31

Disclaimer

This report on medications is for your information only, and is not considered individual patient advice. Because of the changing nature of drug information, please consult your physician or pharmacist about specific clinical use.

The American Society of Health-System Pharmacists, Inc. and Drugs.com represent that the information provided hereunder was formulated with a reasonable standard of care, and in conformity with professional standards in the field. The American Society of Health-System Pharmacists, Inc. and Drugs.com make no representations or warranties, express or implied, including, but not limited to, any implied warranty of merchantability and/or fitness for a particular purpose, with respect to such information and specifically disclaims all such warranties. Users are advised that decisions regarding drug therapy are complex medical decisions requiring the independent, informed decision of an appropriate health care professional, and the information is provided for informational purposes only. The entire monograph for a drug should be reviewed for a thorough understanding of the drug's actions, uses and side effects. The American Society of Health-System Pharmacists, Inc. and Drugs.com do not endorse or recommend the use of any drug. The information is not a substitute for medical care.

AHFS Drug Information. © Copyright, 1959-2013, Selected Revisions October 27, 2011. American Society of Health-System Pharmacists, Inc., 7272 Wisconsin Avenue, Bethesda, Maryland 20814.

† Use is not currently included in the labeling approved by the US Food and Drug Administration.

References

117. Jackson KC II, Lipman AG. Nonopioid analgesics. In: Lipman AG, ed. Pain management for primary care clinicians. Bethesda, MD: American Society of Health-System Pharmacists; 2004:43-58.

118. Cranmer KW, Mason M. Special considerations in geriatric pain management. In: Lipman AG, ed. Pain management for primary care clinicians. Bethesda, MD: American Society of Health-System Pharmacists; 2004:219-232.

119. Fakata KL, Miaskowski C, Lipman AG. Chronic malignant pain. In: Lipman AG, ed. Pain management for primary care clinicians. Bethesda, MD: American Society of Health-System Pharmacists; 2004:139-52.

120. McNicol E, Carr DB. Pharmacological treatment of pain. In: McCarberg B, Passik SD, eds. Expert guide to pain management. Philadelphia: American College of Physicians; 2005:145-78.

121. American Pain Society. Principles of analgesic use in the treatment of acute pain and cancer pain. 5th edition. Glenview, IL; 2003:3,9,13,14.

a. AHFS Drug Information 2004. McEvoy GK, ed. Oxycodone. Bethesda, MD: American Society of Health-System Pharmacists; 2004:2056-8.

b. Purdue Pharma L. P. Oxycontin (oxycodone HCL controlled-release) tablets, prescribing information. Stamford, CT; 2003 Jul.

c. Xanodyne Pharmaceuticals Inc. Roxicodone (oxycodone hydrochloride) tablets, prescribing information. 2006 Mar.

d. Endo Pharmaceuticals. Percocet (oxycodone and acetaminophen) tablets prescribing information. Chadds Ford, PA; 2003 Apr.

e. AHFS drug information 2004. McEvoy GK, ed. Opiate agonists general statement. Bethesda, MD: American Society of Hospital Pharmacists; 2004:2030-5.

f. Jacox A, Carr DB, Payne R et al. Management of cancer pain. Clinical practice guideline. Number 9. US Department of Health and Human Services. March 1994. 49-57.

g. Lipman AG. Pain management for primary care physicians. Bethesda, MD: American Society of Health-System Pharmacists; 2004.

h. Principles of Analgesic Use in the Treamtent of Acute Pain and Cancer Pain. 5th ed. American Pain Society.

i. Behrman RE, Kliegman RM, Jenson HB. Nelson textbook of pediatrics, 17th ed.

j. Purdue Pharma. Oxyir (oxycodone hydrochoride) immediate-release capsules prescribing information. Stamford, CT; 2003 Aug.

k. Briggs GG, Freeman RK, Yaffee SJ. Drugs in pregnancy and pactation. 6th ed.

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