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oxycodone

Pronunciation

Generic Name: oxycodone (ox i KOE done)
Brand Name: Oxaydo, OxyCONTIN, Oxyfast, Roxicodone, Xtampza ER, ...show all 13 brand names

What is oxycodone?

Oxycodone is an opioid pain medication. An opioid is sometimes called a narcotic. Oxycodone is used to treat moderate to severe pain.

The extended-release form of this medicine is for around-the-clock treatment of pain. This form of oxycodone is not for use on an as-needed basis for pain.

Oxycodone may also be used for purposes not listed in this medication guide.

What is the most important information I should know about oxycodone?

You should not use oxycodone if you have severe asthma or breathing problems, or a blockage in your stomach or intestines.

Oxycodone can slow or stop your breathing, and may be habit-forming. MISUSE OF THIS MEDICINE CAN CAUSE ADDICTION, OVERDOSE, OR DEATH, especially in a child or other person using the medicine without a prescription.

Taking this medicine during pregnancy may cause life-threatening withdrawal symptoms in the newborn.

Fatal side effects can occur if you use this medicine with alcohol, or with other drugs that cause drowsiness or slow your breathing.

What should I discuss with my healthcare provider before using oxycodone?

You should not use oxycodone if you are allergic to it, or if you have:

  • severe asthma or breathing problems; or

  • a blockage in your stomach or intestines.

You should not use oxycodone unless you are already using a similar opioid medicine and are tolerant to it.

Most brands of oxycodone are not approved for use in people under 18. OxyContin should not be given to a child younger than 11 years old.

To make sure oxycodone is safe for you, tell your doctor if you have:

  • a history of head injury, brain tumor, or seizures;

  • a history of drug abuse, alcohol addiction, or mental illness;

  • urination problems;

  • liver or kidney disease;

  • problems with your gallbladder, pancreas, or thyroid; or

  • if you use a sedative like Valium (diazepam, alprazolam, lorazepam, Ativan, Klonopin, Restoril, Tranxene, Versed, Xanax, and others).

If you use oxycodone while you are pregnant, your baby could become dependent on the drug. This can cause life-threatening withdrawal symptoms in the baby after it is born. Babies born dependent on habit-forming medicine may need medical treatment for several weeks.

Long-term use of opioid medication may affect fertility (ability to have children) in men or women. It is not known whether opioid effects on fertility are permanent.

Do not breast-feed. Oxycodone can pass into breast milk and may cause drowsiness or breathing problems in a nursing baby.

How should I use oxycodone?

Follow all directions on your prescription label. Oxycodone can slow or stop your breathing, especially when you start using this medicine or whenever your dose is changed. Never take oxycodone in larger amounts, or for longer than prescribed. Tell your doctor if the medicine seems to stop working as well in relieving your pain.

Oxycodone may be habit-forming. Never share this medicine with another person, especially someone with a history of drug abuse or addiction. MISUSE OF NARCOTIC MEDICINE CAN CAUSE ADDICTION, OVERDOSE, OR DEATH, especially in a child or other person using the medicine without a prescription. Selling or giving away oxycodone is against the law.

Stop taking all other around-the-clock narcotic pain medicines when you start taking extended-release oxycodone..

Take oxycodone with food.

Do not crush, break, or open an extended-release tablet. Swallow it whole to avoid exposure to a potentially fatal dose.

Measure liquid medicine with the dosing syringe provided, or with a special dose-measuring spoon or medicine cup. If you do not have a dose-measuring device, ask your pharmacist for one.

You should not stop using oxycodone suddenly. Follow your doctor's instructions about tapering your dose.

Never crush or break an oxycodone pill to inhale the powder or mix it into a liquid to inject the drug into your vein. This can cause in death.

Store at room temperature, away from heat, moisture, and light.

Keep track of the amount of medicine used from each new bottle. Oxycodone is a drug of abuse and you should be aware if anyone is using your medicine improperly or without a prescription.

Do not keep leftover oxycodone pills or liquid. Ask your pharmacist where to locate a drug take-back disposal program. If there is no take-back program, flush any unused pills or liquid medicine down the toilet.

What happens if I miss a dose?

Since oxycodone is used for pain, you are not likely to miss a dose. Skip any missed dose if it is almost time for your next scheduled dose. Do not use extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An oxycodone overdose can be fatal, especially in a child or other person using the medicine without a prescription.

Overdose symptoms may include slow heartbeats, severe muscle weakness, cold and clammy skin, noisy breathing, and very slow breathing.

What should I avoid while using oxycodone?

Do not drink alcohol. Dangerous side effects or death could occur.

Avoid driving or operating machinery until you know how oxycodone will affect you. Dizziness or severe drowsiness can cause falls or other accidents.

Avoid medication errors. Always check the brand and strength of oxycodone you get from the pharmacy.

Oxycodone side effects

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Like other narcotic medicines, oxycodone can slow your breathing. Death may occur if breathing becomes too weak.

A person caring for you should seek emergency medical attention if you have slow breathing with long pauses, blue colored lips, pinpoint pupils, or if you are hard to wake up.

Call your doctor at once if you have:

  • shallow breathing, slow heartbeats;

  • confusion, severe drowsiness, seizure (convulsions);

  • severe constipation;

  • missed menstrual periods;

  • impotence, sexual problems, loss of interest in sex;

  • a light-headed feeling, like you might pass out; or

  • low cortisol levels--nausea, vomiting, loss of appetite, dizziness, worsening tiredness or weakness.

Seek medical attention right away if you have symptoms of serotonin syndrome, such as: agitation, confusion, fever, sweating, fast heart rate, chest pain, feeling short of breath, muscle stiffness, trouble walking, or feeling faint.

Serious side effects may be more likely in older adults and those who are malnourished or debilitated.

Common side effects may include:

  • drowsiness, headache, dizziness, tired feeling; or

  • constipation, stomach pain, nausea, vomiting, loss of appetite.

  • dry mouth; or

  • mild itching.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Oxycodone dosing 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

Immediate-release:
As First Opioid Analgesic: 5 to 15 mg orally every 4 to 6 hours
-Oral solution: To avoid dosing errors include total dose in mg and mL

CONVERSION from Other Oral Opioids: There is great inter-patient variability in the potency of opioid drugs and their formulations; when converting patients to this drug from other opioids or when switching from controlled-release products, it is best to underestimate the oxycodone requirement and provide rescue medication than to overestimate and manage an overdose.

Comments:
-Doses should be individually titrated to provide adequate analgesia while minimizing adverse reactions.
-Because of the risks of addiction, abuse and misuse, the lowest effective dose for the shortest duration consistent with individual patient treatment goals should be used.
-Monitor patients closely for respiratory depression within the first 24 to 72 hours of initiating therapy and following any increase in dose.

Use: For the management of acute pain severe enough to require an opioid analgesic and for which alternative treatments are inadequate

Usual Adult Dose for Chronic Pain:

The following dosing recommendations can only be considered suggested approaches to what is actually a series of clinical decisions over time

60 and 80 mg extended-release (ER) tablets, a single dose greater than 40 mg (36 mg oxycodone base), a total daily dose greater than 80 mg (72 mg oxycodone base), or use of the 100 mg/5 mL (20 mg/mL) oral solution should be restricted to use in opioid-tolerant patients only

Extended-release (ER):
Initial dose for OPIOID-NAIVE and OPIOID NON-TOLERANT patients:
-Oxycodone hydrochloride ER tablets: 10 mg orally every 12 hours
-Oxycodone (base) ER capsules: 9 mg orally every 12 hours with food

Immediate-release (IR):
-Initial dose for OPIOID-NAIVE patients: 5 to 15 mg orally every 4 to 6 hours on an around-the-clock basis
-Oral solution: To avoid dosing errors total dose should be included in both mg and mL

MAINTENANCE: Adjust dose every 1 to 2 days as needed to obtain an appropriate balance between pain management and opioid-related adverse reactions; goal should be to find the lowest effective dosage for the shortest duration consistent with individual patient treatment goals
Maximum daily dose: Oxycodone (base) ER capsules: 288 mg as the safety of the excipients has not been established; maximum dose of oxycodone hydrochloride tablets has not been established

EQUIVALENCE OF OXYCODONE HYDROCHLORIDE TO OXYCODONE BASE:
-Oxycodone hydrochloride 10 mg = Oxycodone base 9 mg
-Oxycodone hydrochloride 15 mg = Oxycodone base 13.5 mg
-Oxycodone hydrochloride 20 mg = Oxycodone base 18 mg
-Oxycodone hydrochloride 30 mg = Oxycodone base 27 mg
-Oxycodone hydrochloride 40 mg = Oxycodone base 36 mg

Comments:
-Use of higher starting doses in patients who are not opioid tolerant may cause fatal respiratory depression with first dose; selection of initial dose should take into account degree of opioid tolerance, patient's general condition, medical status, concurrent medications, type and severity of pain, and risk factors for abuse, addiction, or diversion.
-Opioid tolerant patients are those who have received for 1 week or longer: oral morphine 60 mg/day; transdermal fentanyl 25 mcg/hr; oral oxycodone 30 mg/day; oral hydromorphone 8 mg/day; oral oxymorphone 25 mg/day or an equianalgesic dose of another opioid.
-Extended-release products are reserved for use in patients for whom alternative treatment options (e.g., non-opioid analgesics or immediate-release opioids) are ineffective, not tolerated, or would be otherwise inadequate to provide sufficient management of pain; these products are not intended to be used as as-needed (prn) analgesics.

-DOSE CONVERSIONS from other opioids should be done carefully and with close monitoring due to large patient variability in regards to opioid analgesic response; consult dose adjustment section for recommendations.

Use: For the management of pain severe enough to require daily, around-the-clock, long-term opioid treatment and for which alternative treatment options are inadequate.

Usual Pediatric Dose for Chronic Pain:

Prior to initiating therapy, patients must be receiving and tolerating opioids for at least 5 consecutive days; for the 2 days immediately preceding initiation, patients must be taking a minimum of 20 mg/day of oxycodone or its equivalent.
-Discontinue all around-the-clock opioid drugs when oxycodone ER tablets are initiated

11 years or older: Extended-release (ER) tablets only:
-Initial dose: One-half of calculated total oxycodone daily dose orally every 12 hours

DOSE CALCULATION:
-Multiply total daily dose of prior opioid by the conversion factor (CF) provided below to obtain oxycodone dose in mg/day; divide oxycodone mg/day dose by 2 to get 12-hour oxycodone ER dose; if rounding is necessary, always round down to the nearest tablet strength available
--For prior opioid use of OXYCODONE: Oral CF is 1
--For prior opioid use of HYDROCODONE: Oral CF is 0.9
--For prior opioid use of HYDROMORPHONE: Oral CF is 4; Parenteral CF is 20*
--For prior opioid use of MORPHINE: Oral CF is 0.5; Parenteral CF is 3*
--For prior opioid use of TRAMADOL: Oral CF is 0.17; Parenteral CF is 0.2*
*For patients receiving high-dose parenteral opioids, a more conservative CF is warranted (e.g., for high-dose parenteral morphine, use a CF of 1.5 instead of a CF of 3)
The CFs provided above convert prior opioid use to oxycodone ER tablet dose; do not use the CF to convert from oxycodone ER tablets to another opioid as doing so will result in an over-estimation of the new opioid dose and possibly a fatal overdose.
CONVERSION FROM TRANSDERMAL FENTANYL: Remove patch 18 hours prior to starting oxycodone ER tablets; substitute one 10 mg oxycodone ER tablet every 12 hours for each 25 mcg/hr fentanyl transdermal patch; monitor closely during conversion as there is limited assessment of this conversion

Titration and Maintenance:
-Individually titrate to a dose that provides adequate analgesia and minimizes adverse reactions; dose adjustments can be made every 1 to 2 days; when a dose increase is clinically indicated, it is suggested that the total daily oxycodone dose not be increased by more than 25% at a time.

Comments:
-Dose conversions should be done carefully and with close monitoring due to large patient variability in regards to opioid analgesic response; it is preferable to underestimate a patient's 24-hour oral oxycodone requirement and provide rescue medication than to overestimate and manage an adverse reaction.
-Use of higher starting doses in patients who are not opioid tolerant may cause fatal respiratory depression with first dose; selection of initial dose should take into account degree of opioid tolerance, patient's general condition, medical status, concurrent medications, type and severity of pain, and risk factors for abuse, addiction, or diversion.
-Extended-release oxycodone products are reserved for use in patients for whom alternative treatment options (e.g., non-opioid analgesics or immediate-release opioids) are ineffective, not tolerated, or would be otherwise inadequate to provide sufficient management of pain; these products are not intended to be used as as-needed (prn) analgesics.

Use: For the opioid-tolerant pediatric patient 11 years of age or older who is already receiving and tolerating a minimum oral opioid dose of at least oxycodone 20 mg/day or its equivalent and who has pain severe enough to require daily, around-the-clock, long-term opioid treatment and for which alternative treatment options are inadequate.

What other drugs will affect oxycodone?

Some drugs can raise or lower your blood levels of oxycodone, which may cause side effects or make oxycodone less effective. Tell your doctor if you also use certain antibiotics, antifungal medications, heart or blood pressure medications, or medicines to treat HIV or AIDS.

Narcotic (opioid) medication can interact with many other drugs and cause dangerous side effects or death. Be sure your doctor knows if you also use:

  • other narcotic medications--opioid pain medicine or prescription cough medicine;

  • drugs that make you sleepy or slow your breathing--a sleeping pill, muscle relaxer, sedative, tranquilizer, or antipsychotic medicine; or

  • drugs that affect serotonin levels in your body--medicine for depression, Parkinson's disease, migraine headaches, serious infections, or prevention of nausea and vomiting.

This list is not complete. Other drugs may interact with oxycodone, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

See also: Side effects (in more detail)

Where can I get more information?

  • Your pharmacist can provide more information about oxycodone.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 11.01.

Date modified: August 01, 2017
Last reviewed: May 05, 2017

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