oxycodone (Roxicodone, OxyContin, OxyIR, OxyFast, Oxecta, Xtampza ER)

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Introduction

Tradenames: Roxicodone, OxyContin (controlled release), OxyIR (immediate release). DEA-controlled substance: class 2.

Indications

Dosage

  • 5-10 mg PO every 4-6 hours
  • no maximum dose
  • may be given every 1-2 hours for breakthrough pain
  • children:
    • 6-12 years: 1.25 mg every 6 hours PRN
    • > 12 years: 2.5 mg every 6 hours PRN

Tabs: 5 mg. (OxyIR) Oxycontin. Tabs 10, 20, 40 & 80* mg OxyIR: 20 mg/mL (OxyFast) Syrup 5 mg/5 mL. Oxecta: immediate-release; resistant to abuse[10]

* 80 mg tab to be used in opioid tolerant patients only for doses >= 160 mg

* reformulated OxyContin is intended to prevent the tab from being cut, broken, chewed, crushed or dissolved to render fast-acting oxycodone[8]

Pharmacokinetics

elimination via liver

1/2life = 4-5 hours

Adverse effects

* respiratory depression is dose & tolerance-related

* refrain from driving or activities requiring heightened attention for 1 week after increasing oxyxocodone dose[14]

Drug interactions

Laboratory

Mechanism of action

Notes

Abuse:[5]

Purdue Pharma & Abbott Laboratories pharmaceuticals aggressively marketed Oxycontin to make it a blockbuster drug[13]

More general terms

Additional terms

Component of

References

  1. The Pharmacological Basis of Therapeutics, 9th ed. Gilman et al, eds. Permagon Press/McGraw Hill, 1996
  2. Drug Information & Medication Formulary, Veterans Affairs, Central California Health Care System, 1st ed., Ravnan et al eds, 1998
  3. Kaiser Permanente Northern California Regional Drug Formulary, 1998
  4. Clinical Guide to Laboratory Tests, 3rd ed. Teitz ed., W.B. Saunders, 1995
  5. 5.0 5.1 Prescriber's Letter 8(2):11 2001
  6. 6.0 6.1 Geriatric Dosage Handbook, 6th edition, Selma et al eds, Lexi-Comp, Cleveland, 2001
  7. 7.0 7.1 Veterans Administration Medical Center (VAMC) Greater Los Angeles, clinical laboratory December, 2009
  8. 8.0 8.1 FDA NEWS RELEASE Apr. 5, 2010 FDA Approves New Formulation for OxyContin
  9. Prescriber's Letter 17(6): 2010 Cytochrome P450 Drug Interactions Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=260623&pb=PRL (subscription needed) http://www.prescribersletter.com
  10. 10.0 10.1 Prescriber's Letter 17(12): 2010 COMMENTARY: New OxyContin (Oxycodone Controlled-Release) Formulation Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=261201&pb=PRL (subscription needed) http://www.prescribersletter.com
    Prescriber's Letter 18(10): 2011 COMMENTARY: New Formulation: Oxecta (Oxycodone) CHART: Fentanyl Products for Breakthrough Pain CHART: Drugs with REMS and Other Special Prescribing/ Dispensing Requirements Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=271021&pb=PRL (subscription needed) http://www.prescribersletter.com
  11. 11.0 11.1 Young K. Sadoughi S, Sofair A OxyContin Fails to Deliver 12 Hours of Pain Relief in Many. Physician's First Watch, May 9, 2016 David G. Fairchild, MD, MPH, Editor-in-Chief Massachusetts Medical Society http://www.jwatch.org
    Ryan H, Girion L, Glover S 'You want a description of hell?' OxyContin's 12-hour problem. Los Angeles Times. May 5, 2016 http://static.latimes.com/oxycontin-part1/#nt=oft07a-2gp1
  12. 12.0 12.1 Geriatric Review Syllabus, 9th edition (GRS9) Medinal-Walpole A, Pacala JT, Porter JF (eds) American Geriatrics Society, 2016
  13. 13.0 13.1 Armstrong D Secret trove reveals bold 'crusade' to make OxyContin a blockbuster. STAT. Sept 22,2016 https://www.statnews.com/2016/09/22/abbott-oxycontin-crusade/
  14. 14.0 14.1 NEJM Knowledge+ Internal Medicine Board Review https://myknowledgeplus.nejm.org/flow/flowjs.html
  15. 15.0 15.1 Yunusa I, Gagne JJ, Yoshida K et al Risk of Opioid Overdose Associated With Concomitant Use of Oxycodone and Selective Serotonin Reuptake Inhibitors. JAMA Netw Open. 2022;5(2):e220194 PMID: https://www.ncbi.nlm.nih.gov/pubmed/3520131 https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2789401
  16. Oxycontin. HIGHLIGHTS OF PRESCRIBING INFORMATION. http://www.accessdata.fda.gov/drugsatfda_docs/label/2015/022272s027lbl.pdf

Database