Oxycodone

Oxycodone

Generic Name 藥名	HA Code 藥物代碼	Classification藥物分類
Oxycodone Capsule 5mg	OXYC04	DD
Oxycodone PR Tablet 5mg	OXYC06	DD
Oxycodone PR Tablet 10mg	OXYC07	DD

Mechanism of Action

Equivalent doses of opioid analgesics

Analgesic/Route	Dose
Codeine: PO	100 mg
Diamorphine: IM, IV, SC	3 mg
Dihydrocodeine: PO	100 mg
Morphine: PO	10 mg
Morphine: IM, IV, SC	5 mg
Oxycodone: PO	6.6 mg
Tramadol: PO	100 mg

Dosage

Moderate to severe pain

A usual oral starting dose for opioid-naïve patients in severe pain is 5 mg every 4 to 6 hours increased thereafter as necessary according to response.

For patients who have been receiving a strong opioid analgesic the initial dose of oxycodone should be based on the daily opioid requirement. UK licensed product information suggests that 10 mg of oral oxycodone is equivalent to about 20mg of oral morphine.

Oxycodone hydrochloride may also be given orally as a modified release preparation every 12 hours.

Oral	Immediate release formulations : 5mg q4-6h, max 400 mg PRN Modified release formulation: 10mg q12h, max 200 mg q12h PRN
Intravenous	1 to 10 mg initially, given over 1 to 2 minutes, and repeated every 4 hours.

When transferring between oral and parenteral oxycodone, 2 mg of oral oxycodone is equivalent to about 1 mg of parenteral oxycodone.

Rectal	as suppositories containing 30 mg of oxycodone (as the pectinate) or 10 or 20 mg of oxycodone hydrochloride, every 6 to 8 hours

Administration in children

Although oxycodone hydrochloride is not licensed for use in children under 18 years old, the BMCF suggests that it may be given for the treatment of moderate to severe pain in palliative care.

Those aged from 1 month to 11 years: 200 micrograms/kg (up to 5 mg) every 4 to 6 hours, increased thereafter as necessary according to response.

Older children may be given the usual adult dose.

Side Effects

Euphoria, nausea and vomiting, respiratory depression, constipation and cough suppression.

Opioid Analgesic in general

The commonest adverse effects are nausea, vomiting, constipation, drowsiness and confusion.

Large doses of opioids produce respiratory depression and hypotension, with circulatory failure and deepening coma. Death may occur from respiratory failure.

Treatment of Adverse Effects

1. Constipation can be treated with laxatives such as senna tables and lactulose.
2. Nausea and vomiting can be alleviated by metoclopramide.
3. Intensive supportive therapy may be required to correct respiratory failure and shock. Naloxone is used for rapid reversal of the severe respiratory depression and coma.

Pharmacokinetics

Oral bioavailability	Oxycodone is absorbed from the gastrointestinal tract; oral bioavailability is about 60 to 78% due to first-pass metabolism.
Metabolism	Metabolized in the liver
Elimination half-life	The elimination half-life of oxycodone is reported to be 2 to 4 hours.
Excretion	The oxycodone and metabolites are excreted primarily via the kidneys

Drug Management

Efficiency	pain control
Safety	mental status, blood pressure, respiratory drive, and misuse/overuse.
Caution	Pancreatitis, toxic psychosis Tolerance and dependence
Contraindication	Avoid in moderate to severe hepatic impairment

FAQ

How should I take the tablet?

Follow the doctor's prescription, Take with or without food Take the medication with plenty of water Can be crushed

What should I avoid while taking?

Avoid abrupt withdrawal

What happen if I overdose?

Emergency situation, called 999 immediately Antidote: Naloxone

What happen if I miss a dose?

PO: Take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up. IV infusion and SC : adminstered by professionals