Oxycodone

Oxycodone is a schedule II narcotic analgesic and is widely used in clinical medicine. It is marketed either alone as controlled release (OxyContin?®??©) and immediate release formulations (OxyIR?®, OxyFast?®), or in combination with other nonnarcotic analgesics such as aspirin (Percodan?®) or acetaminophen (Percocet?®). The introduction in 1996 of OxyContin?®, commonly known on the street as OC, OX, Oxy, Oxycotton, Hillbilly heroin, and kicker, led to a marked escalation of its abuse as reported by drug abuse treatment centers, law enforcement personnel, and health care professionals. Although the diversion and abuse of OxyContin?® appeared initially in the eastern U.S., it has now spread to the western U.S. including Alaska and Hawaii. Oxycodone-related adverse health effects increased markedly in recent years. In 2004, Food and Drug Administration (FDA) approved generic forms of controlled release oxycodone products for marketing.

Oxycodone side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Call your doctor at once if you have any of these serious side effects:

• shallow breathing, slow heartbeat;
• seizure (convulsions);
• cold, clammy skin;
• confusion;
• severe weakness or dizziness; or
• feeling light-headed, fainting.

Dosage

Oxycodone is available in 10 mg (white), 15 mg (black), 20 mg (pink), 30 mg (brown), 40 mg (yellow), 60 mg (red), and 80 mg (green) in the U.S. and Canada, and 160 mg (blue) in Canada only. Because of its sustained-release mechanism, the medication is typically effective for eight to twelve hours. The 160 mg tablets were removed from sale due to problems with overdose, but have been re-introduced for limited use under strict medical supervision. On October 18, 2006, the FDA gave approval for four new dosage strengths, to wit, 15, 30, 45, and 60 mg. After removing the colored outer coating, which weighs 8 mg (approx.), the mass of a standard 80 mg OxyContin tablet is 256 mg (approx.): 80 mg of oxycodone hydrochloride and 176 mg (approx.) of innactive material, making the formulation 31% pure (approx.) by weight.

PRECAUTIONS

Tell your doctor if you drink or have ever drunk large amounts of alcohol and if you use or have ever used street drugs, or if you have overused prescription medications. Also tell your doctor if you have or have ever had a head injury,a tumor in your brain or nervous system, any condition causing increased pressure in your brain; hypothyroidism (condition in which the thyroid gland produces less hormone than normal), hallucinations (seeing things or hearing voices that do not exist);delirium tremens (severe withdrawal symptoms that may occur in people who drank large amounts of alcohol over time and have stopped drinking); kyphoscoliosis (curving of the spine that may cause breathing problems) low blood pressure;Addison's disease (condition in which the adrenal gland does not produce enough hormone), seizures;urethral stricture (blockage of the tube that allows urine to leave the body), enlarged prostate (a male reproductive gland),or heart, kidney,liver,or pancreas, or biliary tract disease.

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

Before using oxycodone, tell your doctor if you are allergic to any drugs, or if you have:

• asthma, COPD, sleep apnea, or other breathing disorders;
• liver or kidney disease;
• underactive thyroid;
• curvature of the spine;
• a history of head injury or brain tumor;
• epilepsy or other seizure disorder;
• low blood pressure;
• gallbladder disease;
• Addison's disease or other adrenal gland disorders;
• enlarged prostate, urination problems;
• mental illness; or
• a history of drug or alcohol addiction.

FDA pregnancy category C. This medication may be harmful to an unborn baby, and could cause addiction or withdrawal symptoms in a newborn. Tell your doctor if you are pregnant or plan to become pregnant during treatment. Oxycodone can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby. Older adults may be more sensitive to the effects of this medicine.

How should I use oxycodone?

Take the pill form of this medicine with a full glass of water. Do not crush, chew, or break an extended-release tablet. Swallow the pill whole. It will release medicine slowly in the body. Breaking the pill would cause too much of the drug to be released at one time.

Measure the liquid form of oxycodone with a special dose-measuring spoon or cup, not a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist where you can get one.

What storage conditions are needed for this medicine?

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from light and excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed. Throw away oxycodone concentrate solution 90 days after you open the product. Talk to your pharmacist about the proper disposal of your medication.

Keep oxycodone in a safe place so that no one else can take it accidentally or on purpose. Keep track of how much liquid or how many tablets or capsules are left so you will know if any medication is missing.

DRUG INTERACTIONS:

Your healthcare professionals (e.g., doctor or pharmacist) may already be aware of any possible drug interactions and may be monitoring you for it. Do not start, stop or change the dosage of any medicine before checking with them first. This drug should not be used with the following medication because very serious interactions may occur: naltrexone. If you are currently using this medication listed above, tell your doctor or pharmacist before starting oxycodone. Before using this medication, tell your doctor or pharmacist of all prescription and nonprescription/herbal products you may use, especially of: other medications for pain (e.g., butorphanol, codeine, pentazocine, tramadol), anti-seizure drugs (e.g., carbamazepine, phenobarbital), anticholinergic medications (e.g., atropine, scopolamine), drugs affecting removal of oxycodone from your body (e.g., cimetidine, SSRI antidepressants such as fluoxetine), drugs that lower blood pressure (e.g., diuretics such as hydrochlorothiazide, furosemide), MAO inhibitors (e.g., furazolidone, isocarboxazid, linezolid, phenelzine, procarbazine, selegiline, tranylcypromine), muscle relaxants (e.g., carisoprodol, methocarbamol), pyridostigmine, sodium oxybate. Tell your doctor or pharmacist if you also take drugs that cause drowsiness such as: antihistamines that cause drowsiness (e.g., diphenhydramine), anti-anxiety drugs (e.g., diazepam), medicine for sleep (e.g., zolpidem), psychiatric medicines (e.g., phenothiazines such as chlorpromazine, or tricyclic antidepressants such as amitriptyline), tranquilizers. Check the labels on all your medicines (e.g., cough-and-cold products) because they may contain drowsiness-causing ingredients. Ask your pharmacist about the safe use of those products. This medication can affect the results of certain lab tests. Make sure laboratory personnel and your doctors know you use this drug.