II. Indications

  1. Strong oral Opioid Analgesic for moderate to severe pain

III. Precautions

  1. Risk of serious respiratory depression
  2. Among the most abused and diverted prescription medications
    1. Oxycodone more easily crosses blood brain barrier (lipophilic) and potentiates euphoria

IV. Preparations: Immediate Release

  1. Oxycodone immediate release
    1. Adults (and over age 12 years) 5-10 mg every 4-6 hours as needed
    2. Child
      1. Moderate dose: 0.05 to 0.15 mg/kg/dose (up to 5 mg/dose) every 4-6 hours as needed
      2. High dose: 0.15 to 0.3 mg/kg/dose (up to 10 mg/dose) every 4-6 hours as needed
    3. Tabs: 5 mg (scored), 15, 30 mg
    4. Solution: 5 mg/ml
    5. Concentrate 20 mg/ml (dissolves sublingually)
  2. Acetaminophen and Oxycodone
    1. Percocet (Oxycodone 5 mg with Acetaminophen 325 mg)
      1. Dose: 1-2 orally every 6 hours as needed (adults or age over 12 years)
    2. Roxicet Solution (Oxycodone 5 mg and Acetaminophen 325 mg per 5 ml)
      1. Dose: Base on Oxycodone dose of 0.05 to 0.15 mg/kg/dose every 4-6 hours up to 5 mg/dose

V. Preparations: Controlled-Release (Extended Release)

  1. Oxycontin 10 mg every 12 hours
    1. Available in 10 mg, 15 mg, 20 mg, 30 mg, 40, 60 mg, 80 mg sustained release formulations
    2. Generic in U.S. as of 2016
  2. Precautions
    1. Start with short acting Oxycodone and convert to long acting based on pattern of requirements
    2. Titrate slowly: 80 mg is very high dose and only for Opioid tolerant patients
    3. Do not break or chew sustained release product (risk of Overdose)
    4. Sustained release product is intended only for scheduled use (not prn)
    5. Oxycontin true duration of action approaches 6 hours (instead of 12 hours) in many patients
      1. Oxycontin may offer no duration benefit over other formulations
      2. Oxycontin was released as MS Contin (8 hour duration) patent was expiring
      3. The exaggerated duration may add to misuse and abuse of Opioids
      4. Art Van Zee (2009) Am J Public Health 99(2): 221–7 +PMID:18799767 [PubMed]

VI. Adverse Effects

  1. Respiratory depression or arrest
    1. Reversal: Naloxone
  2. Nausea or Vomiting
  3. Constipation
  4. Sedation

VIII. References

  1. Hamilton (2012) Tarascon Pharmacopeia, Jones and Bartlett, Burlington
  2. Robertson (2005) Harriet Lane Handbook, Mosby, Philadelphia p. 911

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Cost: Medications

oxycodone (on 12/21/2022 at Medicaid.Gov Survey of pharmacy drug pricing)
OXYCODONE HCL (IR) 10 MG TAB Generic $0.11 each
OXYCODONE HCL (IR) 15 MG TAB Generic $0.13 each
OXYCODONE HCL (IR) 20 MG TAB Generic $0.18 each
OXYCODONE HCL (IR) 30 MG TAB Generic $0.27 each
OXYCODONE HCL (IR) 5 MG CAP Generic $0.38 each
OXYCODONE HCL (IR) 5 MG TABLET Generic $0.07 each
OXYCODONE HCL 100 MG/5 ML CONC Generic $1.97 per ml
OXYCODONE HCL 5 MG/5 ML SOLN Generic $0.06 per ml
OXYCODONE-ACETAMINOPHEN 10-325 MG TAB Generic $0.18 each
OXYCODONE-ACETAMINOPHEN 10-325 MG TABLET Generic $0.18 each
OXYCODONE-ACETAMINOPHEN 2.5-325 MG TABLET Generic $0.96 each
OXYCODONE-ACETAMINOPHEN 5-325 MG TAB Generic $0.10 each
OXYCODONE-ACETAMINOPHEN 5-325 MG TABLET Generic $0.10 each
OXYCODONE-ACETAMINOPHEN 7.5-325 MG TABLET Generic $0.14 each
percocet (on 1/1/2022 at Medicaid.Gov Survey of pharmacy drug pricing)
PERCOCET 10-325 MG TABLET Generic $0.18 each
PERCOCET 5-325 MG TABLET Generic $0.10 each
PERCOCET 7.5-325 MG TABLET Generic $0.14 each
oxycontin (on 1/1/2022 at Medicaid.Gov Survey of pharmacy drug pricing)
OXYCONTIN ER 10 MG TABLET $4.48 each
OXYCONTIN ER 15 MG TABLET $6.57 each
OXYCONTIN ER 20 MG TABLET $8.34 each
OXYCONTIN ER 30 MG TABLET $11.61 each
OXYCONTIN ER 40 MG TABLET $14.29 each
OXYCONTIN ER 60 MG TABLET $20.27 each
OXYCONTIN ER 80 MG TABLET $24.87 each
endocet (on 12/21/2022 at Medicaid.Gov Survey of pharmacy drug pricing)
ENDOCET 10-325 MG TABLET Generic $0.18 each
ENDOCET 5-325 MG TABLET Generic $0.10 each
ENDOCET 7.5-325 MG TABLET Generic $0.14 each