Oxycodone (Oxy IR, Oxycontin, Percocet)
Matt Kauflin, Pharm.D., BCPS

Oxycodone - Oxy IR®, Oxycontin®, Percocet®

Drug Class - Opioid Analgesic, C II

Mechanism of Action - Oxycodone primarily binds and activates the mu-opioid receptor in the CNS and promotes analgesia. Binding of oxycodone to this receptor also results in euphoria, respiratory depression, decreased gastrointestinal motility and physical dependence

Dosage Forms – oral cap 5 mg.  Oral tab IR 5 mg, 10 mg, 15 mg, 20 mg, 30 mg.  Oral tab ER 12 hr abuse-deterrent – 10 mg, 15 mg, 20 mg, 30 mg, 40 mg, 60 mg, 80 mg.  Oral cap 12 hr abuse-deterrent 9 mg, 13.5 mg, 18 mg, 27 mg, 36 mg.  Oral soln. 5 mg/5 mL.  Oral concentrate 100 mg/5 mL.  Combination with APAP – most common is 2.5-10 mg with 325 APAP

Dosing – opioid naïve – 5-10 mg po every 4-6 h as needed for pain.  ER 10 mg po q12h.  Titrate to response

Indications

  1. 1.Pain – chronic, moderate to severe 

 

Oxycodone - Oxy IR®, Oxycontin®, Percocet®

Dosage adjustment

  • •Initiate with low dose and titrate with caution in hepatic impairment 

  • •Reduce starting dose with CrCL < 60 mL/min 

Contraindications

  • •Hypersensitivity to oxycodone 

  • •GI obstruction, paralytic ileus 

  • •Respiratory depression 

  • •Severe asthma 

Warnings

  • •Addiction, abuse, misuse 

  • •Accidental ingestion 

  • •Neonatal opioid withdrawal 

  • •Concurrent use with other CNS depressants 

Pregnancy

  • •Oxycodone is not recommended for use in pregnancy and breastfeeding 

 

Oxycodone - Oxy IR®, Oxycontin®, Percocet®

Drug Interactions

  • •CNS depressants 

  • •Opioid agonist/antagonists, opioid antagonists 

  • •CYP3A4 inducers/inhibitors 

Adverse Effects

  • •Constipation/GI distress 

  • •Somnolence/Respiratory depression 

  • •Rash 

  • •Euphoria 

  • •Pruritus 

Monitoring Parameters

  • •Pain relief, refill records (OARRS report in Ohio), excessive drowsiness, urine drug test, respiratory rate, BP, severe constipation, REMS  

Therapeutic Pearls

  • •One of the most prescribed drugs on the market 

  • •Antidote is naloxone 

  • •Constipation is a problem with both acute/chronic use 

  • •Significant drug of abuse 

  • •Store and dispose of properly 

 

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