Generic Name

Oxycodone

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Classification

FDA Approved Indications

• Management of pain severe enough to require an opioid analgesic and for which alternative treatment options are inadequate

Mechanism of Action

Oxycodone binds to mu-opioid receptors in the central nervous system, altering the perception of and response to pain, and producing analgesic effects.

Dosage and Administration

Adult: Dose individualized based on severity of pain, previous analgesic experience, and patient response. Usually 10-20 mg every 12 hours, titrated gradually.

Pediatric: Not established for children under 18 years.

Geriatric: Start at the low end of dosing range; monitor for respiratory depression and sedation.

Renal Impairment: Adjust dosage carefully; monitor for enhanced sensitivity to opioids.

Hepatic Impairment: Use with caution; dosage adjustments may be necessary due to reduced metabolism.

Pharmacokinetics

Absorption: Well absorbed; food may slightly delay absorption.

Distribution: Distributed extensively in body tissues, bound approximately 45% to plasma proteins.

Metabolism: Primarily metabolized in the liver via CYP3A4 and CYP2D6 pathways.

Excretion: Excreted mainly in urine as metabolites; small amount unchanged in urine.

Half Life: Approximate plasma half-life of 4.5 hours.

Contraindications

• Significant respiratory depression, acute or severe bronchial asthma in an unmonitored setting, known hypersensitivity to oxycodone.

Precautions

• Use with caution in elderly, hepatic or renal impairment, head injuries, increased intracranial pressure, and in patients with a history of substance abuse.

Adverse Reactions - Common

• Nausea (Common)
• Dizziness (Common)
• Constipation (Common)
• Drowsiness (Common)

Adverse Reactions - Serious

• Respiratory depression (Rare but serious)
• Circulatory depression (Rare)
• Allergic reactions including rash, pruritus (Rare)

Drug-Drug Interactions

• CNS depressants, hypnotics, sedatives, other opioids, MAO inhibitors

Drug-Food Interactions

N/A

Drug-Herb Interactions

• St. John’s Wort

Nursing Implications

Patient/Family Teaching

• Take exactly as prescribed; do not alter dose or frequency.
• Warn about sedation, dizziness, and the risk of dependence.
• Advise against alcohol consumption and use of CNS depressants.
• Store securely to prevent misuse.

Special Considerations

Black Box Warnings:

• Addiction, abuse, and misuse can lead to overdose and death.
• Respiratory depression is the most serious complication.

Genetic Factors: Genetic variability in CYP2D6 enzymes can affect metabolism and response.

Lab Test Interference: None significant.

Overdose Management

Signs/Symptoms: Respiratory depression, extreme drowsiness, muscle limpness, unconsciousness.

Treatment: Administer naloxone as soon as possible; support respiratory function; establish airway and provide ventilation as needed.

Storage and Handling

Storage: Store in tightly closed container at room temperature, away from moisture, heat, and light.

Stability: Stable under recommended storage conditions.