Oxycodone – pro

Oxycodone is a full opioid agonist with no antagonist properties whose principal therapeutic action is analgesia. It has an affinity for kappa, mu and delta opiate receptors in the brain and spinal cord. Oxycodone is similar to morphine in its action. Other pharmacological actions of oxycodone are in the CNS (respiratory depression, antitussive, anxiolytic, sedative and miosis), smooth muscle (constipation, reduction in gastric, biliary and pancreatic secretions, spasm of sphincter of Oddi and transient elevations in serum amylase) and cardiovascular system (release of histamine and/or peripheral vasodilation, possibly causing pruritus, flushing, red eyes, sweating and/or orthostatic hypotension).

OXYCONTIN tablets should be taken at 12-hourly intervals. The dosage is dependent on the severity of the pain, and the patient’s previous history of analgesic requirements. Increasing severity of pain will require an increased dosage of OXYCONTIN tablets using the 5mg, 10mg, 20mg, 40mg or 80mg tablet strengths, either alone or in combination, to achieve pain relief. The correct dosage for any individual patient is that which controls the pain and is well tolerated, for a full 12 hours. There is no ceiling dose and so patients should be titrated to pain relief unless unmanageable adverse medicine reactions prevent this. The usual starting dose for opioid naïve patients or patients presenting with severe pain uncontrolled by weaker opioids is 10mg 12 hourly, or 5mg 12 hourly for patients with renal or hepatic impairment. The dose should then be carefully titrated, as frequently as once a day if necessary, to achieve pain relief. It is not uncommon for a patient to require higehr doses.

Riley J, Eisenberg E, Müller-Schwefe G, Drewes AM, Arendt-Nielsen L. Oxycodone: a review of its use in the management of pain.Curr Med Res Opin. 2008 Jan;24(1):175-92.

Oxycodone: Pharmacological profile and clinical data in chronic pain management minervamedica.it. Minerva Anestesiologica, 2005;71:451-60.

Management of cancer pain. In VT DeVita Jr et al., eds., Cancer: Principles and Practices of Oncology, 6th ed., pp. 2977–3011. Philadelphia: Lippincott Williams and Wilkins.

Pergolizzi J, Boger R, Budd K, et al. Opioids and the management of chronic severe pain in the elderly: consensus statement of an international expert panel with focus on the six clinically most often used World Health Organisation step III opioids (Buprenorphine, fentanyl, hydromorphone, methadone, morphine, oxycodone. Pain Pract 2008;8(4):287-313.

Manchikanti L, Fellows B, Ailinani H, Pampati V. Therapeutic use, abuse, and nonmedical use of opioids: a ten-year perspective. Pain Physician 2010;13:401-35.

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