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Oxycodone
Oxycodone, sold under the brand name Roxicodone and OxyContin (which is the extended-release form) among others, is a semi-synthetic opioid used medically for the treatment of moderate to severe pain. It is highly addictive[14] and is a commonly abused drug.[15][16] It is usually taken by mouth, and is available in immediate-release and controlled-release formulations.[15] Onset of pain relief typically begins within fifteen minutes and lasts for up to six hours with the immediate-release formulation.[15] In the United Kingdom, it is available by injection.[17] Combination products are also available with paracetamol (acetaminophen), ibuprofen, naloxone, naltrexone, and aspirin.[15]
Common side effects include euphoria, constipation, nausea, vomiting, loss of appetite, drowsiness, dizziness, itching, dry mouth, and sweating.[15] Side effects may also include addiction and dependence, substance abuse, irritability, depression or mania, delirium, hallucinations, hypoventilation, gastroparesis, bradycardia, and hypotension.[15] Those allergic to codeine may also be allergic to oxycodone.[15] Use of oxycodone in early pregnancy appears relatively safe.[15] Opioid withdrawal may occur if rapidly stopped.[15] Oxycodone acts by activating the μ-opioid receptor.[18] When taken by mouth, it has roughly 1.5 times the effect of the equivalent amount of morphine.[19]
Oxycodone was originally produced from the opium poppy opiate alkaloid thebaine in 1916 in Germany. One year later, it was used medically for the first time in Germany in 1917.[20] It is on the World Health Organization’s List of Essential Medicines.[21] It is available as a generic medication.[15] In 2022, it was the 60th most commonly prescribed medication in the United States, with more than 11 million prescriptions.[22][23] A number of abuse-deterrent formulations are available, such as in combination with naloxone or naltrexone.[16][24]
Medical uses
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Oxycodone is used for managing moderate to severe acute or chronic pain when other treatments are not sufficient.[15] It may improve quality of life in certain types of pain.[25] Numerous studies have been completed, and the appropriate use of this compound does improve the quality of life of patients with long term chronic pain syndromes.[26][27][28]
Oxycodone is available as a controlled-release tablet.[29] A 2006 review found that controlled-release oxycodone is comparable to immediate-release oxycodone, morphine, and hydromorphone in management of moderate to severe cancer pain, with fewer side effects than morphine. The author concluded that the controlled-release form is a valid alternative to morphine and a first-line treatment for cancer pain.[29] In 2014, the European Association for Palliative Care recommended oxycodone by mouth as a second-line alternative to morphine by mouth for cancer pain.[30]
In children between 11 and 16, the extended-release formulation is FDA-approved for the relief of cancer pain, trauma pain, or pain due to major surgery (for those already treated with opioids, who can tolerate at least 20 mg per day of oxycodone) – this provides an alternative to Duragesic (fentanyl), the only other extended-release opioid analgesic approved for children.[31]
Oxycodone, in its extended-release form and/or in combination with naloxone, is sometimes used off-label in the treatment of severe and refractory restless legs syndrome.[32]
