Oxycodone is a strong pain reliever drug that belongs to the group of opioids. In medicine, it is mainly used in the form of the hydrochloride s alt. How does oxycodone work and how to properly dose it?
Oxycodone(Latinoxycodonum ) is structurally similar to the more well-known and much more frequently used codeine, from which it differs in the presence of a hydroxyl group at position 14, replacing the hydroxyl group at position 6 with a carbonyl (ketone) group and reducing the double bond between the 7.8 carbons to a single.
Oxycodone: indications for use
- treatment of postoperative pain
- treatment of neoplastic diseases, especially in palliative treatment
- treatment of moderate to severe pain
- second-line symptomatic treatment in patients with severe to very severe idiopathic RLS
- treatment of neuropathic and ischemic pain
- treatment of hip osteoarthritis
Oxycodone: ways of taking and dosage
The drug is most commonly taken orally. It can also be taken rectally or by intramuscular, intravenous and subcutaneous injection. Bioavailability for oral and rectal administration is similar and amounts to approximately 60-87%.
The dosage of oxycodone depends on the individual patient: how their body responds to treatment and to what extent they feel pain.
Most often in adolescents over 12 years of age and adults who have not used opioids before, the starting dose is 10 mg of oxycodone hydrochloride given every 12 hours.
Some patients may be satisfied with a starting dose of 5 mg (this reduces the frequency and intensity of side effects).
However, the size of the dose and the frequency of its administration are individually determined by the attending physician, who is able to determine the sensitivity of the organism and take into account any accompanying diseases and other medications taken by the patient.
Oxycodone: contraindications
Oxycodone, like other drugs, cannot be used by all patients. Contraindications to the administration of this drug are, for example :
- paralytic intestinal obstruction
- pulmonary heart
- hypersensitivity to oxycodone or eitherexcipient
- severe respiratory depression with hypoxia
- severe bronchial asthma
- severe chronic obstructive pulmonary disease
Oxycodone should not be given to children under 12 years of age. There is no specific data on the use of this substance in such young people, so its side effects and their impact on a child's development are difficult to determine.
It should be carefully dosed in elderly or debilitated patients, as well as in people with:
- severe lung dysfunction
- liver or kidney problems
- hypothyroidism
- diseases of the biliary tract
- benign prostatic hyperplasia
- psychosis after poisoning (e.g. with alcohol)
- intestinal inflammation
- with alcoholism
- known addiction to opioids or other drugs
- delirium
- pancreatitis
- gallstone disease
- hypertension
- epilepsy
- tendency to convulsions
- in patients treated concurrently with MAO inhibitors.
Oxycodone and pregnancy and lactation
Oxycodone crosses the placenta, therefore it should not be used in pregnant women. Newborns whose mothers have used opioids within the last 3-4 weeks prior to delivery should be monitored for respiratory depression.
If oxycodone is administered during labor, the fetus may develop respiratory depression.
This drug also passes into breast milk and may cause respiratory depression in the newborn.
Its use in pregnant women and during breastfeeding should take place under strict medical supervision and only when the benefits of its administration outweigh the possible side effects.
Oxycodone: side effects
Oxycodone can cause side effects such as:
- miosis
- bronchospasm
- smooth muscle contraction
- respiratory depression
- can bear the cough reflex
- in extreme cases: severe hypotension and life-threatening
People taking this drug may also experience:
- sleepiness up to impaired consciousness
- constipation
- nausea
- headache
- dizziness
- vomiting
- changes in mood and personality (e.g. anxiety, depression)
- reduction of appetite until its total loss
- excessive psychomotor activity, nervousness, insomnia
- muscle tremors
- confusional state
- shortness of breath
- hiccup
- indigestion
- dry mouthoral
- skin reactions (e.g. rash, erythema)
Oxycodone: drug and food interactions
Oxycodone reacts with:
- opioids
- sleeping pills
- antidepressants
- antihistamines
- antiemetics
- neuroleptics
Alcohol can increase the side effects of alcohol.
Oxycodone should be used with caution during treatment with MAO inhibitors, and also up to 2 weeks after their discontinuation (both of them act on the central nervous system).
Macrolide antibiotics (e.g. clarithromycin, erythromycin), antifungal drugs (e.g. ketoconazole, itraconazole), as well as seemingly innocent grapefruit juice may inhibit the metabolism of oxycodone, which may lead to an increase in the concentration of this substance in the blood (higher probability of side effects).
On the other hand, St. John's wort can accelerate the metabolism of oxycodone, which may lead to a decrease in the concentration of the drug in the blood, and thus weaken its effect.
Oxycodone as a drug
Although oxycodone, when used as prescribed by a doctor, helps overcome pain, allows the patient to function normally, provides relief from disease, unfortunately it is also used as a narcotic agent. This mainly applies to countries such as the USA, Canada and Australia.
Large doses of this drug, if ingested in an uncontrolled manner, can lead to life-threatening respiratory depression. The risk increases if it is taken together with other substances that have the same or similar effects on the respiratory center.
Threatening he alth and life can also be increased drowsiness, occurring after the administration of large doses of this substance, especially when combined with the lack of feeling cold and a tendency to cool the body much faster.
Inflammation of blood vessels and skin occurs after intravenous administration of oxycodone.
Other dangers include infections with blood borne diseases, including HIV and viral hepatitis.
There have also been many reports of death after taking oxycodone, the most common being the concomitant use of other sedatives or the consumption of alcohol.
Therefore, it should be remembered that, unfortunately, what heals can also be harmful, and in case of any doubts that arise during treatment, you should immediately contact your doctor.
What is worth knowing about pain?Painis a very subjective feeling and precisely because of this subjectivity -according to the definition - pain is what the patient calls it. The International Society for the Study of Pain, expanding on this definition, adds that pain is an emotional and sensory sensation with a negative characterization. It appears as a result of stimuli that damage tissue or may damage it.
Acute pain(lasting up to 3 months) - has a protective and warning function, it disappears with the accompanying disease. This is e.g. :
- coronary pain
- sciatica
- renal colic
- pain related to injuries, burns, frostbite
- pain in appendicitis
- pain in acute limb ischemia
Chronic pain(lasts more than 3 months) does not have a warning and defense function and is no longer a symptom, but becomes a disease itself, requires longer pharmacological treatment and very often does not allows the patient to function properly on a daily basis. This is e.g. :
- rheumatic pain
- pain in lower limb ischemia due to atherosclerosis
- migraine headaches
- pain associated with other degenerative changes
- post-traumatic pain
How to treat pain?
In mild pain - paracetamol and non-steroidal anti-inflammatory drugs, e.g. ibuprofen, are used. They have an analgesic and anti-inflammatory effect, incl. reducing the production of prostaglandins, which are responsible for sensitizing our pain receptors.
In moderate pain, weak opioids (e.g. codeine, tramadol) are administered.
In severe pain - strong opioids (e.g., morphine, fentanyl, buprenorphine, methadone, oxycodone).