Roxybond

Generic name:

Oxycodone hydrochloride

Drug class:

Opioid analgesic (Schedule II controlled substance)

Dosage form:

Immediate-release tablets (5 mg, 15 mg, 30 mg), extended-release tablets (10 mg, 20 mg, 30 mg, 40 mg, 60 mg, 80 mg), oral solution (5 mg/5 mL)

Route of administration:

Oral

Dose:

Varies by indication; typical immediate-release: 5–15 mg every 4–6 hours as needed; extended-release: 10–80 mg every 12 hours; adjust based on prior opioid use and renal/hepatic function

Mechanism of action:

Agonist at central and peripheral mu-opioid receptors, inhibiting ascending pain pathways, altering pain perception and response, and producing generalized CNS depression.

Drug usage cases:

• Management of moderate to severe acute pain where use of an opioid analgesic is appropriate
• Management of chronic pain requiring continuous, long-term opioid administration
• Off-label: Dyspnea in palliative care
• Off-label: Cough suppression (in select cases)

Drug contra indications:

• Known hypersensitivity to oxycodone or other opioids
• Significant respiratory depression without resuscitative equipment
• Acute or severe bronchial asthma in unmonitored settings
• Paralytic ileus
• Severe gastrointestinal obstruction, including paralytic ileus
• Concurrent or recent (within 14 days) use of MAO inhibitors

Side effects:

• Respiratory depression
• Constipation
• Nausea and vomiting
• Dizziness and sedation
• Pruritus and sweating
• Dry mouth
• Headache
• Hypotension and syncope
• Flushing
• Urinary retention
• Dependence, tolerance, and addiction
• Confusion and euphoria
• Nightmares and hallucinations
• Endocrine dysfunction with prolonged use
• Serotonin syndrome (with serotonergic agents)

Warnings:

• Risk of addiction, abuse, and misuse, which can lead to overdose and death
• Life-threatening respiratory depression can occur at any time
• Accidental ingestion by children can result in fatal overdose
• Use in patients with head injury or increased intracranial pressure requires caution
• Use during pregnancy can cause neonatal opioid withdrawal syndrome
• Monitor for sedation and respiratory depression when initiating or increasing dose
• Use with caution in patients with GI conditions (e.g., obstruction)
• May impair ability to drive or operate machinery
• Concomitant use with benzodiazepines or other CNS depressants increases risk of sedation, respiratory depression, coma, and death
• Use with CYP3A4 inhibitors or inducers requires dose adjustment
• Seizure threshold may be lowered in susceptible individuals

Use during pregnancy or breastfeeding:

Prolonged use during pregnancy may result in neonatal opioid withdrawal syndrome (NOWS), which can be life-threatening if not recognized and treated. Use only if the potential benefit justifies the potential risk to the fetus. Breastfeeding: Oxycodone is excreted in human milk and may cause sedation and respiratory depression in the nursing infant. Monitor infants for excess sedation and respiratory depression; advise a careful risk/benefit assessment before initiating therapy in nursing mothers.