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Oxycodone

(ox-ee-koh-dohn)

Trade/other name(s): aspirin and oxycodone, Combunox, Endodan, Oxycet, oxycodone and acetaminophen, oxycodone hydrochloride, OxyContin, OxylR, Percocet, Percodan, Roxicet, Roxicodone, Roxilox, Roxiprin, and Tylox are some of the medicines that contain oxycodone. Most contain other ingredients as well.

This information pertains only to oxycodone; it does not pertain to aspirin, acetaminophen, or ibuprofen.

Why would this drug be used?

Oxycodone is a strong pain reliever that is used to treat moderate to moderately severe pain. It comes in different forms, such as short-acting liquids or tablets, and long-acting (sustained-release) pills.

Short and long-acting pain medicines are often used together for severe chronic (long-term) cancer pain. A long-acting pain medicine is given at regular times to provide continuous pain relief for chronic (long-term) pain, and a quick, short-acting medicine is given when pain “breaks through” the longer-acting medicine. The short-acting drug is sometimes called a “rescue” medicine.

Because oxycodone is made in both long-acting and short-acting forms, it can be used for either of these roles. One of oxycodone’s sustained-release forms may be used as the continuous pain relief. A quick, short-acting form of oxycodone may be used as the rescue medicine.

How does this drug work?

Oxycodone is an opioid pain reliever that acts very much like the drug morphine. It binds to opioid receptors in the brain and central nervous system (CNS), reducing both the perception of pain and the emotional response to it.

Before taking this medicine

Tell your doctor…

  • If you are allergic to anything, including medicines, dyes, additives, foods, or sulfites. Oxycodone preparations often contain sulfites, aspirin, ibuprofen, acetaminophen, or other substances.
  • If you have any medical conditions such as kidney disease, liver disease (including hepatitis), thyroid problems, or Addison’s disease (low adrenal function). These conditions may require that your medicine dose, regimen, or timing be changed.
  • If you have abdominal pain or any disorder with slowed or blocked intestines, such as paralytic ileus. People with these problems shouldn’t take oxycodone. If you’ve had this kind of problem in the past, tell your doctor so that you can be watched in case it comes back.
  • If you have trouble passing urine, a narrow urethra, or if you have an enlarged prostate. Oxycodone can make it harder to urinate.
  • If you have ever had a seizure, head injury, or if you have had problems with pressure, infection, or a tumor in your head or brain. Oxycodone can raise your risk of seizures.
  • If you have low blood pressure. Oxycodone can worsen this.
  • If you are planning to have surgery or anything requiring general anesthesia in the near future. (See also “Precautions.”)
  • If you have asthma, emphysema, chronic bronchitis, sleep apnea, or other serious breathing problems. Oxycodone can make these worse, and even cause death by stopping your breathing.
  • If you have gallstones, gallbladder disease, or pancreatitis. Oxycodone can sometimes worsen these problems.
  • If you have taken monoamine oxidase inhibitors (MAOIs) within the past 2 weeks (see “Interactions with other drugs”). Oxycodone can cause slow or shallow breathing, low blood pressure, excitability, seizures, coma, or shock.
  • If you drink alcohol or take any medicine that can affect your brain or nervous system. These may worsen the side effects of oxycodone or cause other problems.
  • If you have trouble with addiction, alcohol, drug abuse, or mental illness now or had it in the past. Oxycodone can be habit forming, especially for those who have had these problems before.
  • If any family members have or have had an addiction or drug problem. Oxycodone is sometimes stolen by or for those who have become addicted to it or drugs like it.
  • If you are pregnant, trying to get pregnant, or if there is any chance of pregnancy. There may be an increased risk of harm to the fetus if a woman takes this drug during pregnancy, especially later in pregnancy (see “Precautions”).
  • If you are breastfeeding. The drug passes into breast milk and may harm the baby.
  • About any other prescription or over-the-counter medicines you are taking, including vitamins and herbs. In fact, keeping a written list of each of these medicines (including the doses of each and when you take them) with you in case of emergency may help prevent complications if you get sick.

Interactions with other drugs

Buprenorphine, (Subutex, Suboxone), butorphanol (Stadol), nalbuphine (Nubain), or pentazocine (Talwin, Talacen) may make oxycodone less effective or stop its action altogether. This can cause withdrawal symptoms very quickly if you have taken the oxycodone for some time.

Antidepressants of the older MAOI type such as phenelzine (Nardil), tranylcypromine (Parnate), isocarboxazid (Marplan), or selegiline (Emsam) may cause slow or shallow breathing, low blood pressure, excitability, seizures, coma, or shock if oxycodone is given within 2 weeks of the last MAOI dose.

Several different medicines can increase the blood level of oxycodone and raise the risk of serious side effects or overdose:

  • Antibiotics such as erythromycin (E.E.S., E-Mycin, Erythrocin), clarithromycin (Biaxin), and norfloxacin (Noroxin)
  • Anti-fungals such as ketoconazole (Nizoral), itraconazole (Sporanox), and voriconazole (Vfend)

Other medicines may have this effect as well.

Medicines or substances that slow down the brain or nervous system, such as these, can cause worse side effects such as slowed breathing, low blood pressure, extreme sleepiness, coma, or even death if taken with oxycodone:

  • Anti-anxiety drugs (tranquilizers or sedatives)
  • Sleeping pills
  • Muscle relaxers
  • Barbiturates
  • Anti-seizure medicines
  • Other opioid drugs such as morphine
  • Anesthetics
  • Tricyclic antidepressants such as amitriptyline (Elavil), nortriptyline (Pamelor), imipramine (Tofranil), desipramine (Norpramin), doxepin (Sinequan), and others Anti-psychotic drugs
  • Certain anti-nausea medicines
  • Certain antihistamines (those that cause sleepiness)
  • Alcohol-containing drugs or beverages, including beer, wine, and mixed drinks

Some medicines can lower the blood level of oxycodone and make it less effective or even cause withdrawal symptoms. Examples include:

  • Anti-seizure medicines such as phenobarbital, carbamazepine, and phenytoin
  • TB medicines such as rifampin and rifabutin
  • HIV medicines such as ritonavir, indinavir, or nelfinavir

Diuretics (“water pills”) may not work as well while you are taking oxycodone.

Check with your doctor, nurse, or pharmacist about whether other medicines, vitamins, herbs, and supplements can cause problems with this medicine.

Do not start or stop any medicines while on oxycodone without talking with the prescribing doctor(s) about all of the medicines you take, including oxycodone.

Interactions with foods

Beverages that contain alcohol, including beer, wine, and mixed drinks, can raise the risk of harmful effects and death if taken while you’re being treated with oxycodone.

No other serious interactions with food are known at this time. Check with your doctor, nurse, or pharmacist about whether foods may be a problem.

Tell all the doctors, dentists, nurses, and pharmacists you visit that you are taking this drug.

How is this drug taken or given?

Oxycodone comes in a number of forms to take by mouth. Oxycodone by itself is a quick-acting pill that lasts 3 to 4 hours. It also comes in a liquid form. Be sure to shake the liquid and measure the dose carefully using the dropper or spoon that came with the medicine. Mix the liquid concentrate with an ounce or 2 of juice or a small amount of pudding or applesauce and swallow it right away.

Sustained-release pills (like OxyContin) are usually taken every 12 hours. If you are taking a long-acting pill, do not chew, break, crush, split, or dissolve it. Do not moisten these pills before swallowing. Swallow these pills whole right away, one at a time, with a full glass of water or juice. If you cannot swallow them whole, or if you have trouble swallowing them, talk with your doctor or nurse about getting another medicine. Time-release pills contain enough oxycodone to last for 12 hours. If they are chewed, dissolved, or crushed, the entire dose can be absorbed by the body all at once, causing overdose symptoms including serious complications such as trouble breathing. Ask your doctor, nurse, or pharmacist if you have other questions about how to safely take your medicines.

The dose depends on how much is needed to control your pain. Your doctor may start you on a lower dose and slowly increase it over a few days or weeks. Take this drug exactly as directed by your doctor. If you do not understand the instructions, ask your doctor or nurse to explain them to you.

Keep the medicine in a tightly closed container away from heat and moisture and safely away from children, pets, and other people. Medicine that will not be used should be flushed down the toilet as soon as possible. Do not allow others to take your medicines.

Precautions

Many forms of oxycodone are combined with acetaminophen (Tylenol), aspirin, or ibuprofen (Motrin, Advil). Check with your doctor, nurse, or pharmacist about what else is in your oxycodone prescription before you take non-prescription medicines for pain, fever, colds, or flu. Many of these remedies also have acetaminophen or aspirin, and you can get too much of them without knowing it. Overdoses of either drug can cause harm or even death.

This medicine can cause drowsiness and lightheadedness. Do not drive, operate machinery, or perform other activities that require alertness until you know how you react to this medicine.

Oxycodone can make you feel dizzy or faint, and increase your risk of falling. Be careful getting up, changing position, or walking. Start slowly and hold onto something or someone to keep you steady. If you feel lightheaded or dizzy, it may help to lie down. It is best to have a responsible adult with you for the first few days after starting the oxycodone and after any increase in dose, until you know how you will respond to it.

Since oxycodone affects the central nervous system, do not take other drugs or substances that slow down the brain or nervous system such as alcohol, sedatives, muscle relaxers, and sleeping medicines unless your doctor tells you to do so (see “Interactions with other drugs”).

Call your doctor right away if you have trouble breathing, get short of breath, get confused, feel very drowsy, or start seeing or hearing things that aren’t there. These may be signs your dose is too high, or you could have gotten an accidental overdose of the medicine.

Tell your doctor or nurse right away if you have trouble passing urine, trouble walking, fainting, or other problems.

If you are having any kind of surgery or medical procedure, be sure to tell the doctor or dentist in charge that you are using this medicine. Some anesthesia drugs might cause a dangerous drop in blood pressure when used with this drug.

Constipation is a very common side effect of taking opioid pain medicines. While you’re taking oxycodone, your doctor may advise you to take medicines such as stool softeners, bulk-forming agents, and/or laxatives as needed to have regular (daily) bowel movements. Talk to your nurse or doctor about this when you first start this medicine. Drink plenty of fluids throughout the day, and try to eat foods high in fiber such as whole grains, bran, fruits, and vegetables. Call your doctor or nurse right away if you have not moved your bowels in 2 days.

Most cancer pain can be controlled. Tell your cancer team if your medicines do not control your pain, and keep them informed about any side effects you are having. Your cancer team may need to adjust your medicines several times before they find the medicines that work best for you.

If you have chronic (long-term) cancer pain, talk to your doctor about taking your pain medicines on a regular schedule to keep it from worsening. If you wait until the pain is bad, it takes more medicine to get it under control. If pain comes back between doses, talk to your cancer team about changing your medicine or adding an extra one for “breakthrough” pain.

Talk to your doctor or nurse about using the smallest effective dose to reduce side effects and the development of tolerance and physical dependence. Tolerance means that larger doses are needed to get the same pain relief. Physical dependence means that the body goes into withdrawal if drug is suddenly stopped. Both happen normally when strong opioid medicines are taken over several weeks to treat chronic pain. But this is different from addiction, which starts when the drug is taken for pleasure rather than pain relief. Tell your doctor or nurse if you still have pain even though you are taking the medicine as directed. Do not adjust your dose without talking to your doctor or nurse.

Do not stop taking this medicine without talking to your doctor or nurse. When no longer needed, this medicine should be stopped gradually with the help of your doctor. If it is stopped suddenly after you have taken it regularly for several weeks, withdrawal symptoms may occur, such as body aches, cramps, runny nose, watering eyes, diarrhea, and rarely, seizures.

This drug is a controlled substance, and may be habit forming. Keep your medicine in a safe place, away from other people, and do not let anyone else take your medicine. A person who has taken opioid medicine such as oxycodone for a long time often needs large doses for pain relief, while the same amount could quickly kill someone else.

Using opioid drugs such as oxycodone during pregnancy, especially near the end of the pregnancy, can cause neonatal opioid withdrawal. This can be life-threatening to a newborn if it’s not recognized and treated.

If you think you or someone else may have taken an overdose of oxycodone, or if someone else has taken even one dose of time-release oxycodone, get emergency help right away. Symptoms of oxycodone overdose may include extreme drowsiness, slow heartbeat, slow or irregular breathing, cold clammy skin, or coma. Oxycodone overdose can cause the heart or breathing to stop. With time release medicine it can take up to a day for all medicine to be absorbed, and the person may need to be observed for some time after treatment. Contact the pharmacy to learn what other drugs are in the pill with the oxycodone, since an overdose could have delayed effects (if it contains acetaminophen, for example), and need special treatments.

Possible side effects

You will probably not have most of the following side effects, but if you have any talk to your doctor or nurse. They can help you understand the side effects and cope with them.

Common

  • Constipation*
  • Drowsiness*
  • Sedation*
  • Nausea
  • Dizziness*
  • Dry mouth

Less common

  • Vomiting
  • Weakness or tiredness
  • Headache
  • Changes in mood, such as euphoria (happiness) or depression
  • Confusion*
  • Slow or shallow breathing*
  • Low blood pressure when sitting or standing up*
  • Delayed digestion
  • Slow heart rate
  • Trouble sleeping
  • Sweating

Rare

  • Trouble urinating*
  • Decreased sexual interest
  • Impotence
  • Itching
  • Red eyes
  • Rash
  • Gagging or pills sticking in throat (time-release pills such as OxyContin)
  • Withdrawal symptoms when stopping the drug*
  • Opioid withdrawal and even death in the newborn if oxycodone is taken during pregnancy*
  • Allergic reaction with itching, skin welts, trouble breathing, or swelling of the face, mouth, tongue, or throat
  • Death due to slow breathing, low blood pressure, overdose, allergic reaction, drug interactions, or other causes

*See the “Precautions” section for more detailed information.

There are other side effects not listed above that can also occur in some patients. Tell your doctor or nurse if you develop these or any other problems.

FDA approval

Yes – first approved before 1984 (FDA cannot verify dates of drugs approved before 1984.)

Disclaimer: This information does not cover all possible uses, actions, precautions, side effects, or interactions. It is not intended as medical advice, and should not be relied upon as a substitute for talking with your doctor, who is familiar with your medical needs.


Last Medical Review: 06/18/2014
Last Revised: 06/18/2014