Select a medication above to begin.
OxyContin
oxycodone
Black Box Warnings .
Appropriate Use
should only be prescribed by healthcare professionals knowledgeable about ER opioid use and how to mitigate assoc. risks; reserve ER forms for pts w/ inadequate tx alternatives; not indicated for prn analgesic use; proper dosing and titration essential to decr. resp. depression risk
Addiction, Abuse, and Misuse
opioid agonist Schedule II controlled substance w/ risk of addiction, abuse, and misuse, which can lead to overdose and death; assess opioid abuse or addiction risk prior to prescribing; regularly reassess all pts for misuse, abuse, and addiction
Respiratory Depression
serious, life-threatening, or fatal cases may occur even w/ recommended use, esp. during tx start or after dose incr; to decr. risk, initiate and titrate dose appropriately; instruct pts to swallow ER tabs whole; crushing, chewing, or dissolving ER tabs can cause rapid release and absorption of potentially fatal oxycodone dose
Accidental Ingestion
accidental ingestion of even one dose, esp. by children, can result in fatal oxycodone overdose
Risks from Concomitant Use w/ Benzodiazepines, CNS Depressants
concomitant opioid use w/ benzodiazepines or other CNS depressants, incl. alcohol, may result in profound sedation, resp. depression, coma, and death; reserve concomitant use for pts w/ inadequate alternative tx options
Neonatal Opioid Withdrawal Syndrome
extended use in pregnant pts can lead to potentially life-threatening neonatal opioid withdrawal syndrome; advise pregnant pts of risks and ensure tx by neonatology experts avail. at delivery if extended opioid use required
Opioid Analgesic REMS
providers are strongly encouraged to complete risk evaluation and mitigation strategy (REMS)-compliant education program, counsel pts and/or caregivers w/ each Rx on serious risks, safe use, and importance of reading medication guide
CYP450 3A4 Interaction
concomitant use w/ CYP450 3A4 inhibitors or D/C of concomitant CYP450 3A4 inducers may incr. oxycodone conc. which may incr. or prolong adverse effects incl. potentially fatal resp. depression; monitor pts receiving any concomitant CYP450 3A4 inhibitor or inducer
Adult Dosing .
Dosage forms: ER TAB: 10 mg, 15 mg, 20 mg, 30 mg, 40 mg, 60 mg, 80 mg
Special Note
- [prescribing info]
- Info: consider prescribing naloxone if risk of opioid overdose or accidental ingestion
- [formulation clarification]
- Info: abuse-deterrent formulation to reduce potential abuse or misuse
pain, severe chronic
- [opioid-naive or opioid-nontolerant pts]
- Dose: individualize dose PO q12h; Start: 10 mg PO q12h, may incr. total daily dose by 25-50% q1-2 days; Info: use lowest effective dose, shortest effective tx duration; titrate slowly in pts 65 yo and older; decr. start dose 50-66% in debilitated pts 65 yo and older and titrate w/ caution; >40 mg/dose, >80 mg/day for use in opioid-tolerant pts only; do not cut/crush/chew/dissolve tab; taper total daily dose by no more than 10-25% q2-4wk to D/C if long-term use
- [opioid-tolerant pts]
- Dose: individualize dose PO q12h; Start: individualize start dose based on current opioid intake, see pkg insert for conversion; may incr. total daily dose by 25-50% q1-2 days; Info: use lowest effective dose, shortest effective tx duration; titrate slowly in pts 65 yo and older; do not cut/crush/chew/dissolve tab; taper total daily dose by no more than 10-25% q2-4wk to D/C if long-term use
renal dosing
- [see below]
- CrCl <60: not defined; Info: titrate slowly
- HD/PD: not defined
hepatic dosing
- [see below]
- hepatic impairment: decr. usual start dose by 50-66%; Info: titrate slowly
Peds Dosing .
- Dosage forms: ER TAB: 10 mg, 15 mg, 20 mg, 30 mg, 40 mg, 60 mg, 80 mg
Special Note
- [prescribing info]
- Info: consider prescribing naloxone if risk of opioid overdose or accidental ingestion
- [formulation clarification]
- Info: abuse-deterrent formulation to reduce potential abuse and misuse
pain, severe chronic
- [opioid-tolerant pts, 11 yo and older]
- Dose: individualize dose PO q12h; Start: individualize start dose based on current opioid intake, see pkg insert for conversion; may incr. total daily dose by 25% q1-2 days; Info: for use in pts receiving at least 20 mg oxycodone/day or equivalent for at least 2 days immed. before tx start; use lowest effective dose, shortest effective tx duration; do not cut/crush/chew/dissolve tab; taper total daily dose by no more than 10-25% q2-4wk to D/C if long-term use
renal dosing
- [see below]
- CrCl 10-50: decr. usual dose by 25%; CrCl <10: decr. usual dose by 50%
- HD: decr. usual dose by 50%; no supplement after dialysis; PD: decr. usual dose by 50%; no supplement
hepatic dosing
- [see below]
- hepatic impairment: decr. usual start dose by 50-66%; Info: titrate slowly