$200.00 – $1,400.00
Product name: Oxycontin
Labeler / Supplier: Purdue Pharma
Active substance: Oxycodone HCl
Band names: Oxaydo, Roxicodone, Roxybond, OxyContin.
Drug Class: Narcotic analgesics
Dosage Strength(s): 20 MG, 40 MG, 60 MG, 80 MG
Quantity: 100 – 750 Tablets
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Oxycontin (oxycodone hydrochloride controlled-release) Tablets are an opioid analgesic supplied in 10 mg, 15 mg, 20 mg, 30 mg, 40 mg, 60 mg, 80 mg, and 160 mg tablet strengths for oral administration. The tablet strengths describe the amount of oxycodone per tablet as the hydrochloride salt.
Oxycodone oral tablet is available as brand-name drugs and as a generic drug. Brand names: Oxaydo, Roxicodone, Roxybond, OxyContin.
Oxycodone comes in five forms: immediate-release tablet, extended-release tablet, immediate-release capsule, extended-release capsule, and solution. All forms are taken by mouth.
Oxycodone is used to treat moderate to severe pain in adults.
Oxycodone belongs to a class of drugs called opioid agonists. A class of drugs is a group of medications that work in a similar way. These drugs are often used to treat similar conditions.
Oxycodone is similar to a group of natural substances in the brain called endorphins. These substances work to decrease the pain messages that your body sends to your brain. By mimicking these substances, oxycodone decreases the amount of pain your brain thinks you’re having.
Oxycodone is a white, odorless crystalline powder derived from the opium alkaloid, thebaine. Oxycodone hydrochloride dissolves in water (1 g in 6 to 7 ml). It is slightly soluble in alcohol (octanol water partition coefficient 0.7). The tablets contain the following inactive ingredients: ammonio methacrylate copolymer, hypromellose, lactose, magnesium stearate, polyethylene glycol 400, povidone, sodium hydroxide, sorbic acid, stearyl alcohol, talc, titanium dioxide, and triacetin.
The 20 mg tablets also contain: polysorbate 80 and red iron oxide.
The activity of OxyContin Tablets is primarily due to the parent drug oxycodone.
OxyContin Tablets are designed to provide controlled delivery of oxycodone over 12 hours.
Breaking, chewing or crushing OxyContin Tablets eliminates the controlled delivery mechanism and results in the rapid release and absorption of a potentially fatal dose of oxycodone.
Oxycodone release from OxyContin Tablets is pH independent. Oxycodone is well absorbed from OxyContin Tablets with an oral bioavailability of 60% to 87%. The relative oral bioavailability of OxyContin to immediate-release oral dosage forms is 100%. Upon repeated dosing in normal volunteers in pharmacokinetic studies, steady-state levels were achieved within 24-36 hours. Dose proportionality and/or bioavailability has been established for the 10 mg, 20 mg, 40 mg, 80 mg, and 160 mg tablet strengths for both peak plasma levels (Cmax) and extent of absorption (AUC). Oxycodone is extensively metabolized and eliminated primarily in the urine as both conjugated and unconjugated metabolites. The apparent elimination half-life of oxycodone following the administration of OxyContin® was 4.5 hours compared to 3.2 hours for immediate-release oxycodone.
Initial Dosage In Adults Who Are Not Opioid-Tolerant
The starting dosage for patients who are not opioid tolerant is OXYCONTIN 10 mg orally every 12 hours. Adult patients who are opioid tolerant are those receiving, for one week or longer, at least 60 mg oral morphine per day, 25 mcg transdermal fentanyl per hour, 30 mg oral oxycodone per day, 8 mg oral hydromorphone per day, 25 mg oral oxymorphone per day, or an equianalgesic dose of another opioid.
Use of higher starting doses in patients who are not opioid tolerant may cause fatal respiratory depression.
Conversion From Opioids To OXYCONTIN In Adults
Conversion From Other Oral Oxycodone Formulations To OXYCONTIN
If switching from other oral oxycodone formulations to OXYCONTIN, administer one half of the patient’s total daily oral oxycodone dose as OXYCONTIN every 12 hours
Conversion From Other Opioids To OXYCONTIN
There are no established conversion ratios for conversion from other opioids to OXYCONTIN defined by clinical trials. Discontinue all other around-the-clock opioid drugs when OXYCONTIN therapy is initiated and initiate dosing using OXYCONTIN 10 mg orally every 12 hours.
It is safer to underestimate a clents 24-hour oral oxycodone requirements and provide rescue medication (e.g., immediate-release opioid) than to overestimate the 24-hour oral oxycodone requirements which could result in adverse reactions. While useful tables of opioid equivalents are readily available, there is substantial inter-client variability in the relative potency of different opioids.
Conversion From Methadone To OXYCONTIN
Close monitoring is of particular importance when converting from methadone to other opioid agonists. The ratio between methadone and other opioid agonists may vary widely as a function of previous dose exposure. Methadone has a long half-life and can accumulate in the plasma.
Conversion from Transdermal Fentanyl To OXYCONTIN
If switching from transdermal fentanyl patch to OXYCONTIN, ensure that the patch has been removed for at least 18 hours prior to starting OXYCONTIN. Although there has been no systematic assessment of such conversion, start with a conservative conversion: substitute 10 mg of OXYCONTIN every 12 hours for each 25 mcg per hour fentanyl transdermal patch. Follow the patient closely during conversion from transdermal fentanyl to OXYCONTIN, as there is limited documented experience with this conversion.
Initial Dosage In Pediatric Patients 11 Years And Older
The following dosing information is for use only in pediatric patients 11 years and older already receiving and tolerating opioids for at least five consecutive days. For the two days immediately preceding dosing with OXYCONTIN, patients must be taking a minimum of 20 mg per day of oxycodone or its equivalent. OXYCONTIN is not appropriate for use in pediatric patients requiring less than a 20 mg total daily dose. Table 1, based on clinical trial experience, displays the conversion factor when switching pediatric patients 11 years and older (under the conditions described above) from opioids to OXYCONTIN.
Discontinue all other around-the-clock opioid drugs when OXYCONTIN therapy is initiated.
Although tables of oral and parenteral equivalents are readily available, there is substantial inter-patient variability in the relative potency of different opioid drugs and formulations. As such, it is preferable to underestimate a clients 24-hour oral oxycodone requirements and provide rescue medication (e.g., immediate-release opioid) than to overestimate the 24-hour oral oxycodone requirements and manage an adverse reaction.
Consider the following when using the information in Table 1.
This is not a table of equianalgesic doses.
The conversion factors in this table are only for the conversion from one of the listed oral opioid analgesics to OXYCONTIN.
The table cannot be used to convert from OXYCONTIN to another opioid. Doing so will result in an over-estimation of the dose of the new opioid and may result in fatal overdose.
The formula for conversion from prior opioids, including oral oxycodone, to the daily dose of OXYCONTIN is mg per day of prior opioid x factor = mg per day of OXYCONTIN. Divide the calculated total daily dose by 2 to get the every-12-hour OXYCONTIN dose. If rounding is necessary, always round the dose down to the nearest OXYCONTIN tablet strength available.
Table 1: Conversion Factors When Switching Pediatric Patients 11 Years and Older to OXYCONTIN
Prior Opioid Conversion Factor
Oxycodone 1 —
Hydrocodone 0.9 —
Hydromorphone 4 20
Morphine 0.5 3
Tramadol 0.17 0.2
*For clients receiving high-dose parenteral opioids, a more conservative conversion is warranted. For example, for high-dose parenteral morphine, use 1.5 instead of 3 as a multiplication factor.
Step #1: To calculate the estimated total OXYCONTIN daily dose using Table 1:
For pediatric patients taking a single opioid, sum the current total daily dosage of the opioid and then multiply the total daily dosage by the approximate conversion factor to calculate the approximate OXYCONTIN daily dosage.
For pediatric patients on a regimen of more than one opioid, calculate the approximate oxycodone dose for each opioid and sum the totals to obtain the approximate OXYCONTIN daily dosage.
For pediatric patients on a regimen of fixed-ratio opioid/non-opioid analgesic products, use only the opioid component of these products in the conversion.
Step #2: If rounding is necessary, always round the dosage down to the nearest OXYCONTIN tablet strength available and initiate OXYCONTIN therapy with that dose. If the calculated OXYCONTIN total daily dosage is less than 20 mg, there is no safe strength for conversion and do not initiate OXYCONTIN.
Example conversion from a single opioid (e.g., hydrocodone) to OXYCONTIN: Using the conversion factor of 0.9 for oral hydrocodone in Table 1, a total daily hydrocodone dosage of 50 mg is converted to 45 mg of oxycodone per day or 22.5 mg of OXYCONTIN every 12 hours. After rounding down to the nearest strength available, the recommended OXYCONTIN starting dosage is 20 mg every 12 hours.
Step #3: Close observation and titration are warranted until pain management is stable on the new opioid. Monitor patients for signs and symptoms of opioid withdrawal or for signs of over-sedation/toxicity after converting patients to OXYCONTIN.
There is limited experience with conversion from transdermal fentanyl to OXYCONTIN in pediatric patients 11 years and older. If switching from transdermal fentanyl patch to OXYCONTIN, ensure that the patch has been removed for at least 18 hours prior to starting OXYCONTIN. Although there has been no systematic assessment of such conversion, start with a conservative conversion: substitute 10 mg of OXYCONTIN every 12 hours for each 25 mcg per hour fentanyl transdermal patch. Follow the patient closely during conversion from transdermal fentanyl to OXYCONTIN.
If using asymmetric dosing, instruct patients to take the higher dose in the morning and the lower dose in the evening
Acute overdosage with oxycodone can be manifested by respiratory depression, somnolence progressing to stupor or coma, skeletal muscle flaccidity, cold and clammy skin, constricted pupils, bradycardia, hypotension, and death.
Deaths due to overdose have been reported with abuse and misuse of Oxycodone HCl Controlled-Release Tablets, by ingesting, inhaling, or injecting the crushed tablets. Review of case reports has indicated that the risk of fatal overdose is further increased when Oxycodone HCl Controlled–Release Tablets are abused concurrently with alcohol or other CNS depressants, including other opioids.
In the treatment of oxycodone overdosage, primary attention should be given to the re-establishment of a patent airway and institution of assisted or controlled ventilation. Supportive measures (including oxygen and vasopressors) should be employed in the management of circulatory shock and pulmonary edema accompanying overdose as indicated. Cardiac arrest or arrhythmias may require cardiac massage or defibrillation.
The pure opioid antagonists such as naloxone or nalmefene are specific antidotes against respiratory depression from opioid overdose. Opioid antagonists should not be administered in the absence of clinically significant respiratory or circulatory depression secondary to oxycodone overdose. In patients who are physically dependent on any opioid agonist including Oxycodone HCl Controlled-Release Tablets, an abrupt or complete reversal of opioid effects may precipitate an acute abstinence syndrome. The severity of the withdrawal syndrome produced will depend on the degree of physical dependence and the dose of the antagonist administered. Please see the prescribing information for the specific opioid antagonist for details of their proper use.
Oxycodone oral tablet may cause drowsiness. This is more likely to occur when you first start taking it or when your dosage is changed. Do not drive, use heavy machinery, or perform any dangerous tasks until you know how this drug affects you.
Oxycodone can also cause other side effects.
More common side effects
The adult side effects for this drug can vary from the side effects for children.
Adult side effects for oxycodone can include:
- nausea and vomiting
- weakness or lack of energy
- severe itching
- dry mouth
- trouble falling or staying asleep
- itching of the skin
Children’s side effects for oxycodone (the extended-release tablets only) can include:
- nausea and vomiting
- If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.
Serious side effects
Call your doctor right away if you have serious side effects. Call emergency service if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:
Serious breathing problems. Symptoms can include:
- slowed breathing
- very shallow breathing (little chest movement with breathing)
- Severely low blood pressure. Symptoms can include:
- dizziness or lightheadedness (especially if you stand up after sitting or lying down)
Physical dependence (addiction) and withdrawal when stopping the drug. Symptoms can include:
- irritability or anxiousness
- trouble sleeping
- increased blood pressure
- fast breathing rate
- fast heart rate
- dilated pupils (enlargement of the dark center of your eyes)
- teary eyes
- runny nose
- nausea, vomiting, and a loss of appetite
- diarrhea and stomach cramps
- muscle aches and backache
- Misuse or addiction to oxycodone. Symptoms can include:
- taking more of the drug than your doctor prescribes
- taking the drug regularly even if you don’t need it
- continuing to use the drug despite negative reactions from friends, family, your job, or the law
- ignoring regular duties of your life
- taking the drug secretly or lying about how much you’re taking
- Adrenal insufficiency. Symptoms can include:
- long-lasting tiredness
- muscle weakness
- pain in your abdomen
- Androgen deficiency. Symptoms can include:
- trouble sleeping
- decreased energy
Every effort has been made to ensure that the information provided is accurate, up-to-date and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This material does not endorse drugs, diagnose patients, or recommend therapy. This information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill , knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate safety, effectiveness, or appropriateness for any given patient.
Vigor Health Pharmacy does not assume any responsibility for any aspect of healthcare administered with the aid of materials provided. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the substances you are taking, check with your doctor, nurse, or pharmacist.
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