Home Drug Guide Oxycodone Hydrochloride

Drug Guide

Generic Name

Oxycodone Hydrochloride

Brand Names Roxicodone, Oxycontin, Oxaydo, Roxybond

Classification

Therapeutic: Opioid analgesic

Pharmacological: Mu-opioid receptor agonist

FDA Approved Indications

Moderate to severe pain management

Mechanism of Action

Binds to mu-opioid receptors in the central nervous system, altering the perception of and response to pain.

Dosage and Administration

Adult: Dose varies based on severity; typically 10-20 mg every 4-6 hours as needed, titrated to response.

Pediatric: Use is generally not recommended for children under 18 due to safety concerns.

Geriatric: Start at lower dose; monitor closely due to increased sensitivity and potential for adverse effects.

Renal Impairment: Adjust dose cautiously; renal function monitoring recommended.

Hepatic Impairment: Dose adjustment may be necessary; hepatic function should be evaluated.

Pharmacokinetics

Absorption: Well absorbed orally.

Distribution: Widely distributed in body tissues, crosses blood-brain barrier.

Metabolism: Primarily metabolized in the liver via CYP3A4 and CYP2D6 pathways.

Excretion: Excreted mainly in urine; metabolites may be detected in feces.

Half Life: Generally 3-4.5 hours for immediate-release; longer for extended-release formulations.

Contraindications

History of hypersensitivity to oxycodone or other opioids
Acute bronchial asthma in an unmonitored setting

Precautions

Use with caution in respiratory depression, increased intracranial pressure, head injury, hepatic impairment, alcoholism, and in the elderly.

Adverse Reactions - Common

Constipation (Common)
Nausea (Common)
Drowsiness (Common)
Dizziness (Common)

Adverse Reactions - Serious

Respiratory depression (Serious)
Hypotension (Serious)
Addiction, abuse, and misuse (Serious)
Serotonin syndrome (when combined with serotonergic agents) (Serious)

Drug-Drug Interactions

CNS depressants (e.g., benzodiazepines, alcohol)
Other opioids
MAO inhibitors

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Assess pain prior to and 1 hour after administration.

Diagnoses:

Acute pain related to tissue injury, as evidenced by patient report

Implementation: Administer around the clock or as needed, monitor respiratory status, bowel function, and signs of misuse.

Evaluation: Effective pain control with minimal adverse effects.

Patient/Family Teaching

Take medication exactly as prescribed.
Do not exceed the recommended dose or frequency.
Avoid alcohol and other CNS depressants.
Report signs of respiratory depression, excessive sedation, or allergic reactions.

Special Considerations

Black Box Warnings:

Addiction, abuse, and misuse potentially leading to overdose and death.
Life-threatening respiratory depression.

Genetic Factors: Variability in CYP2D6 enzyme activity can affect metabolism and response.

Lab Test Interference: May falsely elevate alkaline phosphatase levels.

Overdose Management

Signs/Symptoms: Respiratory depression, extreme somnolence, muscle flaccidity, cold and clammy skin, pinpoint pupils, unresponsiveness.

Treatment: Administer naloxone promptly; ensure airway support, provide ventilatory assistance if needed, and monitor until full recovery.

Storage and Handling

Storage: Store at room temperature away from light and moisture.

Stability: Stable under recommended conditions for shelf life specified in the packaging.