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Oxycodone (40mg)
Imprint: ABG 40
Strength: 40 mg
Color: Orange
Shape: Round
Drug Class: Narcotic analgesics
Manufacturer: Teva Pharmaceuticals USA

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Oxycodone may be a potent opioid which may be useful when used judiciously for pain. However, it can cause physical dependence and addiction. The immediate-release formulation of oxycodone is FDA approved for the management of acute or chronic moderate to severe pain that the utilization of opioid medication is deemed appropriate and that other pain management strategies are insufficient.

The extended-release formulation is FDA approved for the management of pain severe enough to need continuous long-term opioid treatment and that there are not any alternative options to treat the pain. The oxycodone to morphine dose equivalent ratio is approximately 1 to 1.5 for immediate-release and 1 to 2 for extended-release formulations. This activity reviews the indications, side effects, and contraindications for oxycodone and highlights the role of the interprofessional team in helping patients manage their pain.

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Indications

Oxycodone is an opioid agonist prescription medication. The oxycodone immediate-release formulation is FDA-approved for the management of acute or chronic moderate to severe pain that other treatments don't suffice, and that the utilization of opioid medication is acceptable.

The extended-release formulation is FDA-approved for the management of pain severe enough to need continuous (24 hours per day), long-term opioid treatment, and that there are not any alternative options to treat the pain. The oxycodone to morphine dose equivalent ratio is approximately 1 to 1.5 for immediate-release and 1 to 2 for extended-release formulations.

Oxycodone may be a semisynthetic opioid which has agonistic properties on mu, kappa, and delta-type opioid receptors, with the strongest affinity being for mu-type receptors. Upon binding to those G-protein coupled receptors, oxycodone stimulates the exchange of GDP on the G-alpha subunit for GTP, leading to the inhibition of adenylate cyclase and thus a decrease in intracellular cAMP.

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This signal cascade results in a consequent inhibition of the nociceptive neurotransmitters acetylcholine, dopamine, GABA, noradrenaline, and substance P, also because the hormones glucagon, insulin, somatostatin, and vasopressin.

As with other opioids, oxycodone causes hyperpolarization and reduced excitability of neurons within the central systema nervosum (CNS). This generalized CNS depression may be a results of the agonistic effect on kappa-type receptors which cause a closure of N-type voltage-gated calcium channels, while stimulation of the mu and delta-type receptors open calcium-dependent inward-rectifying potassium channels.

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Oxycodone is metabolized by the hepatic enzymes CYP3A4 and CYP2D6, producing the metabolites noroxycodone and oxymorphone, respectively. These metabolites get excreted from the body via the kidneys.

Oxycodone is widely available in tablet, capsule, and oral solutions. it's currently available in 10-mg, 20-mg, 40-mg, or 80-mg pills. Manufacturers discontinued the 160-mg dose in May 2001 thanks to the high misuse potential. Oxycodone is out there together with other analgesics, including acetaminophen, aspirin, or ibuprofen. In select countries, oxycodone could also be available in intramuscular and/or intravenous forms also.