Oxycodone CR
OXYCONTIN
Pronunciation: ox-i-KOE-doen (ox-ee-KON-tin)
“Perky Ox coding”
What it isControlled-release full mu-opioid agonist dosed q12h; severe chronic pain requiring continuous opioid therapy.
Why this oneThe 2010 abuse-deterrent reformulation is harder to manipulate but does not make the drug abuse-proof.
What limits itRespiratory depression and overdose worsen with benzodiazepines or other depressants; never crush the tablet.
FDA-approved for
- chronic pain (around-the-clock) (1995)
FDA label
Read the full label on DailyMed ↗
| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Severe and persistent pain requiring daily, around-the-clock, long-term opioid treatment (not as-needed) | Adults (not opioid-tolerant) | 10 mg PO every 12 hours | 60/80 mg tablets, single dose >40 mg, or total daily dose >80 mg only if opioid-tolerant | |
| Severe and persistent pain requiring daily, around-the-clock opioid treatment | Peds ≥11 yr, opioid-tolerant (already ≥20 mg/day oxycodone or equivalent) | Convert from prior opioid per Table 1; not appropriate if total daily dose would be <20 mg |
Titration May adjust dosage every 1–2 days (steady state approximated in ~1 day)
Renal CrCl <60 mL/min: oxycodone concentrations ~50% higher; use conservative dose initiation and adjust to clinical situation
Hepatic Start at one-third to one-half the usual starting dosage and titrate carefully
Every-12-hour scheduled dosing; not indicated as a PRN analgesic
Instructions
- Swallow tablets whole, one at a time, with enough water; do not cut, break, chew, crush, or dissolve
- Do not pre-soak, lick, or wet the tablet
- Administered every 12 hours; not for as-needed (PRN) use
- Taper gradually to discontinue in physically dependent patients
Available strengths
- ER tab 10, 15, 20, 30, 40, 60, 80 mg
- cap 5 mg
- tab 5, 10, 15, 20, 30 mg
- ER cap 9, 13.5, 18, 27, 36 mg
- sol 5, 100 mg/5 mL
Contraindications
- Significant respiratory depression
- Acute or severe bronchial asthma in an unmonitored setting or in the absence of resuscitative equipment
- Known or suspected gastrointestinal obstruction, including paralytic ileus
Cautions
- Opioid-induced hyperalgesia and allodynia
- Life-threatening respiratory depression in chronic pulmonary disease or elderly/cachectic/debilitated patients
- Adrenal insufficiency
- Severe hypotension (avoid in circulatory shock)
- Increased intracranial pressure / head injury / impaired consciousness
- Difficulty swallowing and risk of GI obstruction
- Seizures in patients with seizure disorders
- Serotonin syndrome with serotonergic drugs
Adverse reactions
- Constipation
- Nausea
- Somnolence
- Dizziness
- Vomiting
- Pruritus
- Headache
- Dry mouth
- Asthenia
- Sweating
Pregnancy Prolonged use during pregnancy may cause NOWS; no adequate human data for birth-defect risk (animal data at high doses)
Lactation Oxycodone present in breast milk; breastfeeding not recommended during treatment
Cost
| Strength | #/mo | generic $/unit | brand $/unit | CostPlus | |
|---|---|---|---|---|---|
| 10 mg | ER tab | per unit | — | $5.87/ea | not offered |
| 15 mg | ER tab | per unit | — | $8.66/ea | not offered |
| 20 mg | ER tab | per unit | — | $10.95/ea | not offered |
| 30 mg | ER tab | per unit | — | $15.22/ea | not offered |
| 40 mg | ER tab | per unit | — | $18.77/ea | not offered |
| 60 mg | ER tab | per unit | — | $26.54/ea | not offered |
| 80 mg | ER tab | per unit | — | $32.66/ea | not offered |
Other forms: Oxycodone (oxycodone IR)
Available combined with: oxycodone / acetaminophen
⚠ BOXED WARNINGS
- Addiction, abuse and misuse
- Life-threatening respiratory depression
- Risk from concomitant use with benzodiazepines
Classes and tags
Clinical profile
Legacy pregnancy categoryNot assigned — PLLR-era drug
Defining liabilityRespiratory depression, dependence and overdose; risk rises sharply with sedatives or impaired clearance.
Open Oxycodone CR in the interactive console ↗
