Select a medication above to begin.
oxycodone
generic
Black Box Warnings .
Appropriate Use
should only be prescribed by healthcare professionals knowledgeable about opioid use and how to mitigate associated risks; reserve opioid analgesics for patients w/ inadequate tx alternatives; ER form not indicated for prn analgesic use; proper dosing and titration essential to decr. resp. depression risk
Medication Error Risk
ensure accuracy when prescribing, dispensing, and administering oxycodone oral solution; dosing errors due to confusion between mg and mL or different concentrations can result in accidental overdose and death
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 patients 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 patients to swallow ER tabs whole; crushing, dissolving, or chewing 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 patients w/ inadequate alternative tx options
Neonatal Opioid Withdrawal Syndrome
advise pregnant patients w/ extended opioid use of risk of potentially life-threatening neonatal opioid withdrawal syndrome; ensure tx by neonatology experts available at delivery
Opioid Analgesic REMS
providers are strongly encouraged to complete risk evaluation and mitigation strategy (REMS)-compliant education program, counsel patients 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 patients receiving any concomitant CYP450 3A4 inhibitor or inducer
Adult Dosing .
Dosage forms: CAP: 5 mg; TAB: 5 mg, 10 mg, 15 mg, 20 mg, 30 mg; TAB (abuse-deterrent): 5 mg, 10 mg, 15 mg, 30 mg; ER TAB: 10 mg, 20 mg, 40 mg, 80 mg; SOL: 5 mg per 5 mL, 100 mg per 5 mL
Dosage Form Details
- [formulation clarification]
- Info: ER products and some IR products formulated w/ abuse-deterrent properties to reduce potential abuse or misuse
Special Note
- [prescribing info]
- Info: consider prescribing opioid overdose reversal agent (e.g., naloxone, nalmefene), especially if risk of opioid overdose or accidental ingestion
- [equivalency or interchangeability info]
- Info: oxycodone ER tab not bioequivalent to Xtampza ER; reassess dose if switching between products
pain, moderate-severe
- [opioid-naive patients]
- Dose: individualize dose PO q4-6h prn; Start: 5-15 mg PO q4-6h prn; Info: use lowest effective dose, shortest effective tx duration; consider low start dose, titrate slowly in patients 65 yo and older; 100 mg per 5 mL solution for use in opioid-tolerant patients only; do not cut/crush/chew/dissolve abuse-deterrent tab; taper dose gradually to avoid withdrawal symptoms if D/C tx in physically opioid-dependent patients; search 'opioid taper' for epocrates Opioid Tapering decision tool
- [opioid-experienced patients]
- Dose: individualize dose PO q4-6h prn; Start: individualize dose based on current opioid intake, see pkg insert for conversion; Info: use lowest effective dose, shortest effective tx duration; consider low start dose, titrate slowly in patients 65 yo and older; 100 mg per 5 mL solution for use in opioid-tolerant patients only; do not cut/crush/chew/dissolve abuse-deterrent tab; taper dose gradually to avoid withdrawal symptoms if D/C tx in physically opioid-dependent patients; search 'opioid taper' for epocrates Opioid Tapering decision tool
pain, severe chronic
- [opioid-nontolerant patients]
- Dose: individualize ER dose PO q12h; Start: 10 mg ER 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 patients 65 yo and older; decr. start dose 50-66% in debilitated patients 65 yo and older and titrate w/ caution; >40 mg/dose ER, >80 mg/day ER for use in opioid-tolerant patients only; do not cut/crush/chew/dissolve ER tab; taper dose gradually to avoid withdrawal symptoms if D/C tx in physically opioid-dependent patients; search 'opioid taper' for epocrates Opioid Tapering decision tool
- [opioid-tolerant patients]
- Dose: individualize ER dose PO q12h; Start: individualize 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 patients 65 yo and older; do not cut/crush/chew/dissolve ER tab; taper dose gradually to avoid withdrawal symptoms if D/C tx in physically opioid-dependent patients; search 'opioid taper' for epocrates Opioid Tapering decision tool
renal dosing
- [immediate-release form]
- CrCl <60: decr. usual start dose, amount not defined; Info: titrate slowly
- HD/PD: not defined
- [extended-release form]
- CrCl <60: not defined, caution advised; Info: titrate slowly
- HD/PD: not defined
hepatic dosing
- [immediate-release form]
- hepatic impairment: decr. usual start dose, amount not defined; Info: titrate slowly
- [extended-release form]
- hepatic impairment: decr. usual start dose by 50-66%; Info: titrate slowly
Peds Dosing .
- Dosage forms: CAP: 5 mg; TAB: 5 mg, 10 mg, 15 mg, 20 mg, 30 mg; TAB (abuse-deterrent): 5 mg, 10 mg, 15 mg, 30 mg; ER TAB: 10 mg, 20 mg, 40 mg, 80 mg; SOL: 5 mg per 5 mL, 100 mg per 5 mL
Dosage Form Details
- [formulation clarification]
- Info: ER products and some IR products formulated w/ abuse-deterrent properties to reduce potential abuse or misuse
Special Note
- [prescribing info]
- Info: consider prescribing opioid overdose reversal agent (e.g., naloxone, nalmefene), especially if risk of opioid overdose or accidental ingestion
pain, severe chronic
- [opioid-tolerant patients, 11 yo and older]
- Dose: individualize ER dose PO q12h; Start: individualize 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 patients receiving opioids for >5 consecutive days w/ a dose of at least 20 mg oxycodone/day or equivalent for at least 2 days immediately before tx start; use lowest effective dose, shortest effective tx duration; do not cut/crush/chew/dissolve ER tab; taper dose gradually to avoid withdrawal symptoms if D/C tx in physically opioid-dependent patients; search 'opioid taper' for epocrates Opioid Tapering decision tool
pain, moderate-severe (off-label)
- [opioid-naive patients, <6 mo]
- Dose: 0.025-0.05 mg/kg/dose PO q4-6h prn; Info: use lowest effective dose, shortest effective tx duration; 100 mg per 5 mL solution for use in opioid-tolerant patients only; do not cut/crush/chew/dissolve abuse-deterrent tab; taper dose gradually to avoid withdrawal symptoms if D/C tx in physically opioid-dependent patients; search 'opioid taper' for epocrates Opioid Tapering decision tool
- [opioid-naive patients, 6 mo and older, <50 kg]
- Dose: 0.05-0.15 mg/kg/dose PO q4-6h prn; Max: 5 mg/dose; Info: use lowest effective dose, shortest effective tx duration; 100 mg per 5 mL solution for use in opioid-tolerant patients only; do not cut/crush/chew/dissolve abuse-deterrent tab; taper dose gradually to avoid withdrawal symptoms if D/C tx in physically opioid-dependent patients; search 'opioid taper' for epocrates Opioid Tapering decision tool
- [opioid-naive patients, 6 mo and older, >50 kg]
- Dose: 5-10 mg PO q4-6h prn; Info: use lowest effective dose, shortest effective tx duration; 100 mg per 5 mL solution for use in opioid-tolerant patients only; do not cut/crush/chew/dissolve abuse-deterrent tab; taper dose gradually to avoid withdrawal symptoms if D/C tx in physically opioid-dependent patients; search 'opioid taper' for epocrates Opioid Tapering decision tool
renal dosing
- [immediate-release form]
- 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
- [extended-release form]
- CrCl <60: not defined, caution advised; Info: titrate slowly
- HD/PD: not defined
hepatic dosing
- [immediate-release form]
- hepatic impairment: decr. usual start dose, amount not defined; Info: titrate slowly
- [extended-release form]
- hepatic impairment: decr. usual start dose by 50-66%; Info: titrate slowly