OxyContin, a trade name for the narcotic oxycodone hydrochloride, is a painkiller . OxyContin is legitimately prescribed for relief of moderate to severe pain resulting from injuries, bursitis, neuralgia, arthritis, and cancer. Individuals abuse OxyContin for the euphoric effect it produces–an effect similar to that associated with heroin use.
OxyContin is available as a 10 milligram (mg), 20 mg, 40 mg, or 80 mg tablet. The tablets vary in color and size according to dosage. The tablets are imprinted with the letters OC on one side and the number of milligrams on the opposite side.
OxyContin 10 mg
Each 10 mg tablet contains 9.0 mg of oxycodone as 10 mg of oxycodone hydrochloride.
The 10 mg tablets are white, round, convex tablets marked OC on one side and 10 on the other.
OxyContin tablets have a controlled-release feature and are designed to be swallowed whole. In order to bypass the controlled-release feature, users either chew or crush the tablets. Crushed tablets can be snorted or dissolved in water and injected.
For the treatment of moderate to severe pain in patients with cancer and post-operative pain. For the treatment of severe pain requiring the use of a strong opioid
Posology and method of administration
Adults over 18 years:
OxyContin tablets should be taken at 12-hourly intervals. The dosage is dependent on the severity of the pain, and the patient’s previous history of analgesic requirements.
Prior to starting treatment with opioids, a discussion should be held with patients to put in place a strategy for ending treatment with oxycodone in order to minimise the risk of addiction and drug withdrawal syndrome
OxyContin is not intended for use as a prn analgesic.
Generally, the lowest effective dose for analgesia should be selected. Increasing severity of pain will require an increased dosage of OxyContin tablets, using the different tablet strengths, either alone or in combination, to achieve pain relief. The correct dosage for any individual patient is that which controls the pain and is well tolerated for a full 12 hours. Patients should be titrated to pain relief unless unmanageable adverse drug reactions prevent this. If higher doses are necessary, increases should be made in 25% – 50% increments. The need for escape medication more than twice a day indicates that the dosage of OxyContin tablets should be increased.
The usual starting dose for opioid naïve patients or patients presenting with severe pain uncontrolled by weaker opioids is 10 mg, 12-hourly. Some patients may benefit from a starting dose of 5 mg to minimise the incidence of side effects. The dose should then be carefully titrated, as frequently as once a day if necessary, to achieve pain relief.
Conversion from oral morphine:
Patients receiving oral morphine before OxyContin therapy should have their daily dose based on the following ratio: 10 mg of oral oxycodone is equivalent to 20 mg of oral morphine. It must be emphasised that this is a guide to the dose of OxyContin tablets required. Inter-patient variability requires that each patient is carefully titrated to the appropriate dose.
A dose adjustment is not usually necessary in elderly patients.
Controlled pharmacokinetic studies in elderly patients (aged over 65 years) have shown that, compared with younger adults, the clearance of oxycodone is only slightly reduced. No untoward adverse drug reactions were seen based on age, therefore adult doses and dosage intervals are appropriate.
Method of administration
OxyContin tablets are for oral use.
OxyContin tablets must be swallowed whole and not broken, chewed or crushed.
Duration of treatment
When a patient no longer requires therapy with oxycodone, it may be advisable to taper the dose gradually to prevent symptoms of withdrawal.
Oxycodone must not be used in any situation where opioids are contraindicated: severe respiratory depression with hypoxia, paralytic ileus, acute abdomen, delayed gastric emptying, severe chronic obstructive lung disease, cor pulmonale, severe bronchial asthma, elevated carbon dioxide levels in the blood, moderate to severe hepatic impairment, chronic constipation.
Patients with rare hereditary problems of galactose intolerance, total lactase deficiency or glucose-galactose malabsorption should not take this medicine.
OxyContin tablets must be administered with caution in patients taking MAOIs or who have received MAOIs within the previous two weeks.
OxyContin tablets should not be used where there is a possibility of paralytic ileus occurring. Should paralytic ileus be suspected or occur during use, OxyContin tablets should be discontinued immediately.
OxyContin tablets are not recommended for pre-operative use or within the first 12-24 hours post-operatively.
OxyContin 60 mg, 80 mg and 120 mg tablets should not be used in patients not previously exposed to opioids. These tablet strengths may cause fatal respiratory depression when administered to opioid naïve patients
Patients may find that treatment is less effective with chronic use ad express a need to increase the dose to obtain the same level of pain control as initially experienced. Patients may also supplement their treatment with additional pain relievers. These could be signs that the patient is developing tolerance. The risks of developing tolerance should be explained to the patient.
Overuse or misuse may result in overdose and/or death. It is important that patients only use medicines that are prescribed for them at the dose they have been prescribed and do not give this medicine to anyone else.
Patients should be closely monitored for signs of misuse, abuse or addiction.
The clinical need for analgesic treatment should be reviewed regularly.