Oxycodone
Oxycodone Side Effects: Oxycodone is a potent oral opioid analgesic, approved for treatment of moderate to severe pain. Oxycodone is most often prescribed in combination with acetaminophen, although it is also available as a stand-alone drug. Trade names for oxycodone alone include Roxicodone an OxyFast, and trade names for oxycodone with acetaminophen include Percocet and Roxicet. Oxycodone as a single ingredient product is available in 5 mg, 10 mg, 15 mg, 20 mg and 30 mg doses as well as a 20 mg/ml elixir. Oxycodone is also available as a sustained release product under the brand name Oxycontin and others. (See Oxycontin side effects)
Black Box Warnings: The oral concentrated solution oxycodone 20 mg/ml is for use only in opioid tolerant patients, and confusion with other concentrations and products can lead to serious opioid overdose and respiratory depression and even death. Due to overdose dangers, taking special care to keep this out of reach of children is strongly advised.
Common Oxycodone Side Effects: Among the most common oxycodone side effects are several side effects common to all opioid medications. These include opioid induced constipation, nausea, vomiting, pruritus, somnolence, miosis (small pupils), euphoria, and headache. Other common oxycodone side effects can include insomnia, dizziness, asthenia, sweating, dysphoria, rash and orthostatic hypotension. Almost all patients on oxycodone will have some degree of constipation or other gastrointestinal oxycodone side effects. Many physicians recommend sennakot-S as an antidote to the constipation, and unlike most other types of constipation fiber supplementation is not very helpful in preventing or treating the opioid induced constipation.
Serious Oxycodone Side Effects: Like all opioids, oxycodone can cause serious respiratory depression. Among the serious oxycodone side effects are respiratory depression, respiratory arrest and death, cardiac arrest, apnea, circulatory collapse, and seizures. Most of these serious oxycodone side effects are related to intentional or accidental overdose, although opioid naïve patients, especially the elderly, or patients with serious respiratory diseases may be more at risk for the respiratory depression and cardiac serous oxycodone side effects. Serious gastrointestinal oxycodone side effects include paralytic ileus and biliary spasm.
Abuse and dependency are very common with oxycodone. Oxycodone is among the most abused of the prescription medications, and diversion of prescribed medications to be sold for their high street value, and obtaining prescriptions from multiple physicians is common practice among opioid abusers and black-market dealers.
Acetaminophen Concerns: Many times oxycodone is prescribed in fixed dose combination pills with acetaminophen. When higher doses of oxycodone are needed, special care needs to be taken to avoid acetaminophen over dosage. The maximum recommended daily dose of acetaminophen (Tylenol, Paracetamol, and other generic brands) is 4000 mg daily, although recent evidence suggests limiting to 3000 mg daily may be safer. It is easy for patients experiencing pain to, sometimes unknowingly, take more than this dose of acetaminophen when prescribed products like oxycodone-acetaminophen 5-500 mg, where each pill contains 500 mg of acetaminophen.
Cautions and Drug Interactions: The list of cautions is extensive, and readers should refer to the product labeling for more complete details. In general caution is advised in elderly patients, patients with either severe liver or kidney function concerns, in patients with serious respiratory disorders including asthma, COPD, hypercarbia, and any disorders that can lead to sedation or confusion. Examples of these conditions include CNS depression, significant hypotension, toxic psychosis, delirium tremens, alcohol use and adrenal insufficiency.
Drug interactions include nearly any medication that can lead to CNS depression. Examples of this are all medications with anticholinergic side effects, antihistamines, other opioids, tricyclic antidepressants, muscle relaxants like baclofen and cyclobenzaprine, barbiturates, and benzodiazapines.
Withdrawal Issues: Prolonged use of oxycodone, like other opioids, leads to a physical dependence on the medication, and abrupt discontinuation of oxycodone is often associated with a significant withdrawal syndrome. Although opioid withdrawal is serious and very uncomfortable it is rarely life threatening. Usually a slow taper of oxycodone will avoid most of the symptoms of opioid withdrawal. Symptoms of opioid withdrawal typically include diarrhea, nausea, shakiness, an overall “sick” feeling, and anxiety among other symptoms. These symptoms usually resolve within 1 to 3 weeks after discontinuation of the medication. Referral to a detox unit and subsequent rehab therapy is needed to get off the medication of abuse in some patients who are abusing oxycodone.
Pregnancy and Lactation: Oxycodone is pregnancy category B, and is probably safe in lactation. With use in late pregnancy neonatal withdrawal may be an issue.
Unusual Oxycodone Side Effects: Oxycodone tends to be associated with more experiences of euphoria than is noted with many other opioids, and therefore is a desirable drug of abuse for opioid addicts and abusers. The street value is very high and diversion and abuse are major issues. Otherwise most of the oxycodone side effects are class type effects of the opioid class of drugs.