Oxycodone

This is available in four formulations: OxyNormTM capsules and OxyNorm oral liquidTM (both immediate-release), OxyContinTM tablets (controlled-release), and OxyNormTM Injection.

OxyCodone is similar to morphine in its action and has a similar side effect profile. This drug is more expensive than morphine and there is no clinical evidence to support its use first line. Morphine therefore remains the drug of first choice.

The main indications for use at present are:

Morphine allergy (rare).
Persistent hallucinations or other signs of morphine neurotoxicity.
Evidence of Morphine tolerance.

Note: When taken orally, Oxycodone is more potent than Morphine - 10 mg Oral Morphine @ 5 mg Oral Oxycodone.

The dose should be titrated in the same way as Morphine, however OxyNorm™ is often given 6 hourly rather than 4 hourly.
Usual starting dose is 2.5 – 5 mg 6 hourly.
It is renally cleared and should be used with caution in renal impairment.
OxyNorm™ is available in the following strengths: 5 mg, 10 mg, 20 mg.
OxyContin™ is available in the following strengths: 5 mg, 10 mg, 20 mg, 40 mg, 80 mg and is taken 12 hourly.
OxyNorm™ liquid is available in 5 mg/5 ml.
Oxycodone capsules and tablets MUST be swallowed whole and are not to be broken, chewed or crushed.
Not to be given rectally.
Oxycodone injection is available in 10 mg/ml strength in either 1 ml or 2 ml ampoules and is between 1.5 and 2.0 times more potent than oral. 10 mg oral oxycodone @ 5 – 7.5 mg subcut oxycodone.
It may be necessary to convert oxycodone to morphine and vice versa – the following approximate conversion examples can guide practice. (No conversions however are completely reliable and patients should be monitored closely.)
10 mg oral oxycodone @ 20 mg oral morphine

10 mg subcut oxycodone @ 10 mg subcut morphine

See the Oxycodone Information Sheet.


Information about this Canterbury DHB document (4060):
Document Owner:	Palliative Care Service (see Who's Who)
Issue Date:	July 2009
Next Review:	July 2010
Note: Only the electronic version is controlled. Once printed, this is no longer a controlled document.
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Topic Code: 4060