Oxycodone Patient Tips

Medically reviewed by Carmen Pope, BPharm. Last updated on Nov 14, 2024.

1. How it works

• Oxycodone is a semisynthetic opioid medication with potent pain-relieving properties that may be used to relieve severe pain that is unresponsive to less potent pain-relieving medicines (analgesics). It can be addictive and cause physical dependence.
• Oxycodone is an opioid agonist (this means it produces similar effects to morphine) and is relatively selective for the mu-opioid receptor, although it binds to other opioid receptors, such as kappa and delta, at higher dosages. Oxycodone is a full agonist at the mu receptor (full agonists have a larger effect at higher dosages).
• Oxycodone belongs to the group of drugs known as opioids or opioid analgesics. It may also be called a narcotic analgesic.

2. Upsides

• Immediate-release oxycodone may be used to treat moderate-to-severe pain that is sudden and severe in onset (acute) or persistent (chronic), and cannot be relieved by other, less addictive, medications.
• Extended-release (longer-lasting) oxycodone is approved for severe pain, such as cancer pain, that requires continuous, round-the-clock treatment when no alternative options are suitable. Oxycontin and Xtampza ER are brands of extended-release oxycodone.
• Oxycodone is also available in combination with acetaminophen, ibuprofen, or aspirin for added pain control. People who take combination oxycodone medications should be aware of the potential for addiction and dependence.
• Oxycodone is less likely to cause an itchy rash compared to some other opioids such as morphine.
• Oxycodone does not have a ceiling effect for analgesia, which means that if a person finds that oxycodone is no longer controlling their pain, a higher dosage should provide pain relief. However, the risk of side effects, such as respiratory and CNS depression, increases with higher dosages of oxycodone.
• Generic oxycodone is available. Brands of immediate-release oxycodone include OxyNorm and Oxaydo. RoxyBond is a brand of immediate-releae oxycodone with abuse-deterrent technology.

3. Downsides

If you are between the ages of 18 and 60, take no other medication or have no other medical conditions, side effects you are more likely to experience include:

• Sedation that may impair your reaction skills and affect your ability to drive or operate machinery. Avoid alcohol as the combination can lead to dangerous or fatal side effects.
• Other common side effects include constipation, dizziness, nausea, vomiting, and confusion. This can lead to low blood pressure, which may increase the risk of falls. May cause flushing, red eyes, sweating, and an itchy rash (although less likely to cause an itchy rash than some other opioids).
• Oxycodone can be habit-forming (addictive), even at regular doses. It has a high abuse potential, and personal legitimate supplies of oxycodone may be sought out by drug seekers. It should be reserved for more severe types of pain, such as that caused by cancer.
• Respiratory depression (slow and shallow breathing), which may be fatal or life-threatening can occur with oxycodone use. The risk is greatest during the first 24 to 72 hours after drug initiation or after a dosage increase. Children, the elderly, the frail, or those with pre-existing respiratory disease are more at risk.
• The dosage of oxycodone may need to be reduced in people with kidney or liver disease.
• Oxycodone interacts with several other drugs, including those that inhibit or induce hepatic enzymes, particularly CYP3A4 or CYP2D6 (such as erythromycin, ketoconazole, ritonavir); depress the CNS (such as benzodiazepines, muscle relaxants, antipsychotics); have partial agonist or mixed effects on opioid receptors (such as buprenorphine, pentazocine); diuretics; with anticholinergic effects; and monoamine oxidase inhibitors.
• Overdosage of oxycodone or interactions with other medications that increase serotonin levels (such as tramadol or antidepressants) can increase levels of serotonin in the body and lead to a serious and potentially fatal condition called serotonin syndrome. Symptoms can include mental status changes such as agitation, hallucinations, coma, delirium, a fast heart rate, dizziness, flushing, muscle tremor or rigidity, and stomach symptoms (including nausea, vomiting, and diarrhea). Seek emergency help right away.
• Abrupt discontinuation of oxycodone in a person who has become physically dependent on it may lead to a withdrawal syndrome and symptoms such as restlessness, pupil dilation, watery eyes and a runny nose, sweating, muscle aches, insomnia, irritability, stomach upset, and opioid cravings.
• Not for use in patients with severe asthma or other breathing problems, or people with a blockage in their stomach or intestines.
• Long-term use of oxycodone also affects the endocrine system, which may cause symptoms such as sexual dysfunction, an absence of periods, or infertility.
• Should not be given during pregnancy unless the benefits outweigh the risks. Babies born to mothers who are physically dependent on oxycodone will also be physically dependent and may suffer withdrawal symptoms after delivery.

Note: In general, seniors or children, people with certain medical conditions (such as liver or kidney problems, heart disease, diabetes, seizures) or people who take other medications are more at risk of developing a wider range of side effects. View complete list of side effects

4. Bottom Line

Oxycodone is a semisynthetic opioid medication with potent pain-relieving properties that may be used to relieve severe pain that is unresponsive to less potent pain-relieving medicines (analgesics), such as cancer-related pain. It can be addictive and cause physical dependence and common side effects include sedation and constipation.

5. Tips

• You can take oxycodone with or without food, whichever works best for you.
• Take exactly the amount prescribed by your doctor. Don't take more than that, even if your pain isn't fully controlled. Talk to your doctor if your pain level changes.
• Don't chew, break, crush, or dissolve extended-release tablets. Swallow them whole.
• Oxycodone can cause constipation, nausea, and vomiting. Your doctor can recommend laxatives or anti-nausea medication to help manage these side effects.
• Oxycodone may lower your blood pressure when you stand up. Get up slowly to avoid feeling dizzy or lightheaded.
• Drinking alcohol while taking oxycodone can be dangerous and even deadly.
• Oxycodone can make you drowsy and slow your reflexes. Avoid driving or activities requiring alertness until you know how oxycodone affects you.
• If you've been taking oxycodone for a long time, stopping suddenly can cause unpleasant withdrawal symptoms, such as muscle and bone pain, diarrhea, insomnia, vomiting, and opioid cravings. Talk to your doctor about the best way to slowly wean yourself off oxycodone.
• Don't take oxycodone if you're pregnant or breastfeeding unless your doctor specifically recommends it.
• Avoid grapefruit juice and products while taking oxycodone, as they can interact with the medication.
• Store oxycodone securely, out of reach of children and pets. Accidental overdose can be fatal.

6. Response and effectiveness

• For immediate-release formulations of oxycodone, peak concentrations are reached within 1-2 hours and the duration of effect is approximately 3-4 hours.
• Extended-release formulations of oxycodone (Oxycontin) last for 12 hours. Longer-acting formulations of oxycodone should not be initiated without a trial of shorter-acting formulations first.
• Side effects (such as nausea, vomiting, and respiratory depression) are more likely with higher dosages of oxycodone; however, long-term users of oxycodone may develop a tolerance to these effects.

7. Interactions

Medicines that interact with oxycodone may either decrease its effect, affect how long it works, increase side effects, or have less of an effect when taken with oxycodone. An interaction between two medications does not always mean that you must stop taking one of the medications; however, sometimes it does. Speak to your doctor about how drug interactions should be managed.

Common medications that may interact with oxycodone include:

• antibiotics, such as clarithromycin and erythromycin
• antidepressants, such as tricyclic antidepressants (eg, amitriptyline), monoamine oxidase inhibitors (eg, isocarboxazid, phenelzine, and tranylcypromine), or SSRIs (eg, fluoxetine, sertraline)
• antifungal agents, such as itraconazole and ketoconazole
• anticonvulsants, such as carbamazepine, phenytoin, phenobarbital, or primidone
• antipsychotics (such as butyrophenones, phenothiazines, or thioxanthenes) and atypical antipsychotics (eg, olanzapine, quetiapine, ziprasidone)
• any medication that may cause drowsiness, such as benzodiazepines (eg, diazepam, lorazepam), first-generation antihistamines (such as doxylamine or promethazine), metoclopramide, or opioids (such as codeine, morphine)
• buprenorphine
• migraine medications, such as almotriptan, eletriptan, or sumatriptan
• muscle relaxants, such as cyclobenzaprine
• rifampin
• any other medication that inhibits hepatic enzymes CYP3A4 or CYP2D6 or induces CYP3A4.
• other medications that affect serotonin, such as amphetamines, fentanyl, lithium, tramadol, triptans (eg, almotriptan, eletriptan, or sumatriptan), or St. John's Wort.

Avoid grapefruit products and drinking alcohol or taking illegal or recreational drugs while taking oxycodone.

Note that this list is not all-inclusive and includes only common medications that may interact with oxycodone. You should refer to the prescribing information for oxycodone for a complete list of interactions.

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Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use oxycodone only for the indication prescribed.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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