Oxycodone

Generality

Oxycodone (or oxicodone) is a drug belonging to the class of opioid painkillers.

It is a semi-synthetic drug derived from thebaine, a natural alkaloid extracted from the opium poppy.

Oxycodone - Chemical Structure

Oxycodone has an analgesic power similar to that of morphine and has a plasma half-life of about four hours. For this reason, frequent administration is required (every 4-6 hours). To overcome this problem, oxycodone was made available in the form of prolonged-release capsules or tablets.

Examples of medicinal specialties containing oxycodone

• Depalgos ® (in combination with paracetamol).
• Oxycontin ®
• Targin ® (in association with naloxone).

Indications

For what it uses

The use of oxycodone is indicated for the treatment of painful states of moderate to severe intensity.

Warnings

Before starting an oxycodone treatment, it is advisable to inform your doctor if you are in one or more of the following conditions:

• If you suffer from hypothyroidism;
• If you suffer from myxedema;
• If you suffer from increased intracranial pressure, as the drug could worsen this situation;
• If it is hypothesis;
• If you suffer from toxic psychosis;
• If you have pancreatitis or suffer from gallbladder or bile duct disorders;
• If you suffer from gastrointestinal disorders (such as intestinal blockage, colic or inflammation of the intestine);
• If you are suffering from prostatic hyperplasia;
• If you have reduced adrenal function;
• If you suffer from severe respiratory function impairments;
• If you are suffering from liver and / or kidney disorders;
• If you suffer from alcohol or other drug addiction;
• If you suffer from epilepsy.

Furthermore, if during treatment with oxycodone, the need arises to take a larger dose of the drug to obtain the same analgesic effect that was obtained at the beginning of the treatment (tolerance), it is necessary to immediately inform the doctor.

Alcohol intake during oxycodone therapy should be avoided, as there may be an increase in the side effects induced by the same drug. Furthermore, the intake of grapefruit juice should be avoided, since the latter can cause alterations of the effects induced by oxycodone.

Oxycodone alters the ability to drive and use machines, therefore these activities should be avoided during treatment with the drug.

Finally, for those who play sports, the use of oxycodone without therapeutic necessity is doping and in any case the drug can cause positive doping tests even when used for therapeutic purposes.

Interactions

Concomitant intake of oxycodone and other drugs that exert central depression can increase the risk of side effects. These drugs include:

• Other opioid analgesics ;
• Hypnotic sedatives ;
• Antihistamines ;
• Anti-asthmatics ;
• Antidepressants ;
• Antipsychotics .

Furthermore, before starting any therapy with oxycodone, you must inform your doctor if you are already taking any of the following drugs:

• Anticoagulants ;
• Macrolides (antibiotic drugs);
• Azole antifungals, such as ketoconazole, itraconazole, etc .;
• Ritonavir and other antivirals used in the treatment of HIV;
• Rifampicin, an antibiotic used to treat tuberculosis;
• Carbamazepine and phenytoin, antiepileptic drugs;
• Monoamine oxidase inhibitors (or MAOIs, drugs used in the treatment of depression and Parkinson's disease);
• Hypericum (or St. John's wort, a plant with antidepressant properties) preparations.

However, it is always a good idea to inform your doctor if you are taking - or have recently been - any type of medication, including over-the-counter medicines and herbal and homeopathic products.

Side effects

Oxycodone can cause different types of side effects, although not all patients experience them. This depends on each person's sensitivity to the drug. Therefore, it is not said that the adverse effects occur all with the same intensity in each individual.

The main side effects that may occur during oxycodone treatment are listed below.

Allergic reactions

Oxycodone can cause allergic reactions in sensitive individuals. These reactions can occur in the form of:

• Wheezing or difficulty breathing;
• Angioedema;
• Rash and itching.

Gastrointestinal disorders

Oxycodone treatment can cause vomiting, dyspepsia, abdominal pain, inflammation of the stomach, diarrhea or constipation.

Nervous system disorders

Oxycodone therapy can cause:

• Headache;
• dizziness;
• Drowsiness;
• Weakness and fatigue;
• Tremors;
• Convulsions;
• Pins and needles;
• Reduced state of consciousness.

Psychiatric disorders

Oxycodone treatment can promote the onset of:

• Confusion;
• Depression;
• Mood changes;
• Hallucinations;
• Insomnia;
• agitation;
• Euphoria.

Skin and subcutaneous tissue disorders

Oxycodone-based therapy can cause:

• Skin eruptions;
• Itch;
• Sweating;
• Dry skin;
• Urticaria.

Other side effects

Other side effects that may occur during treatment with oxycodone are:

• Tolerance and dependence (both physical and psychic);
• Respiratory depression;
• Syndrome of inappropriate antidiuretic hormone secretion (or SIADH);
• Urination difficulties;
• Ulceration of the oral cavity;
• Dehydration;
• Change in body weight;
• Edema;
• Miosi;
• Chills;
• Orthostatic hypotension;
• Blockage of bile flow;
• Increased sensitivity to pain.

Overdose

If overdoses of oxycodone are taken, symptoms such as:

• Miosi;
• Respiratory depression;
• Drowsiness;
• Loss of consciousness;
• bradycardia;
• Hypotension;
• Pulmonary edema.

The most severe cases of overdose can also lead to coma and death.

If you suspect overdose with oxycodone, contact your doctor immediately or contact the nearest hospital.

Action mechanism

Oxycodone performs its pain-relieving action by interacting with opioid μ receptors. These receptors are arranged along the pain pathways of our body and their task is to modulate the neurotransmission of painful stimuli. More precisely, when the aforementioned receptors are stimulated, a cascade of chemical signals is triggered which culminates in the induction of analgesia.

Oxycodone is an μ receptor agonist, therefore, it is able to activate them and perform an analgesic activity.

Mode of Use - Posology

As mentioned, oxycodone is available for oral administration and can be found in the form of prolonged-release tablets or hard capsules.

The dose of oxycodone to be taken must be established by the doctor depending on the severity of the pain that afflicts each patient.

To avoid the occurrence of dangerous side effects and the development of tolerance and dependence, it is essential to scrupulously follow all the indications provided by the doctor, both as regards the amount of oxycodone to be used, both as regards the frequency of administration and the duration of the treatment.

Pregnancy and breastfeeding

Since oxycodone can cause respiratory depression and withdrawal syndrome in newborns, its use in pregnant women is generally contraindicated, especially during labor.

Furthermore, since oxycodone is excreted in breast milk, its use is also contraindicated in breastfeeding mothers.

Contraindications

The use of oxycodone is contraindicated in the following cases:

• In patients with known hypersensitivity to the same oxycodone or to other opioid analgesics;
• In patients suffering from respiratory tract diseases, such as chronic obstructive pulmonary disease (COPD), bronchial asthma or respiratory depression;
• In patients with pulmonary heart;
• In patients who have suffered a head injury;
• In patients suffering from paralytic ileus, slowing of gastric emptying or acute abdomen;
• In patients suffering from severe liver and / or renal disorders;
• Pregnant;
• During breastfeeding.