Oxecta (oxycodone HCl)

Dosage of oxycodone hydrochloride is expressed in terms of the salt; dosage of oxycodone myristate is expressed in terms of oxycodone base.

Oxycodone should be given at the lowest effective dosage and for the shortest duration of therapy consistent with the treatment goals of the patient. Reduced dosage is indicated in debilitated patients and in very young or very old patients. If concomitant therapy with other CNS depressants is required, the lowest effective dosages and shortest possible duration of concomitant therapy should be used. Some manufacturers recommend that initial dosages of 33-50% of the usual dosage be employed when therapy with oxycodone hydrochloride extended-release tablets is initiated in patients receiving other CNS depressants. When therapy with extended-release tablets containing oxycodone hydrochloride in fixed combination with acetaminophen is initiated in patients receiving other CNS depressants, the manufacturer states that the initial oxycodone hydrochloride dosage should be reduced by 50% (i.e., to 7.5 mg twice daily).

For acute pain not related to trauma or surgery, the prescribed quantity should be limited to the amount needed for the expected duration of pain severe enough to require opiate analgesia (generally 3 days or less and rarely more than 7 days). When opiate analgesics are used for the management of chronic noncancer pain, the US Centers for Disease Control and Prevention (CDC) recommends that primary care clinicians carefully reassess individual benefits and risks before prescribing dosages equivalent to 50 mg or more of morphine sulfate daily (approximately 33 mg or more of oxycodone hydrochloride daily) and avoid dosages equivalent to 90 mg or more of morphine sulfate daily (approximately 60 mg or more of oxycodone hydrochloride daily) or carefully justify their decision to titrate the dosage to such levels. Other experts recommend consulting a pain management specialist before exceeding a dosage equivalent to 80-120 mg of morphine sulfate daily.

Patients receiving long-term, daily, around-the-clock opiate analgesia should be reevaluated continually for adequacy of pain control and for adverse effects, as well as for manifestations of opiate withdrawal and for the development of addiction, abuse, or misuse. To reduce the risk of respiratory depression, appropriate dosage selection and titration are essential. The initial dosage of oxycodone must be individualized, taking into account the patient's severity of pain, response, prior analgesic use, and risk factors for addiction, abuse, and misuse. Because there is substantial interpatient variability in the relative potency of opiate analgesics and analgesic formulations, it is preferable to underestimate the patient's 24-hour opiate requirements and provide ''rescue'' therapy with an immediate-release opiate analgesic than to overestimate the requirements and manage an adverse reaction. Patients should be monitored closely for respiratory depression, especially during the first 24-72 hours of therapy and following any increase in dosage.

In patients requiring long-term around-the-clock opiate analgesia, dosage of oxycodone should be titrated to a level that provides adequate analgesia and minimizes adverse effects. Frequent communication among the prescriber, other members of the healthcare team, the patient, and the patient's caregiver or family is important during periods of changing analgesic requirements, including the initial dosage titration period. Patients who experience breakthrough pain may require dosage adjustment or supplemental analgesia (i.e., ''rescue'' therapy with an immediate-release analgesic). If the level of pain increases after dosage stabilization, an attempt should be made to identify the source of increased pain before increasing the oxycodone dosage. During long-term therapy, the continued need for opiate analgesics should be continually reevaluated. If discontinuance of opiate therapy is required, the dosage should be tapered gradually to avoid manifestations of abrupt withdrawal.

For further information on the management of opiate analgesic therapy, see Dosage and Administration: Dosage, in the Opiate Agonists General Statement 28:08.08.

In patients with impaired hepatic function, initial oxycodone dosages should be conservative and adjusted according to the clinical situation. The manufacturers recommend that therapy with oxycodone hydrochloride extended-release tablets or oxycodone myristate extended-release capsules be initiated at 33-50% of the usual dosage and titrated carefully. When extended-release tablets containing oxycodone hydrochloride in fixed combination with acetaminophen are used for the management of acute pain in patients with hepatic impairment, the manufacturer recommends an initial oxycodone hydrochloride dose of 7.5 mg (given in fixed combination with 325 mg of acetaminophen); dosage should be adjusted as needed with close monitoring for respiratory depression.

In patients with impaired renal function (creatinine clearance less than 60 mL/minute), initial oxycodone dosages should be conservative and adjusted according to the clinical situation. When extended-release tablets containing oxycodone hydrochloride in fixed combination with acetaminophen are used for the management of acute pain in patients with renal impairment, the manufacturer recommends an initial oxycodone hydrochloride dose of 7.5 mg (given in fixed combination with 325 mg of acetaminophen); dosage should be adjusted as needed with close monitoring for respiratory depression.

If the required dose of oxycodone myristate extended-release capsules is less than 9 mg of oxycodone, an alternative analgesic should be selected.

Oxycodone is administered orally as the hydrochloride salt, often in combination with nonopiate analgesics (e.g., acetaminophen), or as the myristate salt.

No dosing information is available for this tab.

No dosing information is available for this tab.

There is no enhanced messaging for this drug.

There are no contraindication interactions for this drug.

There are no severe interactions for this drug.

There are no moderate interactions for this drug.

There is no enhanced messaging for this drug.

There are no contraindication contraindications for this drug.

There are no severe contraindications for this drug.

There are no moderate contraindications for this drug.

There is no enhanced messaging for this drug.

There are no severe adverse reactions for this drug.

There are no less severe adverse reactions for this drug.

No enhanced messaging available.

No enhanced messaging available.

No enhanced messaging available.

No enhanced messaging available.

No enhanced messaging available.