Uses. This drug is considered more addictive than codeine, from which oxycodone is derived. Some authorities say oxycodone comes from thebaine, which is correct also, because thebaine is the parent chemical that yields codeine. Oxycodone is anywhere from 7 to 12 times stronger than codeine and about 0.3 to 2.2 times the strength of morphine, depending on the way the drugs are used. Body chemistry transforms part of an oxycodone dose into oxymorphone. Patients have found pain relief from oxycodone to be as satisfactory as relief from ketamine and morphine. Oxycodone has been used successfully to reduce pain from dentistry, surgery, cancer, and osteoarthritis (a painful disease of a person's joints). The drug is also used as a sedative and as a cough suppressant. It is sometimes prescribed for "restless leg syndrome," an affliction in which persons keep moving their arms and legs around. The drug has also reduced tics associated with Tourette's syndrome. Oxycodone can relax people and at times even create euphoria. Some researchers speculate that oxycodone's euphoric effects may improve patients' sensation of pain relief, making the substance more effective for that purpose than a drug that lacks euphoric effects. The drug works an antidepressant for some persons.
Blood levels from a given dose of oxycodone tend to be about 25% higher in females than in males. The cause is unknown, but the difference apparently has no impact on medical usage.
Drawbacks. Unwanted effects include nausea, vomiting, constipation, itching, sweating, sleepiness, reduced sex drive, general weakness, impairment of breathing, and momentary low blood pressure when a person stands up. One study found the drug to impair breathing more than various other opiates do, and in another study, doses of oxycodone had to be stopped lest the volunteers be harmed by further breathing difficulty. Normally the drug should be avoided if a person suffers from pancreatitis, enlarged prostate, difficulty with urination, or poorly functioning thyroid or adrenal glands. Experimenters have demonstrated that the drug reduces physical and mental abilities needed for driving automobiles.
Abuse factors. The drug's potential for abuse is considered the same as morphine's, and oxycodone is a sought-after product among opiate abusers. A study that reviewed medical records found no evidence of tolerance developing in a medical context. Regardless of whether people use the drug medically or recreationally, dependence can develop, followed by withdrawal symptoms if dosage stops suddenly. Withdrawal symptoms are described as minor and can be avoided by gradually discontinuing the drug instead of suddenly stopping it or by administering clonidine, a substance normally used to control high blood pressure.
Drug interactions. People should use oxycodone cautiously if they are also taking antihistamines, various antidepressants, or a monoamine oxidase inhibitor (MAOI, found in some antidepressants and other medicine). Combining those sorts of drugs with oxycodone can produce excessive effects. The same is true of alcohol. Oxycodone also seems to interact with cyclosporine, a substance used to suppress an individual's immune system (an effect useful in preventing rejection of organs in transplant patients).
Cancer. Oxycodone's potential for causing cancer is unknown.
Pregnancy. Oxycodone is believed to pose a small risk of causing birth defects, but safety for administration during pregnancy has not been determined. An examination of medical records found a slightly higher likelihood of birth defects if pregnant women use oxycodone, but, unlike most drugs associated with malformations, no particular type of birth defect appeared after using oxycodone. That suggests the drug might not be responsible for the observed abnormalities.
Newborns may have dependence on the drug if their mothers have been taking it during pregnancy. Enough of the drug can pass into a woman's milk to cause dependence in a breast-feeding infant.
Combination products. Tylox contains sodium metabisulfite, to which asthmatics and other persons may have a serious allergic reaction, and should be used cautiously if the user is sensitive to sulfites.
Additional scientific information may be found in:
Kalso, E., and A. Vainio. "Morphine and Oxycodone Hydrochloride in the Management of Cancer Pain." Clinical Pharmacology and Therapeutics 47 (199Q): 639-46.
Saarialho-Kere, U., M.J. Mattila, and T. Seppala. "Psychomotor, Respiratory and Neu-roendocrinological Effects of a Mu-Opioid Receptor Agonist (Oxycodone) in Healthy Volunteers." Pharmacology and Toxicology 65 (1989): 252-57.
Schick, B., et al. "Preliminary Analysis of First Trimester Exposure to Oxycodone and Hydrocodone." Reproductive Toxicology 1Q (1996): 162.
Stoll, A.L., and S. Rueter. "Treatment Augmentation with Opiates in Severe and Refractory Major Depression." American Journal of Psychiatry 156 (1999): 2017.
Walters, A.S., et al. "Successful Treatment of the Idiopathic Restless Legs Syndrome in a Randomized Double-Blind Trial of Oxycodone versus Placebo." Sleep 16 (1993): 327-32.
Ytterberg, S.R., M.L. Mahowald, and S.R. Woods. "Codeine and Oxycodone Use in Patients with Chronic Rheumatic Disease Pain." Arthritis and Rheumatism 41 (1998): 1603-12.
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