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Strong opioid

Oxycodone hydrochloride

Brand names: OxyNorm, OxyContin, Shortec, Longtec

Adult dose

Dose: PO IR (OxyNorm): 5mg every 4–6h, titrate. PO MR (OxyContin/Longtec): 10mg every 12h. IV/SC: 1–10mg every 4h or 0.5–1 mg/h infusion
Route: PO/IV/SC
Frequency: q4-6h

Dose adjustments

Renal

Use cautiously; reduce in moderate-severe renal impairment

Clinical pearls

  • Equianalgesic ratio: PO oxycodone : PO morphine = 1.5:1 (i.e. 5mg oxycodone ≈ 7.5mg morphine)
  • Brand-specific MR formulations not interchangeable
  • Co-prescribe stimulant + softener laxative routinely

Contraindications

  • Acute respiratory depression
  • Paralytic ileus
  • Acute abdomen
  • Concurrent MAOI / within 14 days
  • Severe COPD

Side effects

  • Constipation
  • Nausea/vomiting
  • Sedation
  • Respiratory depression
  • Confusion
  • Hypogonadism
  • Dependence
  • Tolerance

Interactions

  • CNS depressants
  • MAOIs
  • Strong CYP3A4 modulators
  • SSRIs (serotonin syndrome — rare)

Monitoring

  • Pain
  • Sedation
  • RR
  • Bowel function

Reference: BNF; NICE CG140; UK FPM; Palliative care formulary; https://bnf.nice.org.uk/drugs/oxycodone-hydrochloride/. Verify against your local formulary and the latest BNF before prescribing.

Related

Curated clinical cross-links plus same-class fallbacks.

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