Strong opioid + peripheral opioid antagonist
Oxycodone with naloxone
Brand names: Targinact
Adult dose
Dose: 5/2.5mg or 10/5mg PO BD initially, titrate; max 80/40mg BD
Route: PO
Frequency: BD
Clinical pearls
- Severe pain where opioid-induced constipation refractory to laxatives
- Naloxone has very low oral bioavailability — selectively antagonises gut μ-receptors
Contraindications
- Moderate-severe hepatic impairment
- Acute respiratory depression
- Paralytic ileus
- Concurrent MAOI
Side effects
- Constipation (less than oxycodone alone)
- As oxycodone
- Naloxone-mediated opioid withdrawal at higher doses
Interactions
- CNS depressants
- MAOIs
- Strong CYP3A4 modulators
Monitoring
- Pain
- Bowel function
- Sedation
Reference: BNF; NICE CG140; SmPC; https://bnf.nice.org.uk/drugs/oxycodone-with-naloxone/. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Calculators
- Morphine Milligram Equivalents (MME) Calculator · Pain / Opioids
- Opioid Conversion / Equianalgesic Guide · Pain Management
- Numeric Rating Scale (NRS) Pain Assessment and Management · Pain Management
- HINTS Plus (Central vs Peripheral Vertigo) · Vertigo / Dizziness
- Carpal Tunnel Syndrome-6 (CTS-6) Diagnostic Tool · Peripheral Nerve
- Peripheral Blood Stem Cell (PBSC) Collection Target Calculator · Stem Cell Transplant
Pathways
- New-Onset Atrial Fibrillation · ESC 2020 AF Guidelines; NICE NG196
- Hypertensive Emergency · ESC/ESH 2018 Hypertension Guidelines; NICE NG136
- Bradycardia Management · Resuscitation Council UK ABCDE; ESC 2021 Pacing Guidelines
- Ventricular Tachycardia / Fibrillation · Resuscitation Council UK ACLS; ESC 2022 Ventricular Arrhythmia Guidelines
- Syncope Assessment · ESC 2018 Syncope Guidelines; NICE NG109
- Acute Chest Pain · NICE CG95; ESC 2023 ACS Guidelines