Opioid Analgesic (Strong) Pregnancy: Use with caution — neonatal opioid withdrawal syndrome if used near term

Oxycodone (Burns — Background Analgesia)

Brand names: OxyContin (SR), OxyNorm (IR), Targinact (with naloxone)

Adult dose

Dose: Immediate-release: 5–10 mg every 4–6 hours; Sustained-release: 10–20 mg every 12 hours

Route: Oral

Frequency: Every 4–6h (IR) or every 12h (SR)

Max: Titrated to pain response

Used for background burns pain where oral route available. IR oxycodone for breakthrough pain on top of SR background. Targinact (oxycodone/naloxone) preferred if opioid-induced constipation is a concern. More bioavailable than oral morphine (~60–87%).

Paediatric dose

Dose: 0.05–0.1 mg/kg

Route: Oral

Frequency: Every 4–6 hours

Max: 5 mg/dose (under 12 years)

Children ≥1 year: 0.05–0.1 mg/kg every 4–6 hours under specialist guidance. IR formulation only.

Dose adjustments

Renal

Reduce dose and frequency in renal impairment — active metabolite (oxymorphone) accumulates. Start at 50% of normal dose.

Hepatic

Significant hepatic metabolism — reduce dose by 30–50% in moderate–severe impairment.

Paediatric weight-based calculator

Patient weight (kg)

Children ≥1 year: 0.05–0.1 mg/kg every 4–6 hours under specialist guidance. IR formulation only.

Clinical pearls

Antidote: naloxone 0.4–2 mg IV — titrate carefully to avoid acute withdrawal in opioid-tolerant burns patients
Opioid rotation: if inadequate analgesia or intolerable side effects — switch to equianalgesic dose of alternative opioid (morphine, hydromorphone) using conversion charts
Targinact (oxycodone/naloxone 2:1 ratio): naloxone acts locally in gut to prevent opioid-induced constipation without reversing systemic analgesia

Contraindications

Respiratory depression without ventilatory support
Acute abdomen
Paralytic ileus
Delayed gastric emptying

Side effects

Constipation
Nausea/vomiting
Sedation
Respiratory depression
Dependence and tolerance
Pruritus

Interactions

MAOIs (contraindicated within 14 days)
CNS depressants (additive)
CYP3A4 inhibitors — fluconazole (increase oxycodone levels)
CYP3A4 inducers — rifampicin (reduce oxycodone levels)

Monitoring

Pain scores (NRS 0–10)
Sedation score
Respiratory rate
Bowel function (constipation)
Signs of opioid toxicity

Reference: BNFc; BNF 90; BBA Pain Management in Burns Guidelines; BNFc; Faculty of Pain Medicine Opioid Guidelines. Verify against your local formulary and the latest BNF before prescribing.

Curated clinical cross-links plus same-class fallbacks.

Calculators