Oxycodone
Strong opioid analgesic for moderate to severe pain
Oxycodone is a powerful opioid analgesic (pain reliever) used to treat moderate to severe pain when other analgesics are not sufficient. It is a controlled substance with a high potential for addiction, abuse, and misuse. Oxycodone works by binding to opioid receptors in the brain and spinal cord, changing the way the body perceives and responds to pain. This medication requires a prescription and should only be used under close medical supervision.
Quick Facts
Key Takeaways
- Oxycodone is a strong opioid prescribed only for moderate to severe pain that does not respond to non-opioid treatments.
- It carries a high risk of addiction, dependence, and tolerance — use the lowest effective dose for the shortest duration.
- Never combine oxycodone with alcohol, benzodiazepines, or other CNS depressants due to the risk of life-threatening respiratory depression.
- Extended-release tablets must be swallowed whole — crushing, chewing, or breaking them can cause a fatal overdose.
- Stopping oxycodone suddenly can cause withdrawal symptoms; your doctor will taper the dose gradually when ending treatment.
What Is Oxycodone and What Is It Used For?
Quick Answer: Oxycodone is a strong opioid pain medication used for the treatment of moderate to severe pain in adults and adolescents (aged 12 and above) when other pain relievers are inadequate. It is available in several formulations including extended-release tablets, immediate-release tablets, oral solutions, and injectable forms.
Oxycodone belongs to a class of medications known as opioid analgesics. It acts on the central nervous system by binding to mu-opioid receptors in the brain and spinal cord. This action inhibits ascending pain pathways, alters the perception of and emotional response to pain, and produces a general depression of central nervous system activity. The result is effective pain relief for conditions that are not adequately managed by non-opioid alternatives.
Extended-release (also called modified-release or depot) formulations of oxycodone are designed to provide steady, around-the-clock pain relief over a 12-hour period. These are typically used for chronic pain conditions such as cancer pain or severe chronic non-cancer pain. Immediate-release formulations, on the other hand, take effect more quickly and are sometimes used for breakthrough pain episodes in patients who are already on a stable opioid regimen.
The most common clinical indications for oxycodone include chronic cancer-related pain where ongoing analgesic therapy is needed, severe post-surgical pain, and certain chronic non-cancer pain conditions when non-opioid therapies have been tried and found insufficient. It is important to note that opioids like oxycodone are not recommended as first-line treatment for chronic non-cancer pain, and when used for this purpose, they should form part of a comprehensive pain management plan that includes physical therapy, psychological support, and other medications where appropriate.
Oxycodone is classified as a controlled substance in most countries. In the United States it is listed as a Schedule II controlled substance, and in the United Kingdom it is classified under Schedule 2 of the Misuse of Drugs Regulations. This classification reflects its recognized medical use alongside its high potential for abuse and dependence. Prescriptions for oxycodone are therefore subject to additional regulatory requirements in most jurisdictions.
What Should You Know Before Taking Oxycodone?
Quick Answer: Before starting oxycodone, your doctor must assess your full medical history. Oxycodone is contraindicated in patients with severe respiratory depression, severe bronchial asthma, known hypersensitivity, and paralytic ileus. Numerous conditions require extra caution, and patients should disclose all current medications and any history of substance use disorders.
Contraindications
Oxycodone must not be used in the following situations:
- Hypersensitivity to oxycodone hydrochloride or any of the excipients in the formulation.
- Severe respiratory depression with low blood oxygen levels (hypoxia) and/or elevated carbon dioxide levels (hypercapnia).
- Severe chronic obstructive pulmonary disease (COPD) with significant airway narrowing.
- Cor pulmonale (heart changes caused by chronic lung disease).
- Severe bronchial asthma in unmonitored settings or without resuscitative equipment.
- Paralytic ileus (a type of bowel obstruction where the intestines are not moving).
- Acute abdomen or delayed gastric emptying conditions.
Warnings and Precautions
Talk to your doctor before taking oxycodone if any of the following conditions apply to you:
- You are elderly or debilitated, as you may be more sensitive to the effects of opioids, particularly respiratory depression.
- You have moderately or severely impaired lung function or any condition that affects your breathing.
- You have sleep apnea (repeated pauses in breathing during sleep), as oxycodone can worsen this condition.
- You have impaired kidney or liver function, which can affect how oxycodone is metabolized and increase the risk of side effects.
- You have thyroid disorders such as myxedema or hypothyroidism.
- You have adrenal insufficiency, such as Addison's disease.
- You have a history of mental illness, including psychosis related to substance use, depression, or anxiety.
- You have a current or past history of alcohol or drug misuse (substance use disorder).
- You have an enlarged prostate (prostatic hypertrophy), which can cause urinary retention.
- You have pancreatitis (inflammation of the pancreas) or gallbladder disease.
- You have inflammatory bowel disease or any obstructive bowel condition.
- You have chronic constipation, as opioids make this worse.
- You have conditions with raised intracranial pressure, such as head injury.
- You have epilepsy or a tendency toward seizures.
- You have low blood pressure (hypotension) or reduced blood volume (hypovolemia).
- You are taking monoamine oxidase (MAO) inhibitors, or have taken them within the last 14 days.
- You have recently undergone abdominal or intestinal surgery.
Oxycodone contains an opioid that carries a serious risk of addiction (substance use disorder), even when used as prescribed. Repeated use can lead to physical dependence and tolerance. Risk factors for opioid addiction include personal or family history of substance abuse, being a smoker, and a history of mental health conditions such as depression, anxiety, or personality disorders. If you notice that you need to take the medication for longer than prescribed, need higher doses, use it for reasons other than pain relief, or feel unwell when you stop taking it, speak to your doctor immediately.
The most serious risk of opioid use is respiratory depression (abnormally slow and shallow breathing). This is more likely to occur at the start of treatment, after dose increases, in elderly or debilitated patients, and in those with pre-existing respiratory conditions. Oxycodone can also cause sleep-related breathing disorders including central sleep apnea and sleep-related hypoxemia. If you or others notice breathing pauses during sleep, nighttime awakenings with breathlessness, or excessive daytime drowsiness, contact your doctor.
Pregnancy and Breastfeeding
If you are pregnant, planning to become pregnant, think you may be pregnant, or are breastfeeding, consult your doctor before using oxycodone.
Pregnancy: Use of oxycodone during pregnancy should be avoided whenever possible. There is insufficient clinical data on the safety of oxycodone in pregnant women. Oxycodone crosses the placenta into the fetal circulation. Prolonged use during pregnancy can cause neonatal opioid withdrawal syndrome (NOWS) in the newborn, which may be life-threatening if not recognized and treated. Symptoms in the newborn may include irritability, hyperactivity, abnormal sleep patterns, high-pitched crying, tremors, vomiting, diarrhea, and failure to gain weight. Use in the last 3–4 weeks before delivery carries a risk of respiratory depression in the newborn.
Breastfeeding: Oxycodone should not be taken while breastfeeding. Oxycodone passes into breast milk and can cause respiratory depression in the nursing infant. If oxycodone treatment is medically necessary, breastfeeding should be discontinued for the duration of treatment.
Driving and Operating Machinery
Oxycodone can impair your ability to drive vehicles or operate machinery. This is particularly likely at the start of treatment, after a dose increase, or when oxycodone is combined with other medications that affect the central nervous system. During stable, long-term treatment, your doctor will assess whether driving is safe in your individual case. Do not drive or use machinery if you feel drowsy, dizzy, or if your reactions are impaired.
Children Under 12 Years
The safety and efficacy of oxycodone have not been adequately studied in children under 12 years of age. Use of this medication is therefore not recommended in this age group.
How Does Oxycodone Interact with Other Drugs?
Quick Answer: Oxycodone interacts with many medications, most critically with benzodiazepines and other CNS depressants, which can cause fatal respiratory depression. MAO inhibitors, CYP3A4 inhibitors/inducers, and serotonergic drugs also have significant interactions. Always inform your doctor about all medications you take, including over-the-counter drugs and herbal supplements.
Oxycodone is metabolized in the liver primarily by the cytochrome P450 enzymes CYP3A4 and CYP2D6. Drugs that inhibit or induce these enzymes can significantly alter oxycodone blood levels, either increasing the risk of toxicity or reducing its analgesic effectiveness. Additionally, combining oxycodone with other central nervous system (CNS) depressants can have additive or synergistic depressant effects, potentially leading to life-threatening respiratory depression.
Concurrent use of opioids like oxycodone with benzodiazepines (e.g., diazepam, lorazepam, alprazolam) or other CNS depressants (sedatives, hypnotics, anxiolytics, certain antihistamines, alcohol) increases the risk of profound sedation, respiratory depression, coma, and death. If co-prescription is unavoidable, the dose and duration of both medications should be limited, and the patient should be closely monitored.
Major Interactions
| Drug / Drug Class | Effect | Clinical Significance |
|---|---|---|
| Benzodiazepines (diazepam, lorazepam, alprazolam) | Additive CNS and respiratory depression | Life-threatening; avoid if possible. If necessary, use lowest doses and shortest duration. |
| MAO Inhibitors (tranylcypromine, phenelzine, moclobemide, linezolid) | Potentially severe, unpredictable reactions including serotonin syndrome and CNS excitation or depression | Contraindicated within 14 days of MAO inhibitor use. |
| Alcohol | Enhanced CNS depression; may increase oxycodone absorption from extended-release formulations | Strictly prohibited. Can cause fatal respiratory depression and loss of consciousness. |
| CYP3A4 Inhibitors (ketoconazole, itraconazole, clarithromycin, ritonavir, voriconazole) | Increased oxycodone plasma concentrations | May increase or prolong opioid effects, including respiratory depression. Dose reduction may be needed. |
| CYP3A4 Inducers (rifampicin, carbamazepine, phenytoin, St. John's Wort) | Decreased oxycodone plasma concentrations | May reduce analgesic effect. Dose adjustment or alternative analgesic may be necessary. |
| Serotonergic drugs (SSRIs, SNRIs: fluoxetine, paroxetine, sertraline, venlafaxin, duloxetine) | Risk of serotonin syndrome | May cause agitation, hyperthermia, tremor, muscle rigidity, hyperreflexia. Monitor closely. |
| Other opioid analgesics | Additive CNS and respiratory depression | Use with caution and adjust doses carefully. |
Other Notable Interactions
| Drug / Drug Class | Effect | Recommendation |
|---|---|---|
| Muscle relaxants | Enhanced sedation and respiratory depression | Monitor closely; dose reduction may be needed. |
| Antihistamines (sedating types) | Increased drowsiness and CNS depression | Use non-sedating alternatives if possible. |
| Antipsychotics / Neuroleptics | Enhanced sedation and hypotension | Monitor blood pressure and sedation level. |
| Gabapentin / Pregabalin | Increased CNS depression and respiratory depression risk | Use lowest effective doses of both. |
| Cimetidine | May inhibit oxycodone metabolism | Monitor for increased opioid effects. |
| Coumarin anticoagulants (warfarin) | Potential changes in anticoagulant effect | Monitor INR closely when starting or stopping oxycodone. |
| Grapefruit juice | CYP3A4 inhibition may increase oxycodone levels | Avoid grapefruit juice during treatment. |
What Is the Correct Dosage of Oxycodone?
Quick Answer: Oxycodone dosing is highly individualized. For opioid-naive adults, the typical starting dose of extended-release oxycodone is 10 mg every 12 hours. Your doctor will adjust the dose based on your response and tolerance. Extended-release tablets must be swallowed whole and should never be crushed, chewed, or broken, as this can release a potentially fatal dose all at once.
Oxycodone must always be used exactly as prescribed by your doctor. Before starting treatment and at regular intervals during therapy, your doctor will discuss treatment goals, duration, when to contact the doctor, and how to safely discontinue the medication. The dose is determined by the severity of your pain, your prior opioid exposure, and your individual response to treatment.
Adults and Adolescents (12 Years and Older)
Extended-Release (Depot) Tablets
- Starting dose (opioid-naive): 10 mg every 12 hours. In some cases, doctors may start with 5 mg every 12 hours to minimize initial side effects.
- Non-cancer pain: A dose of 20 mg twice daily is usually adequate; higher doses may be needed in individual cases.
- Cancer pain: Higher doses are often required, typically ranging from 80 mg to 120 mg daily, and in some cases up to 400 mg daily.
- Patients with prior opioid use: May start at higher doses based on previous opioid exposure and tolerance.
| Patient Group | Starting Dose | Typical Range | Notes |
|---|---|---|---|
| Opioid-naive adults | 5–10 mg every 12 hours | 10–40 mg/day | Start low, titrate slowly based on response |
| Opioid-tolerant adults (cancer pain) | Based on prior opioid dose | 80–120 mg/day (up to 400 mg) | Equianalgesic dose conversion required |
| Adolescents (12+ years) | 5–10 mg every 12 hours | Individualized | Same as adult dosing; close monitoring required |
| Elderly patients | 5 mg every 12 hours | Individualized, lower doses | Increased sensitivity; start at the low end and titrate carefully |
| Impaired kidney or liver function | Reduced starting dose | Individualized | Reduced metabolism/excretion; monitor closely for signs of toxicity |
| Low body weight | Reduced starting dose | Individualized | May have increased sensitivity to opioids |
How to Take Extended-Release Tablets
Swallow the extended-release tablet whole with a sufficient amount of liquid (half a glass of water), in the morning and evening at fixed times (for example, at 8:00 AM and 8:00 PM). You may take the tablets with or without food.
Extended-release tablets must be swallowed whole. Breaking, crushing, or chewing them destroys the controlled-release mechanism and releases the entire dose of oxycodone at once. This can cause a rapid absorption of a potentially fatal dose of oxycodone. Intentional misuse by injecting dissolved tablet material can also lead to tissue necrosis, lung granulomas, and other serious, potentially fatal complications.
Missed Dose
If you miss a dose, take it as soon as you remember, provided that the next scheduled dose is at least 8 hours away. If the next dose is sooner than 8 hours, skip the missed dose and continue with your regular schedule. In any case, do not take oxycodone more frequently than every 8 hours. Never take a double dose to compensate for a missed dose.
Overdose
If you or someone else may have taken too much oxycodone, seek emergency medical attention immediately. An opioid overdose is a medical emergency.
Signs and symptoms of oxycodone overdose include:
- Constricted (pinpoint) pupils (miosis)
- Severely slowed, shallow, or absent breathing (respiratory depression)
- Extreme drowsiness or inability to stay awake (somnolence)
- Reduced muscle tone (skeletal muscle flaccidity)
- Dangerously low blood pressure (hypotension)
- Slow heartbeat (bradycardia)
- Cold, clammy skin
- In severe cases: circulatory collapse, coma, pulmonary edema, and death
Treatment of opioid overdose involves the administration of naloxone, an opioid antagonist, along with supportive measures including assisted ventilation. Naloxone may need to be administered repeatedly because its duration of action is shorter than that of oxycodone, particularly extended-release formulations.
What Are the Side Effects of Oxycodone?
Quick Answer: The most common side effects of oxycodone include constipation, nausea, drowsiness, dizziness, and itching. The most serious adverse effect is respiratory depression (dangerously slow breathing), which can be fatal. Stop taking oxycodone and seek emergency help if you experience sudden breathing difficulties, severe allergic reactions, or loss of consciousness.
Like all medications, oxycodone can cause side effects, although not everyone will experience them. Some side effects are very common and expected, while others are rare but potentially serious. The side effects below are listed by frequency, based on clinical trial data and post-marketing surveillance.
- Sudden difficulty breathing, swelling of the eyelids, face, or lips, hives or itching all over the body (signs of severe allergic reaction)
- Very slow, shallow breathing (respiratory depression) — especially dangerous in elderly or debilitated patients
- Sudden drop in blood pressure causing dizziness or fainting
- Chest pain or irregular heartbeat
Very Common
Affects more than 1 in 10 people
- Drowsiness or excessive sleepiness (especially at the start of treatment or after dose increases; usually improves after a few days)
- Dizziness
- Headache
- Constipation (persistent — does not usually resolve on its own)
- Nausea
- Vomiting
- Itching (pruritus)
Common
Affects up to 1 in 10 people
- Decreased appetite
- Anxiety, confusion, depression, nervousness, difficulty sleeping (insomnia)
- Abnormal thoughts or thought disturbances
- Tremor, lethargy (feeling sluggish)
- Shortness of breath (dyspnea), wheezing, bronchospasm, reduced cough reflex
- Abdominal pain, diarrhea, dry mouth, indigestion (dyspepsia)
- Skin rash, excessive sweating (hyperhidrosis)
- Increased urinary frequency
- Weakness (asthenia), fatigue
Uncommon
Affects up to 1 in 100 people
- Allergic hypersensitivity reactions
- Inappropriate antidiuretic hormone secretion (SIADH)
- Agitation, mood swings, euphoria, hallucinations
- Decreased sex drive, drug dependence (see Warnings section)
- Seizures (particularly in patients with epilepsy), muscle rigidity, involuntary muscle contractions
- Reduced sensation to pain or touch (hypoesthesia), speech difficulties, fainting, tingling (paraesthesia)
- Memory loss, migraine, changes in taste
- Visual disturbances, changes in tear production
- Increased heart rate, palpitations
- Vasodilation (widening of blood vessels)
- Voice changes, cough, sore throat, runny nose
- Mouth ulcers, gum inflammation, difficulty swallowing, flatulence, belching, bowel obstruction
- Elevated liver enzymes
- Dry skin
- Difficulty urinating, impotence
- Chills, pain (including chest pain), malaise, thirst
- Edema (swelling of hands, ankles, or feet)
- Physical dependence with withdrawal symptoms, drug tolerance
- Accidental injuries
Rare and Very Rare
Affects up to 1 in 1,000 people (or fewer)
- Herpes simplex infections
- Lymph node disorders
- Increased appetite, weight changes
- Drop in blood pressure upon standing (orthostatic hypotension)
- Dark, tarry stools (indicating gastrointestinal bleeding), tooth discoloration, bleeding gums
- Hives (urticaria), increased sensitivity to light (photosensitivity)
- Blood in urine (hematuria)
- Exfoliative dermatitis (very rare, peeling skin rash)
- Aggression
- Increased pain sensitivity (hyperalgesia — paradoxical, does not improve with dose increase)
- Dental caries (tooth decay)
- Sphincter of Oddi dysfunction (can cause severe upper abdominal pain)
- Absence of menstruation (amenorrhea)
Hormonal Effects
Like other opioids, prolonged use of oxycodone — especially at high doses — may affect the body's normal production of hormones, including cortisol and sex hormones (testosterone, estrogen). Symptoms may include nausea, vomiting, loss of appetite, fatigue, dizziness, changes in sexual function, menstrual irregularities, or erectile dysfunction. Discuss any such symptoms with your doctor.
Managing Common Side Effects
Your doctor will usually take measures to manage expected side effects. Constipation is the most persistent side effect and can be prevented or managed with a fiber-rich diet, adequate fluid intake, and laxatives if necessary. Nausea and vomiting are often temporary and may be treated with antiemetic medications. Drowsiness typically decreases after the first few days of treatment or after a dosage adjustment.
What Happens When You Stop Taking Oxycodone?
Quick Answer: Do not stop taking oxycodone abruptly. Sudden discontinuation can cause unpleasant and sometimes severe withdrawal symptoms. Your doctor will gradually reduce (taper) your dose to minimize these effects. Withdrawal symptoms may include yawning, sweating, anxiety, restlessness, insomnia, muscle aches, nausea, and diarrhea.
When oxycodone is taken regularly over a period of time, the body develops a physical dependence on the medication. This is a normal physiological response to opioid therapy and does not necessarily mean that a person has developed an addiction. However, it does mean that abruptly stopping the medication or rapidly reducing the dose can trigger a set of withdrawal symptoms.
Withdrawal symptoms from oxycodone may include:
- Frequent yawning
- Dilated (widened) pupils
- Excessive tearing (lacrimation) and runny nose (rhinorrhea)
- Tremors (shaking)
- Excessive sweating
- Anxiety, agitation, and restlessness
- Difficulty sleeping (insomnia)
- Muscle pain and cramps
- Nausea, vomiting, and diarrhea
- Goosebumps (piloerection)
- Increased heart rate and blood pressure
When your doctor determines that oxycodone is no longer needed, the daily dose will be reduced gradually — typically over days to weeks — to prevent withdrawal symptoms. The tapering schedule depends on the dose you have been taking, the duration of treatment, and your individual response. Never change or stop your oxycodone dose on your own without medical guidance.
How Should You Store Oxycodone?
Quick Answer: Store oxycodone in a locked, secure location, out of sight and reach of children and others who have not been prescribed the medication. Keep at room temperature (below 25–30°C). Never share oxycodone with anyone else, and return unused medication to a pharmacy for safe disposal.
Oxycodone is a controlled substance and should be stored with the same level of security as other valuables in the home. Accidental ingestion, particularly by children, can cause a fatal overdose. Keep the medication in its original packaging and use child-resistant packaging where available.
- Blister packs: Store at or below 25°C.
- HDPE bottles (5 mg, 10 mg, 15 mg): Store at or below 30°C.
- HDPE bottles (20 mg, 30 mg, 40 mg, 60 mg, 80 mg): No special storage conditions.
- Do not use after the expiry date printed on the packaging.
- Do not dispose of in wastewater or household waste. Return unused or expired medication to a pharmacy or authorized disposal program.
Accidental ingestion of even one dose of oxycodone, especially by a child, can result in a fatal overdose. If you suspect accidental ingestion, seek emergency medical help immediately.
What Does Oxycodone Contain?
Quick Answer: The active ingredient is oxycodone hydrochloride. Extended-release tablets are available in strengths from 5 mg to 80 mg. Inactive ingredients include lactose monohydrate, hypromellose, povidone, stearic acid, and magnesium stearate, with various coloring agents used for different tablet strengths.
Active substance: Oxycodone hydrochloride. Each extended-release tablet contains 5 mg, 10 mg, 15 mg, 20 mg, 30 mg, 40 mg, 60 mg, or 80 mg of oxycodone hydrochloride.
Inactive Ingredients (Excipients)
Tablet core: Lactose monohydrate, hypromellose, povidone, stearic acid, magnesium stearate, colloidal anhydrous silica.
This medication contains lactose. If you have been told by your doctor that you have an intolerance to some sugars, consult your doctor before taking this medicine.
Tablet coating varies by strength and may include polyvinyl alcohol, titanium dioxide (E171), macrogol (polyethylene glycol), talc, and various iron oxide colorants (E172) and indigo carmine (E132). Each strength is a different color for easy identification:
- 5 mg: Blue, round, biconvex, marked "OX 5"
- 10 mg: White, round, biconvex, marked "OX 10"
- 15 mg: Gray, round, biconvex, marked "OX 15"
- 20 mg: Pink, round, biconvex, marked "OX 20"
- 30 mg: Brown, round, biconvex, marked "OX 30"
- 40 mg: Yellow, round, biconvex, marked "OX 40"
- 60 mg: Red, round, biconvex, marked "OX 60"
- 80 mg: Green, round, biconvex, marked "OX 80"
Frequently Asked Questions About Oxycodone
Oxycodone is a strong opioid analgesic prescribed for moderate to severe pain that cannot be adequately managed with non-opioid pain medications. It is most commonly used for chronic cancer pain, severe post-surgical pain, and in some cases for chronic non-cancer pain when other treatments have proven insufficient. Extended-release formulations provide around-the-clock pain relief, while immediate-release forms are used for breakthrough pain.
Yes, oxycodone carries a significant risk of addiction (substance use disorder), physical dependence, and tolerance. This risk exists even when the medication is used as directed, although it increases with higher doses and longer treatment duration. People with a personal or family history of substance abuse, smokers, and those with mental health conditions are at higher risk. Treatment should always be at the lowest effective dose for the shortest necessary duration, with regular medical review.
The most dangerous side effect of oxycodone is respiratory depression (severely slowed or stopped breathing), which can be fatal. This risk is highest at the start of therapy, after dose increases, when combining oxycodone with other CNS depressants (such as benzodiazepines or alcohol), and in elderly or debilitated patients. Other serious adverse effects include severe allergic reactions (anaphylaxis), dangerously low blood pressure (hypotension), and in overdose situations, circulatory collapse, coma, and death.
No, you must never drink alcohol while taking oxycodone. Alcohol and oxycodone are both central nervous system depressants, and combining them significantly increases the risk of severe respiratory depression, profound sedation, loss of consciousness, and death. Additionally, alcohol can increase the release rate of oxycodone from extended-release formulations, leading to dangerously high blood levels. This prohibition applies to all forms of alcohol, including beer, wine, and spirits.
Unused oxycodone should never be thrown in household waste or flushed down the toilet. Due to the risks of diversion, misuse, and environmental contamination, all unused opioid medications should be returned to a pharmacy or an authorized medication take-back program for safe disposal. Many pharmacies and hospitals offer drug disposal services. Keeping unused oxycodone in the home increases the risk of accidental exposure or intentional misuse by others, including children.
If you miss a dose of extended-release oxycodone, take it as soon as you remember, provided the next dose is at least 8 hours away. If less than 8 hours remain until your next scheduled dose, skip the missed dose entirely and continue with your regular dosing schedule. Never take a double dose to compensate for a missed one, as this increases the risk of dangerous side effects including respiratory depression and overdose.
References
- World Health Organization (WHO). WHO Guidelines for the Pharmacological and Radiotherapeutic Management of Cancer Pain in Adults and Adolescents. Geneva: WHO; 2018. Available at: who.int
- European Medicines Agency (EMA). Oxycodone Hydrochloride – Summary of Product Characteristics (SmPC). European public assessment reports. Available at: ema.europa.eu
- U.S. Food and Drug Administration (FDA). OxyContin (oxycodone hydrochloride) Extended-Release Tablets – Prescribing Information. FDA Approved Drug Products. Available at: fda.gov
- British National Formulary (BNF). Oxycodone hydrochloride. NICE Evidence Services. Available at: bnf.nice.org.uk
- Dowell D, Ragan KR, Jones CM, Baldwin GT, Chou R. CDC Clinical Practice Guideline for Prescribing Opioids for Pain – United States, 2022. MMWR Recomm Rep. 2022;71(No. RR-3):1–95. DOI: 10.15585/mmwr.rr7103a1
- Chou R, Hartung D, Turner J, et al. Opioid Treatments for Chronic Pain. Comparative Effectiveness Review No. 229. AHRQ Publication No. 20-EHC011. Rockville, MD: AHRQ; 2020.
- Caraceni A, Hanks G, Kaasa S, et al. Use of opioid analgesics in the treatment of cancer pain: evidence-based recommendations from the EAPC. Lancet Oncol. 2012;13(2):e58–e68. DOI: 10.1016/S1470-2045(12)70040-2
- Scholten W, Henningfield JE. Negative outcomes of unbalanced opioid policy supported by clinicians, politicians, and the media. J Pain Palliat Care Pharmacother. 2016;30(1):4–14.
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