Oxycontin

Oxycontin

Oxycontin Side Effects:   Oxycontin is an extended release form of the opioid oxycodone. Generic equivalent products are available. Oxycontin is available in doses of 10mg, 15mg, 20mg, 30mg, 40mg, 60mg, and 80mg. It is usually dosed twice daily although some patients need three times daily dosing as the duration of efficacy in some patients may not last the full 12 hours. Oxycontin side effects are generally those of most opioids with the likely exception of it’s very high abuse potential. Oxycontin has both an immediate release and an extended release action, and the relatively high extended release portion may lead to a higher likelihood of addiction and abuse. It is also abused by crushing or chewing the tablet leading to full immediate release of the full dose. Over dosage including death is not rare with abuse of Oxycontin, and can occur with accidental over dosage also.

Oxycontin Black Box Warnings: The lead black box warning for Oxycontin is abuse. Physicians are urged to consider the potential for abuse, diversion, and misuse when prescribing. These risks may be higher in patients with mental illness, a family history of substance abuse, or a history of substance abuse. Additional black box warnings for Oxycontin include misuse of its extended release function. It is not intended to be chewed, crushed, or otherwise manipulated. Rapid release of a dose safe for extended release may cause dangerous or fatal over dosage when taken improperly resulting in immediate release of the full dose. The dosing of the higher strength doses of Oxycontin is restricted to opioid tolerant patients. Use of single doses greater than 40 mg or daily doses greater than 80 mg in opioid naïve patients may lead to respiratory depression and death. The last black box warning for Oxycontin is that concurrent use with CPY-450 3A4 inhibitors may lead to prolonged duration of effect of the oxycodone and to lethal respiratory depression. Examples of other drugs with CYP450 3A4 effects include the macrolide antibiotics like erythromycin and clarithromycin, antifungal drugs in the azole class like ketoconazole, and certain anti-HIV drugs like ritonavir. For full details on the Oxycontin black box warnings see the manufacturer’s prescriber details.

Common Oxycontin Side Effects: The most common Oxycontin side effects are those related to the whole opioid family. These are primarily related to the opioid mu receptor functions which occur not just in the central nervous system leading to the drugs analgesic effects, but also in the GI tract and elsewhere. Many of these side effects are so common that they can be expected to some degree in nearly all patients taking Oxycontin. Gastrointestinal common Oxycontin side effects include constipation, nausea, vomiting, abdominal pain, dry mouth and cholestasis.  Central nervous system depression Oxycontin side effects include somnolence, dizziness, nervousness, insomnia, confusion, anxiety, dysphoria and euphoria, abnormal dreams and abnormal thinking. Other common Oxycontin side effects include itching, asthenia, sweating, fever and chills, rashes, as well as low blood pressure and associated orthostatic dizziness.

Serious Oxycontin Side Effects:  The serious Oxycontin side effects are primarily related to the central nervous system depression effects of oxycodone including respiratory depression that can be severe and lethal. Other CNS depression Oxycontin side effects include coma, dependency and abuse, hypotension and cardiovascular collapse, seizures, apnea, and as a dermatological serious Oxycontin side effects exfoliative dermatitis.

Oxycontin Drug Interactions and Cautions: The list of drug interactions with Oxycontin is extensive and included nearly every medication that can have sedating side effects as well as all of the drugs with CYP 450 3A4 metabolism. To see the entire list see the manufacturer’s prescriber information, but especially pertinent cautions and interactions include the very high abuse potential for Oxycontin. See the Black Box Warning section above. Oxycontin use should be avoided in conjunction with buprenorphine, butorphanol, nalbuphine, pentazocine and sodium oxybate. Especial care and caution is advise in conjunction with any drugs that can cause CNS sedation including other opioids or opiates, benzodiazapines, tricyclic antidepressants, antihistamines, as well as amiodarone, any anticholinergics, barbiturates, marijuana or other caniboids, and many other drugs.

Pregnancy and Lactation: Oxycontin is a pregnancy category B drug, although like with other opioids infant withdrawal can be expected with prolonged use by the mother. Safety on lactation is unknown.

Special Considerations: The abuse potential of Oxycontin is so high that many physicians choose not to prescribe Oxycontin. Other physicians strictly limit prescriptions to select terminally ill patients. Abuse includes diversion (high street values), altering the method of drug delivery including crushing or chewing the tablets, smoking Oxycontin, using Oxycontin intra-nasally, and IV Injection of Oxycontin among others.

Unusual Oxycontin Side Effects: The relatively high immediate release component of Oxycontin makes the risk of addiction high even among other opioids.

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