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TY - JOUR. T1 - Risk of Constipation in Patients Prescribed Fentanyl Transdermal System or Oxycodone Hydrochloride Controlled-Release in a California Medicaid Population. AU - Ackerman, Stacey J.. AU - Knight, Tyler. AU - Schein, Jeff. AU - Carter, Chureen. AU - Staats, Peter. PY - 2004/2. Y1 - 2004/2. N2 - Objective: To compare the risk of developing constipation between patients prescribed fentanyl transdermal system or oxycodone hydrochloride (HCl) controlled-release. Design: California Medicaid (Medi-Cal) claims data. Setting: Medicaid beneficiaries in California. Participants: Chronic pain patients who received a prescription for transdermal fentanyl or oxycodone controlled-release between October 1, 1997, and February 28, 2000, for at least three consecutive months. Main Outcome Measures: Constipation was defined using the International Classification of Diseases, Ninth Revision, Clinical Modification code (ICD-9-CM 564.0). The association between long-acting opioid use and constipation ...
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Although oxycodone has been generally considered to act as a typical μ-opioid agonist in humans, preclinical studies indicate that the antinociceptive effects of oxycodone are mediated by a combination of μ-opioid and κ-opioid receptors.11,50,51,52 Consistent with this view, morphine-tolerant rats continue to exhibit analgesia with oxycodone, whereas oxycodone-tolerant rats fail to display analgesia with morphine.53 Recently, it has also been shown that oxycodone and morphine have distinctly different pharmacological profiles in rat models of neuropathic pain.54 Nevertheless, it is difficult to attribute these findings to κ-opioid receptor binding activity of oxycodone (receptor affinity greater than 1000 nm) or its metabolites (Staahl et al. 55). In human subjects, the only two metabolites with significant κ-opioid receptor binding activity are oxymorphone (receptor affinity 148 nm) and noroxymorphone (receptor affinity 87 nm), but these compounds are still 15-fold more potent at μ-opioid ...
General Opioid analgesics should be used with caution when combined with CNS depressant drugs, and should be reserved for cases where the benefits of opioid analgesia outweigh the known risks of respiratory depression, altered mental state, and postural hypotension.. Acute Abdominal Conditions. The administration of oxycodone and acetaminophen tablets or other opioids may obscure the diagnosis or clinical course in patients with acute abdominal conditions. Oxycodone and acetaminophen tablets should be given with caution to patients with CNS depression, elderly or debilitated patients, patients with severe impairment of hepatic, pulmonary, or renal function, hypothyroidism, Addisons disease, prostatic hypertrophy, urethral stricture, acute alcoholism, delirium tremens, kyphoscoliosis with respiratory depression, myxedema, and toxic psychosis.. Oxycodone and acetaminophen tablets may obscure the diagnosis or clinical course in patients with acute abdominal conditions. Oxycodone may aggravate ...
The researchers noted that "the quality of the evidence was low," concluding that oxycodone is not considered to be a better solution to cancer pain in adults compared to other strong analgesics like morphine.. In a February 2015 study from Cochrane, researchers also looked into the benefits of oxycodone for cancer pain relief. They concluded,. "Overall, the data included within this review suggest that oxycodone offers similar levels of pain relief and adverse events to other strong opioids including morphine, which is commonly considered the gold standard strong opioid. Our conclusions are consistent with other recent reviews and suggest that while the reliability of the evidence base is low, given the absence of important differences within this analysis it seems unlikely that larger head to head studies of oxycodone versus morphine will be justified. This means that for clinical purposes oxycodone or morphine can be used as first line oral opioids for relief of cancer pain." ...
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Information for Patients/Caregivers Advise the patient to read the FDA-approved patient labeling (Medication Guide).. Addiction, Abuse, and Misuse Inform patients that the use of Oxycodone and Acetaminophen Tablets, even when taken as recommended, can result in addiction, abuse, and misuse, which can lead to overdose and death [see WARNINGS]. Instruct patients not to share Oxycodone and Acetaminophen Tablets with others and to take steps to protect Oxycodone and Acetaminophen Tablets from theft or misuse.. Life-Threatening Respiratory Depression Inform patients of the risk of life-threatening respiratory depression, including information that the risk is greatest when starting Oxycodone and Acetaminophen Tablets or when the dosage is increased, and that it can occur even at recommended dosages [see WARNINGS]. Advise patients how to recognize respiratory depression and to seek medical attention if breathing difficulties develop.. Accidental Ingestion Inform patients that accidental ingestion, ...