Oxycodone IR

Strong Opioid·Analgesia - Opioids

Moderate to severe acute and chronic pain, post-operative pain, cancer pain

S8PBSOPIOIDEndone, Oxynorm5 mg tablet+1

Max Dose

Titrated

Half-life

3-5 h

Dependence

CRITICAL

Constipation

HIGH RISK

Rapid Summary

Overview

Highly potent, pure mu-opioid receptor agonist. The most widely prescribed strong oral opioid on the ward. Extremely high abuse and dependence potential.

Maximum Dose

No absolute ceiling dose. Titrated strictly to pain response and respiratory tolerance.

Clinical Focus

Has roughly 1.5 to 2 times the oral potency of oral Morphine. Massive risk of iatrogenic addiction if sent home with large discharge supplies.

Bottom Line

Oxycodone IR is a potent Schedule 8 opioid for moderate-severe acute pain, but has high abuse potential and causes significant respiratory depression, constipation, and dependence.

Formulation & Access

Brand Names

Endone, Oxynorm

Oral Routes

Tablets/Capsules (5 mg, 10 mg, 20 mg). Oral liquid (1 mg/mL and 10 mg/mL).

Prescribing & PBS

Highly Restricted (S8). PBS strictly limits quantities for acute pain.

Indications & Use

Primary

PBSTGA

Moderate to severe acute and chronic pain, post-operative pain, cancer pain.

Clinical Place

The workhorse 'breakthrough' analgesic on surgical and medical wards. Used when pain breaks through the Paracetamol/NSAID baseline.

Quick reference

Class & Role

Strong Opioid — Highly potent, pure mu-opioid receptor agonist.

Route / Formulation

Tablets/Capsules (5 mg, 10 mg, 20 mg). Oral liquid (1 mg/mL and 10 mg/mL). (Endone, Oxynorm)

Usual Dose & Max

PO 5-10 mg q4-6h PRN. Titrate to effect. No absolute ceiling dose. Titrated strictly to pain response and respiratory tolerance.

Key Indication Doses

Acute Severe Pain: PO 5-10 mg q4-6h PRN. Titrate to effect. Breakthrough Pain (for SR users): PO Give 1/6th of the total daily Sustained Release dose as an IR PRN dose q2-4h. Elderly / Frail: Start at 2.5 mg (half a 5mg tablet) q6h PRN. Highly sensitive to sedation/delirium. Renal Impairment: Reduce dose/increase interval if eGFR < 30. (Accumulates, though less toxic than morphine metabolites).

Best Uses

Oxycodone IR is a potent Schedule 8 opioid for moderate-severe acute pain, but has high abuse potential and causes significant respiratory depression, constipation, and dependence.

Avoid / Cautions

Severe respiratory depression, severe acute asthma, paralytic ileus. Pregnancy Category C. Chronic use causes Neonatal Abstinence Syndrome (NAS).

Key Risks

Respiratory: Dose-dependent respiratory depression and fatal apnoea. Neurological: Euphoria, rapid tolerance, severe physical/psychological dependence. HIGH — Sedation, delirium, miosis (pinpoint pupils). Gastrointestinal: Severe constipation (paralyzes gut peristalsis), nausea, vomiting.

Key Interactions

Benzodiazepines, Gabapentinoids, Alcohol. Co-administration is the #1 cause of fatal opioid overdoses due to profound synergistic respiratory depression. CYP3A4 inhibitors (Clarithromycin, Azoles) increase oxycodone blood levels and toxicity.

Monitoring

Strict monitoring of SpO2, RR, and Sedation Score (AVPU). Withhold if RR < 12 or patient is unrousable. Must co-prescribe a stimulant laxative (Senna) from Day 1 to prevent bowel impaction.

Clinical Pearl

Never discharge a patient with a box of 20 Endone for a simple sprain. 3 days of opioid use triggers physical tolerance; 5 days triggers withdrawal. Prescribe tiny quantities (e.g., 5-10 tablets) and instruct them to use Paracetamol/Ibuprofen first.

Access

Endone, Oxynorm5 mg tablet

Brand: Endone, Oxynorm
Formulation: Tablets/Capsules (5 mg, 10 mg, 20 mg)

Oxycodone IR

Strong Opioid·Analgesia - Opioids

Moderate to severe acute and chronic pain, post-operative pain, cancer pain

S8PBSOPIOIDEndone, Oxynorm5 mg tablet+1

Max Dose

Titrated

Half-life

3-5 h

Dependence

CRITICAL

Constipation

HIGH RISK

Rapid Summary

Overview

Highly potent, pure mu-opioid receptor agonist. The most widely prescribed strong oral opioid on the ward. Extremely high abuse and dependence potential.

Maximum Dose

No absolute ceiling dose. Titrated strictly to pain response and respiratory tolerance.

Clinical Focus

Has roughly 1.5 to 2 times the oral potency of oral Morphine. Massive risk of iatrogenic addiction if sent home with large discharge supplies.

Bottom Line

Oxycodone IR is a potent Schedule 8 opioid for moderate-severe acute pain, but has high abuse potential and causes significant respiratory depression, constipation, and dependence.

Formulation & Access

Brand Names

Endone, Oxynorm

Oral Routes

Tablets/Capsules (5 mg, 10 mg, 20 mg). Oral liquid (1 mg/mL and 10 mg/mL).

Prescribing & PBS

Highly Restricted (S8). PBS strictly limits quantities for acute pain.

Indications & Use

Primary

PBSTGA

Moderate to severe acute and chronic pain, post-operative pain, cancer pain.

Clinical Place

The workhorse 'breakthrough' analgesic on surgical and medical wards. Used when pain breaks through the Paracetamol/NSAID baseline.

Quick reference

Class & Role

Strong Opioid — Highly potent, pure mu-opioid receptor agonist.

Route / Formulation

Tablets/Capsules (5 mg, 10 mg, 20 mg). Oral liquid (1 mg/mL and 10 mg/mL). (Endone, Oxynorm)

Usual Dose & Max

PO 5-10 mg q4-6h PRN. Titrate to effect. No absolute ceiling dose. Titrated strictly to pain response and respiratory tolerance.

Key Indication Doses

Best Uses

Oxycodone IR is a potent Schedule 8 opioid for moderate-severe acute pain, but has high abuse potential and causes significant respiratory depression, constipation, and dependence.

Avoid / Cautions

Severe respiratory depression, severe acute asthma, paralytic ileus. Pregnancy Category C. Chronic use causes Neonatal Abstinence Syndrome (NAS).

Key Risks

Key Interactions

Monitoring

Strict monitoring of SpO2, RR, and Sedation Score (AVPU). Withhold if RR < 12 or patient is unrousable. Must co-prescribe a stimulant laxative (Senna) from Day 1 to prevent bowel impaction.

Clinical Pearl

Access

Endone, Oxynorm5 mg tablet

Brand: Endone, Oxynorm
Formulation: Tablets/Capsules (5 mg, 10 mg, 20 mg)