Oxycodone SR / MR

Strong Opioid·Analgesia - Opioids

Management of severe chronic pain, cancer pain, or severe post-op pain requiring around-the-clock analgesia

S8Authority requiredPBSOPIOIDOxyContin, Targin (Oxycodone/Naloxone)+2

Max Dose

Titrated

Freq

BD Dosing

Do Not Crush

FATAL RISK

Targin

NALOXONE COMBO

Rapid Summary

Overview

Sustained-release pure mu-opioid agonist. Provides a flat, 12-hour baseline of pain control. Often formulated with naloxone (Targin) to prevent gut paralysis.

Maximum Dose

Titrated to effect. Must calculate Total Daily Dose of IR opioids to convert safely to SR.

Clinical Focus

Never crush or chew SR tablets. Doing so destroys the release matrix, dumping 12 hours of fentanyl-strength opioid into the blood instantly, causing fatal respiratory arrest.

Bottom Line

Oxycodone SR / MR is a sustained-release opioid for chronic severe pain requiring around-the-clock analgesia, but must never be crushed (dose-dumping risk) and carries the highest abuse potential among oral opioids.

Formulation & Access

Brand Names

OxyContin, Targin (Oxycodone/Naloxone)

Oral Routes

Sustained-release tablets (5, 10, 15, 20, 30, 40, 80 mg). MUST be swallowed whole.

Prescribing & PBS

Highly Restricted (S8). Authority Required (PBS).

Indications & Use

Primary

PBSTGA

Management of severe chronic pain, cancer pain, or severe post-op pain requiring around-the-clock analgesia.

Clinical Place

The 'Basal' pain control. Should always be paired with an IR 'Bolus' opioid for breakthrough pain.

Quick reference

Class & Role

Strong Opioid — Sustained-release pure mu-opioid agonist.

Route / Formulation

Sustained-release tablets (5, 10, 15, 20, 30, 40, 80 mg). MUST be swallowed whole. (OxyContin, Targin (Oxycodone/Naloxone))

Usual Dose & Max

PO 10-20 mg BD (q12h strictly). Titrate every 2-3 days. Titrated to effect. Must calculate Total Daily Dose of IR opioids to convert safely to SR.

Key Indication Doses

Chronic / Post-Op Pain: PO 10-20 mg BD (q12h strictly). Titrate every 2-3 days. Opioid Conversion: Calculate the 24-hour total of immediate-release (IR) Oxycodone used, divide by 2, and prescribe that amount BD. Elderly / Frail: Start at 5 mg BD.

Best Uses

Avoid / Cautions

Paralytic ileus, severe respiratory depression.

Key Risks

Respiratory: Respiratory depression, especially during dose escalation or if tablets are crushed. Gastrointestinal: Constipation (Significantly lower if using Targin, but still requires monitoring). Neurological: Sedation, delirium, tolerance, hyperalgesia (worsening pain sensitivity with chronic use).

Key Interactions

Benzodiazepines (Synergistic respiratory arrest). CYP3A4 inhibitors (spikes levels).

Monitoring

Monitor SpO2, RR, and Sedation score. If the patient is difficult to rouse, withhold the next dose immediately and notify medical staff. Ensure the patient is actually swallowing the tablet intact. Checking mouths in confused patients is critical to prevent chewing.

Clinical Pearl

The Naloxone in Targin has a ceiling. If you prescribe more than 80/40mg or 120/60mg of Targin a day, the liver becomes overwhelmed and the Naloxone spills into the blood, triggering withdrawal. If they need massive doses, switch back to OxyContin + Senna.

Access

Authority requiredOxyContin, Targin (Oxycodone/Naloxone)80 mg tablet

Brand: OxyContin, Targin (Oxycodone/Naloxone)
PBS status: Authority required
Formulation: Sustained-release tablets (5, 10, 15, 20, 30, 40, 80 mg)