Oxycodone for the treatment of postoperative pain

Abstract

The recent interest in oxycodone is based on its favorable pharmacokinetics and pharmacodynamics, especially in the central nervous system. Moreover, relatively high enteral bioavailability allows an easy switch from one drug formulation to another during the course of pain management. Oxycodone is highly effective and well tolerated in different types of surgical procedures and patient groups, from preterm to aged patients. In the future, the use of transmucosal administration and enteral oxycodone-naloxone controlled-release tablets is likely to increase, and an appropriate concurrent use of different enteral drug formulations will decrease the need for more complex administration techniques, such as intravenous patient-controlled analgesia.

Effect of preoperative intravenous oxycodone administration on sufentanil consumption after retroperitoneal laparoscopic nephrectomy

“…One hour after intravenous administration, oxycodone concentration in plasma is three times as high as that in cerebrospinal fluid. This indicates that oxycodone has a strong analgesic effect on the central nervous system [6]. However, the mechanism of the analgesic action of oxycodone is still unknown.…”

Maximizing value in opioid utilization: Is oxycodone immediate release a good option for pain management?

“…[22] Although similar in effect and tolerability to other opioids, there are unique attributes to oxycodone (like any other opioid) that may make it more or less appropriate for a given patient. In the United States, oxycodone is the most-prescribed opioid, [20] although this usage pattern is not observed in other countries. [46] Oxycodone, both as monotherapy and in combination, has demonstrated effectiveness for the treatment of postsurgical pain, [47] cancer pain, [15,48] neuropathic pain, [49][50][51] and acute pain syndromes.…”

“…Among Caucasians, about 8% can be categorized as an oxycodone "poor metabolizer," while 90% or more are "extensive metabolizers" although metabolism in this group is somewhat variable. [20] However, CYP2D6 does not appear to impact the analgesic effect of oxycodone, thus these different metabolizer classifications usually do not impact dosing.…”

“…Oxycodone should be prescribed with caution in patients hepatic dysfunction; in end-stage liver failure the half-life of oxycodone can exceed 12 hours. [20] Oxycodone produces metabolites (most notably oxymorphone and noroxymorphone), but the analgesic effect appears to reside primarily in the parent drug. [21] Oxycodone is indicated for relief of moderate to severe pain [22] and the IR oxycodone oral formulation was designed to allow for highly individualized, patient-tailored pain therapy.…”

“…[21] Oxycodone is indicated for relief of moderate to severe pain [22] and the IR oxycodone oral formulation was designed to allow for highly individualized, patient-tailored pain therapy. Oxycodone is the most frequently prescribed opioid analgesic in the United States and some European countries, [20] although usage patterns for opioids tend to vary widely among nations. [23][24][25] In evaluating the appropriate role of oral oxycodone IR, it is important to consider how pain is actually treated.…”