Safety and Efficacy of Controlled‐Release Oxycodone: A Systematic Literature Review

Abstract

Prescriptions for controlled-release oxycodone, a narcotic analgesic, recently contributed to a dramatic increase in pharmacy costs for a large private insurance company. To determine whether this agent offered clinical benefits over other available drugs that would justify its significantly greater cost, a systematic review of 16 clinical trials was undertaken. The review suggested that immediate-release and controlled-release preparations of oxycodone have similar efficacy and comparable side effect profiles. Controlled-release oxycodone has the advantage of less frequent dosing than immediate-release oxycodone; however, other agents may be dosed infrequently at much lower costs. For patients requiring a controlled-release opioid treatment, controlled-release morphine and methadone should be considered because they appear to be as effective as oxycodone and cost considerably less. Controlled-release oxycodone may be appropriate for some patients, particularly if they cannot tolerate other controlled-release or long-acting opioid analgesics.

A primary care, multi-disciplinary disease management program for opioid-treated patients with chronic non-cancer pain and a high burden of psychiatric comorbidity

“…methadone and long-acting morphine) were preferred over proprietary products of equal or lesser efficacy [55]. …”

Trends in Abuse of OxyContin® and Other Opioid Analgesics in the United States: 2002-2004

“…28 It was approved in 1995 by the Food and Drug Administration (FDA) for use as an analgesic in individuals with moderate to severe pain requiring relief for several days or more. It was judged at the time of its approval to carry a risk of drug abuse because of its properties as a narcotic, and it was placed in Schedule II of the Controlled Substances Act.…”

Early oral analgesia after fast-track cardiac anesthesia

“…Several studies in patients after noncardiac surgery reported good pain control and high patient satisfaction with rapid conversion of iv opioid analgesics to oral immediaterelease or controlled-release oxycodone. [4][5][6] A review of the recent literature 7 suggests that immediate-release and controlled-release oxycodone have similar efficacy in the treatment of noncancer pain and similar side effects. Controlled-release oxycodone may offer the advantage of less frequent dosing, thereby decreasing nursing workload.…”