Oxycodone HCl 15mg – Mid-Range Opioid for Moderate-to-Severe Pain
(Available in Immediate-Release [IR] and Extended-Release [ER] Formulations)
Therapeutic Profile
• Schedule II Controlled Substance (High Abuse Potential)
• Onset/Duration:
-
IR: 15-30 min onset | 4-6 hr duration
-
ER: 1-2 hr onset | 12 hr duration
• Metabolism: Liver (CYP3A4/2D6) – Caution with inhibitors/inducers
Clinical Indications
✔ Breakthrough Cancer Pain (with ER baseline)
✔ Post-Surgical Pain (IR only, short-term)
✔ Chronic Pain (ER only for opioid-tolerant patients)
✔ Trauma/Injury Pain (IR, ≤5 day supply recommended)
Dosing Guidelines
For OPIOID-NAÏVE Patients (IR only):
-
Not recommended as initial dose – start with 5mg
-
Only after tolerance established: 15mg q4-6h PRN
For OPIOID-TOLERANT Patients:
-
ER: 15mg q12h (must be on ≥30mg MEDD baseline)
-
IR: 15mg q4-6h PRN breakthrough pain
Critical Administration Notes:
-
ER Tablets: Must swallow whole – never crush/chew (risk of fatal overdose)
-
IR Tablets: May be split for dose titration
-
Food Effect: High-fat meals increase ER absorption
Abuse-Deterrent Formulations
-
OxyContin ER 15mg: Round, gray tablet with “OP” on one side
-
Xtampza ER: Capsule formulation (tamper-resistant)
-
IR Options: Oxaydo (nasal abuse-resistant)
Black Box Warnings
⚠️ HIGH ADDICTION/OVERDOSE RISK
⚠️ LIFE-THREATENING RESPIRATORY DEPRESSION (especially with alcohol/benzos)
⚠️ NEONATAL OPIOID WITHDRAWAL SYNDROME
Safety & Monitoring Requirements
• Naloxone Co-Prescription Mandatory
• PDMP Check Before Each Prescription
• Urine Drug Screening for Chronic Use
• Storage: Locked container required
• Max Initial IR Prescription: 3-7 day supply
Special Populations
-
Elderly: Reduce dose by 25-50%
-
Renal Impairment: Avoid ER if CrCl <30mL/min
-
Hepatic Dysfunction: Start with 50% dose
