 |
 |
 |
 |
#83944 - 03/04/04 06:02 AM
Oxycodone - Oxycontin
|
Moderator
Pooh-Bah
Registered: 03/20/03
Posts: 1384
Loc: DrugBuyers.Com
|
Oxycodone HCl
WARNING
OxyContin® is an opioid agonist and a Schedule II controlled substance with an abuse liability similar to morphine.
Oxycodone can be abused in a manner similar to other opioid agonists, legal or illicit. This should be considered when prescribing or dispensing OxyContin® in situations where the physician or pharmacist is concerned about an increased risk of misuse, abuse, or diversion.
OxyContin® tablets are a controlled-release oral formulation of oxycodone hydrochloride indicated for the management of moderate to severe pain when a continuous, around-the-clock analgesic is needed for an extended period of time.
OxyContin® tablets are NOT intended for use as a prn analgesic.
OxyContin® 80 mg and 160 mg Tablets ARE FOR USE IN OPIOID TOLERANT PATIENTS ONLY. These tablet strengths may cause fatal respiratory depression when administered to patients not previously exposed to opioids.
OxyContin® (oxycodone hydrochloride controlled-release) TABLETS ARE TO BE SWALLOWED WHOLE AND ARE NOT TO BE BROKEN, CHEWED, OR CRUSHED. TAKING BROKEN, CHEWED, OR CRUSHED OxyContin® TABLETS LEADS TO RAPID RELEASE AND ABSORPTION OF A POTENTIALLY FATAL DOSE OF OXYCODONE.
OxyContin® (oxycodone hydrochloride controlled-release) tablets are an opioid analgesic supplied in 10 mg, 20 mg, 40 mg, 80 mg, and 160 mg tablet strengths for oral administration. The tablet strengths describe the amount of oxycodone per tablet as the hydrochloride salt.
Its molecular formula is C18H21NO4 · HCl. Its molecular weight is 351.83.
The chemical formula is 4, 5-epoxy-14-hydroxy-3-methoxy-17-methylmorphinan-6-one hydrochloride.
Oxycodone is a white, odorless crystalline powder derived from the opium alkaloid, thebaine. Oxycodone hydrochloride dissolves in water (1 g in 6 to 7 mL). It is slightly soluble in alcohol (octanol water partition coefficient 0.7). The tablets contain the following inactive ingredients: ammonio methacrylate copolymer, hydroxypropyl methylcellulose, lactose, magnesium stearate, povidone, red iron oxide (20 mg strength tablet only), stearyl alcohol, talc, titanium dioxide, triacetin, yellow iron oxide (40 mg strength tablet only), yellow iron oxide with FD&C blue No.2 (80 mg strength tablet only), FD&C blue No.2 (160 mg strength tablet only) and other ingredients.
INDICATIONS
OxyContin® tablets are a controlled-release oral formulation of oxycodone hydrochloride indicated for the management of moderate to severe pain when a continuous, around-the-clock analgesic is needed for an extended period of time.
OxyContin® is NOT intended for use as a prn analgesic.
Physicians should individualize treatment in every case, initiating therapy at the appropriate point along a progression from non-opioid analgesics, such as nonsteroidal anti-inflammatory drugs and acetaminophen to opioids in a plan of pain management such as outlined by the World Health Organization, the Agency for Health Research and Quality (formerly known as the Agency for Health Care Policy and Research), the Federation of State Medical Boards Model Guidelines, or the American Pain Society.
OxyContin® is not indicated for pain in the immediate post-operative period (the first 12-24 hours following surgery), or if the pain is mild, or not expected to persist for an extended period of time. OxyContin® is only indicated for post-operative use if the patient is already receiving the drug prior to surgery or if the postoperative pain is expected to be moderate to severe and persist for an extended period of time. Physicians should individualize treatment, moving from parenteral to oral analgesics as appropriate. (See American Pain Society guidelines.)
DOSAGE AND ADMINISTRATION
General Principles
OxyContin® IS AN OPIOID AGONIST AND A SCHEDULE II CONTROLLED SUBSTANCE WITH AN ABUSE LIABILITY SIMILAR TO MORPHINE.
OXYCODONE, LIKE MORPHINE AND OTHER OPIOIDS USED IN ANALGESIA, CAN BE ABUSED AND IS SUBJECT TO CRIMINAL DIVERSION.
OxyContin® (oxycodone hydrochloride controlled-release) TABLETS ARE TO BE SWALLOWED WHOLE, AND ARE NOT TO BE BROKEN, CHEWED OR CRUSHED. TAKING BROKEN, CHEWED OR CRUSHED OxyContin® TABLETS LEADS TO THE RAPID RELEASE AND ABSORPTION OF A POTENTIALLY FATAL DOSE OF OXYCODONE.
One OxyContin® 160 mg tablet is comparable to two 80 mg tablets when taken on an empty stomach. With a high fat meal, however, there is a 25% greater peak plasma concentration following one 160 mg tablet. Dietary caution should be taken when patients are initially titrated to 160 mg tablets (see Special Instructions for OxyContin® 80 mg and 160 mg Tablets).
In treating pain it is vital to assess the patient regularly and systematically. Therapy should also be regularly reviewed and adjusted based upon the patient's own reports of pain and side effects and the health professional's clinical judgment.
OxyContin® tablets are a controlled-release oral formulation of oxycodone hydrochloride indicated for the management of moderate to severe pain requiring treatment with a strong opioid for continuous, around-the-clock analgesia for an extended period of time. The controlled-release nature of the formulation allows OxyContin® to be effectively administered every 12 hours (see CLINICAL PHARMACOLOGY: PHARMACOKINETICS AND METABOLISM). While symmetric (same dose AM and PM), around-the-clock, q12h dosing is appropriate for the majority of patients, some patients may benefit from asymmetric (different dose given in AM than in PM) dosing, tailored to their pain pattern. It is usually appropriate to treat a patient with only one opioid for around-the-clock therapy.
Physicians should individualize treatment using a progressive plan of pain management such as outlined by the World Health Organization, the American Pain Society and the Federation of State Medical Boards Model Guidelines. Health care professionals should follow appropriate pain management principles of careful assessment and ongoing monitoring [See BOXED WARNING].
Initiation of Therapy
It is critical to initiate the dosing regimen for each patient individually, taking into account the patient's prior opioid and non-opioid analgesic treatment. Attention should be given to:
(1) the general condition and medical status of the patient;
(2) the daily dose, potency, and kind of the analgesic(s) the patient has been taking;
(3) the reliability of the conversion estimate used to calculate the dose of oxycodone;
(4) the patient's opioid exposure and opioid tolerance (if any);
(5) special safety issues associated with conversion to OxyContin® doses at or exceeding 160 mg q12h (see Special Instructions for OxyContin® 80 mg and 160 mg Tablets); and
(6) the balance between pain control and adverse experiences.
Care should be taken to use low initial doses of OxyContin® in patients who are not already opioid-tolerant, especially those who are receiving concurrent treatment with muscle relaxants, sedatives, or other CNS active medications (see drug INTERACTIONS).
For initiation of OxyContin® therapy for patients previously taking opioids, the conversion ratios from Foley, KM. [NEJM, 1985; 313:84-95], found below, are a reasonable starting point, although not verified in well-controlled, multiple-dose trials.
Experience indicates a reasonable starting dose of OxyContin® for patients who are taking non-opioid analgesics and require continuous around-the-clock therapy for an extended period of time is 10 mg q12h. If a non-opioid analgesic is being provided, it may be continued. OxyContin® should be individually titrated to a dose that provides adequate analgesia and minimizes side effects.
1. Using standard conversion ratio estimates (see Table 4 below), multiply the mg/day of the previous opioids by the appropriate multiplication factors to obtain the equivalent total daily dose of oral oxycodone.
2. When converting from oxycodone, divide the 24-hour oxycodone dose in half to obtain the twice a day (q12h) dose of OxyContin®.
3. Round down to a dose which is appropriate for the tablet strengths available (10 mg, 20 mg, 40 mg, 80 mg, and 160 mg tablets).
4. Discontinue all other around-the-clock opioid drugs when OxyContin® therapy is initiated.
5. No fixed conversion ratio is likely to be satisfactory in all patients, especially patients receiving large opioid doses. The recommended doses shown in Table 4 are only a starting point, and close observation and frequent titration are indicated until patients are stable on the new therapy.
Table 4
Multiplication Factors for Converting the Daily Dose of
Prior Opioids to the Daily Dose of Oral Oxycodone*
(Mg/Day Prior Opioid x Factor = Mg/Day Oral Oxycodone)
Oral Prior Opioid Parenteral Prior Opioid
Oxycodone 1 —
Codeine 0.15 —
Hydrocodone 0.9 —
Hydromorphone 4 20
Levorphanol 7.5 15
Meperidine 0.1 0.4
Methadone 1.5 3
Morphine 0.5 3
To be used only for conversion to oral oxycodone. For patients receiving high-dose parenteral opioids, a more conservative conversion is warranted. For example, for high-dose parenteral morphine, use 1.5 instead of 3 as a multiplication factor.
In all cases, supplemental analgesia (see below) should be made available in the form of a suitable short-acting analgesic.
OxyContin® can be safely used concomitantly with usual doses of non-opioid analgesics and analgesic adjuvants, provided care is taken to select a proper initial dose (see PRECAUTIONS).
Conversion from Transdermal Fentanyl to OxyContin®
Eighteen hours following the removal of the transdermal fentanyl patch, OxyContin® treatment can be initiated. Although there has been no systematic assessment of such conversion, a conservative oxycodone dose, approximately 10 mg q12h of OxyContin®, should be initially substituted for each 25 µg/hr fentanyl transdermal patch. The patient should be followed closely for early titration, as there is very limited clinical experience with this conversion.
Managing Expected Opioid Adverse Experiences
Most patients receiving opioids, especially those who are opioid-naive, will experience side effects. Frequently the side effects from OxyContin® are transient, but may require evaluation and management. Adverse events such as constipation should be anticipated and treated aggressively and prophylactically with a stimulant laxative and/or stool softener. Patients do not usually become tolerant to the constipating effects of opioids.
Other opioid-related side effects such as sedation and nausea are usually self-limited and often do not persist beyond the first few days. If nausea persists and is unacceptable to the patient, treatment with anti-emetics or other modalities may relieve these symptoms and should be considered.
Patients receiving OxyContin® may pass an intact matrix "ghost" in the stool or via colostomy. These ghosts contain little or no residual oxycodone and are of no clinical consequence.
Individualization of Dosage
Once therapy is initiated, pain relief and other opioid effects should be frequently assessed. Patients should be titrated to adequate effect (generally mild or no pain with the regular use of no more than two doses of supplemental analgesia per 24 hours). Patients who experience breakthrough pain may require dosage adjustment or rescue medication. Because steady-state plasma concentrations are approximated within 24 to 36 hours, dosage adjustment may be carried out every 1 to 2 days. It is most appropriate to increase the q12h dose, not the dosing frequency. There is no clinical information on dosing intervals shorter than q12h. As a guideline, except for the increase from 10 mg to 20 mg q12h, the total daily oxycodone dose usually can be increased by 25% to 50% of the current dose at each increase.
If signs of excessive opioid-related adverse experiences are observed, the next dose may be reduced. If this adjustment leads to inadequate analgesia, a supplemental dose of immediate-release oxycodone may be given. Alternatively, non-opioid analgesic adjuvants may be employed. Dose adjustments should be made to obtain an appropriate balance between pain relief and opioid-related adverse experiences.
If significant adverse events occur before the therapeutic goal of mild or no pain is achieved, the events should be treated aggressively. Once adverse events are under control, upward titration should continue to an acceptable level of pain control.
During periods of changing analgesic requirements, including initial titration, frequent contact is recommended between physician, other members of the healthcare team, the patient and the caregiver/family.
Special Instructions for OxyContin® 80 mg and 160 mg Tablets (For use in opioid-tolerant patients only)
OxyContin® 80 mg and 160 mg Tablets are for use only in opioid-tolerant patients requiring daily oxycodone equivalent dosages of 160 mg or more for the 80 mg tablet and 320 mg or more for the 160 mg tablet. Care should be taken in the prescribing of these tablet strengths. Patients should be instructed against use by individuals other than the patient for whom it was prescribed, as such inappropriate use may have severe medical consequences, including death.
One OxyContin® 160 mg tablet is comparable to two 80 mg tablets when taken on an empty stomach. With a high fat meal, however, there is a 25% greater peak plasma concentration following one 160 mg tablet. Dietary caution should be taken when patients are initially titrated to 160 mg tablets.
Supplemental Analgesia
Most patients given around-the-clock therapy with controlled-release opioids may need to have immediate-release medication available for exacerbations of pain or to prevent pain that occurs predictably during certain patient activities (incident pain).
Maintenance of Therapy
The intent of the titration period is to establish a patient-specific q12h dose that will maintain adequate analgesia with acceptable side effects for as long as pain relief is necessary. Should pain recur then the dose can be incrementally increased to re-establish pain control. The method of therapy adjustment outlined above should be employed to re-establish pain control.
During chronic therapy, especially for non-cancer pain syndromes, the continued need for around-the-clock opioid therapy should be reassessed periodically (e.g., every 6 to 12 months) as appropriate.
Cessation of Therapy
When the patient no longer requires therapy with OxyContin® tablets, doses should be tapered gradually to prevent signs and symptoms of withdrawal in the physically dependent patient.
Conversion from OxyContin® to Parenteral Opioids
To avoid overdose, conservative dose conversion ratios should be followed.
SAFETY AND HANDLING
OxyContin® (oxycodone HCl controlled-release) tablets are solid dosage forms that contain oxycodone which is a controlled substance. Like morphine, oxycodone is controlled under Schedule II of the Controlled Substances Act. OxyContin® has been targeted for theft and diversion by criminals. Healthcare professionals should contact their State Professional Licensing Board or State Controlled Substances Authority for information on how to prevent and detect abuse or diversion of this product.
HOW SUPPLIED
OxyContin® (oxycodone hydrochloride controlled-release) 10 mg tablets are round, unscored, white-colored, convex tablets bearing the symbol OC on one side and 10 on the other. They are supplied as follows:
NDC 59011-100-10: child-resistant closure, opaque plastic bottles of 100
NDC 59011-100-25: unit dose packaging with 25 individually numbered tablets per card; one card per glue end carton
OxyContin® (oxycodone hydrochloride controlled-release) 20 mg tablets are round, unscored, pink-colored, convex tablets bearing the symbol OC on one side and 20 on the other. They are supplied as follows:
NDC 59011-103-10: child-resistant closure, opaque plastic bottles of 100
NDC 59011-103-25: unit dose packaging with 25 individually numbered tablets per card; one card per glue end carton
OxyContin® (oxycodone hydrochloride controlled-release) 40 mg tablets are round, unscored, yellow-colored, convex tablets bearing the symbol OC on one side and 40 on the other. They are supplied as follows:
NDC 59011-105-10: child-resistant closure, opaque plastic bottles of 100
NDC 59011-105-25: unit dose packaging with 25 individually numbered tablets per card; one card per glue end carton
OxyContin® (oxycodone hydrochloride controlled-release) 80 mg tablets are round, unscored, green-colored, convex tablets bearing the symbol OC on one side and 80 on the other. They are supplied as follows:
NDC 59011-107-10: child-resistant closure, opaque plastic bottles of 100
NDC 59011-107-25: unit dose packaging with 25 individually numbered tablets per card; one card per glue end carton
OxyContin® (oxycodone hydrochloride controlled-release) 160 mg tablets are caplet-shaped, unscored, blue-colored, convex tablets bearing the symbol OC on one side and 160 on the other. They are supplied as follows:
NDC 59011-109-10: child-resistant closure, opaque plastic bottles of 100
NDC 59011-109-25: unit dose packaging with 25 individually numbered tablets per card; one card per glue end carton
Store at 25°C (77 F); excursions permitted between 15°-30°C (59°-86°F).
Dispense in tight, light-resistant container.
Healthcare professionals can telephone Purdue Pharma’s Medical Services Department (1-888-726-7535) for information on this product.
PATIENT INFORMATION
If clinically advisable, patients receiving OxyContin® (oxycodone hydrochloride controlled-release) tablets or their caregivers should be given the following information by the physician, nurse, pharmacist, or caregiver:
1. Patients should be aware that OxyContin® tablets contain oxycodone, which is a morphine-like substance.
2. Patients should be advised that OxyContin® tablets were designed to work properly only if swallowed whole. OxyContin® tablets will release all their contents at once if broken, chewed, or crushed, resulting in a risk of fatal overdose.
3. Patients should be advised to report episodes of breakthrough pain and adverse experiences occurring during therapy. Individualization of dosage is essential to make optimal use of this medication.
4. Patients should be advised not to adjust the dose of OxyContin® without consulting the prescribing professional.
5. Patients should be advised that OxyContin® may impair mental and/or physical ability required for the performance of potentially hazardous tasks (e.g., driving, operating heavy machinery).
6. Patients should not combine OxyContin® with alcohol or other central nervous system depressants (sleep aids, tranquilizers) except by the orders of the prescribing physician, because dangerous additive effects may occur, resulting in serious injury or death.
7. Women of childbearing potential who become, or are planning to become, pregnant should be advised to consult their physician regarding the effects of analgesics and other drug use during pregnancy on themselves and their unborn child.
8. Patients should be advised that OxyContin® is a potential drug of abuse. They should protect it from theft, and it should never be given to anyone other than the individual for whom it was prescribed.
9. Patients should be advised that they may pass empty matrix "ghosts" (tablets) via colostomy or in the stool, and that this is of no concern since the active medication has already been absorbed.
10. Patients should be advised that if they have been receiving treatment with OxyContin® for more than a few weeks and cessation of therapy is indicated, it may be appropriate to taper the OxyContin® dose, rather than abruptly discontinue it, due to the risk of precipitating withdrawal symptoms. Their physician can provide a dose schedule to accomplish a gradual discontinuation of the medication.
11. Patients should be instructed to keep OxyContin® in a secure place out of the reach of children. When OxyContin® is no longer needed, the unused tablets should be destroyed by flushing down the toilet.
|
|
Top
|
|
|
|
|
 |
 |
 |
 |
|
|
|
|
|
#83945 - 05/10/04 06:14 PM
Oxycontin - Questions & Answers
|
Administrator
GRAND Pooh-Bah
Registered: 11/18/01
Posts: 6596
Loc: DrugBuyers.Com
|
Link to FDA - Source Quote:
OxyContin: Questions and Answers
--------------------------------------------------------------------------------
Questions and Answers about OxyContin
What kind of medicine is OxyContin?
What kind of pain is appropriate to treat with OxyContin?
How do I know if I have the right kind of pain to use OxyContin?
Are there any activities that I should not perform while using OxyContin for pain relief?
What should I do if I still have pain after I take the OxyContin?
Can I take other medicines while I am using OxyContin for pain relief?
Can I drink an alcoholic beverage while I am using OxyContin for pain relief?
Will I become addicted to OxyContin if I take it every day?
What should I do when I no longer need the OxyContin for pain relief?
Haven't there been press reports about the misuse of OxyContin?
Can I take OxyContin if I am pregnant, planning to become pregnant, or planning to nurse my baby?
Are there any other special precautions I should take with my OxyContin?
1. What kind of medicine is OxyContin?
OxyContin contains oxycodone, a very strong narcotic pain reliever similar to morphine. OxyContin is designed so that the oxycodone is slowly released over time, allowing it to be used twice daily. You should never break, chew, or crush the OxyContin tablet since this causes a large amount of oxycodone to be released from the tablet all at once, potentially resulting in a dangerous or fatal drug overdose.
2. What kind of pain is appropriate to treat with OxyContin?
OxyContin is intended to help relieve pain that is moderate to severe in intensity, when that pain is present all the time, and expected to continue for a long time. This level of pain severity may be caused by a variety of different medical conditions.
Back to Top
3. How do I know if I have the right kind of pain to use OxyContin?
Only a physician can determine if OxyContin is a good choice to manage a your pain. If you have pain every day that lasts for a large part of the day, and the pain is moderate or severe in intensity, depending upon other factors in your medical history, OxyContin may be a good choice for you. Speak with your physician.
If you feel you only need to take a pain reliever occasionally and this adequately treats your pain, OxyContin is NOT the right drug for you. If you only need a pain reliever for a few days, for example following a dental or surgical procedure, OxyContin is not the right drug for you.
4. Are there any activities that I should not perform while using OxyContin for pain relief?
OxyContin may interfere with your ability to do certain things that require your full attention. You should not drive a car, operate heavy machinery, or do other possibly dangerous activities while taking OxyContin.
Back to Top
5. What should I do if I still have pain after I take the OxyContin?
Because OxyContin is a very strong medication, you should not adjust the dose without first speaking with your physician.
6. Can I take other medicines while I am using OxyContin for pain relief?
Combining OxyContin with some other types of medication such as sleeping pills, tranquilizers, and other pain medications may be dangerous due to the risk of interactions of these medications that can result in injury or death. You should speak with your physician before taking any other medicines with OxyContin. You should also tell your physician about all prescription drugs, over-the-counter drugs, and dietary supplements/herbal remedies that you are taking before starting OxyContin.
Back to Top
7. Can I drink an alcoholic beverage while I am using OxyContin for pain relief?
You should not drink any beverage that contains alcohol while you are taking OxyContin. This includes beer, wine, and all distilled liquors. OxyContin and alcoholic beverages may have dangerous interactions that can result in serious injury or death.
8. Will I become addicted to OxyContin if I take it every day?
OxyContin is only intended for moderate to severe pain that is present on a daily basis and that requires a very strong pain reliever. Patients with this type of severe pain condition require daily pain treatment. Taking OxyContin daily can result in physical dependence, a condition in which the body shows signs of narcotic withdrawal if the OxyContin is stopped suddenly. This is not the same thing as addiction, which represents a situation in which people obtain and take narcotics because of a psychological need, and not just to treat a legitimate painful condition. Physical dependence can be treated by slowly under the advice of a physician by slowing decreasing the OxyContin dose when it is no longer needed for the treatment of pain. Concerns of addiction should not prevent patients with appropriate pain conditions from using OxyContin or other narcotics for pain relief.
Back to Top
9. What should I do when I no longer need the OxyContin for pain relief?
When you no longer need OxyContin, the dose should be gradually reduced so that you do not feel sick with withdrawal symptoms. You should ask your physician for a plan on how to gradually decrease the dose and when to stop the OxyContin.
10. Haven't there been press reports about the misuse of OxyContin?
OxyContin is a safe and effective pain medication when properly prescribed and used as directed. OxyContin has also been used as a drug of abuse. You should protect your prescription and your medication from theft and never give OxyContin to anyone else. You should destroy any left over OxyContin tablets that you may have once your physician instructs you to stop taking the medication.
Back to Top
11. Can I take OxyContin if I am pregnant, planning to become pregnant, or planning to nurse my baby?
Your should speak to your physician about the effects of drugs like OxyContin on an unborn or newborn child.
12. Are there any other special precautions I should take with my OxyContin?
Because there is a large dose of medication in each OxyContin tablet, you must be very careful to keep OxyContin stored in a secure location, out of the reach of children. When you no longer need OxyContin for pain relief, you should flush the unused tablets down the toilet.
|
|
Top
|
|
|
|
|
|
|
|
|
|
|
|
|
|
#83946 - 05/10/04 06:17 PM
Oxycontin - FDA STRENGTHENS WARNINGS
|
Administrator
GRAND Pooh-Bah
Registered: 11/18/01
Posts: 6596
Loc: DrugBuyers.Com
|
LINK
Quote:
FDA STRENGTHENS WARNINGS FOR OXYCONTIN
FDA has strengthened the warnings and precautions sections in the labeling of OxyContin (oxycodone HCl controlled-release) Tablets, a narcotic drug approved for the treatment of moderate to severe pain, because of continuing reports of abuse and diversion.
OxyContin contains oxycodone HCL, an opioid agonist with an addiction potential similar to that of morphine. Opioid agonists are substances that act by attaching to specific proteins called opioid receptors, which are found in the brain, spinal cord, and gastrointestinal tract. When these drugs attach to certain opioid receptors in the brain and spinal cord they can effectively block the transmission of pain messages to the brain.
OxyContin is a controlled substance in Schedule II of the Controlled Substances Act (CSA), which is administered by the drug Enforcement Administration (DEA). Schedule II provides the maximum amount of control possible under the CSA for approved drug products.
In recent months, there have been numerous reports of OxyContin diversion and abuse in several states. Some of these reported cases have been associated with serious consequences including death. In an effort to educate health care providers about these risks, Purdue Pharmaceuticals, manufacturer of the product, has issued a warning in the form of a "Dear Healthcare Professional" letter. The "Dear Healthcare Professional" letter will be distributed widely to physicians, pharmacists, and other healthcare professionals. The letter explains the changes to the labeling including proper prescribing information and highlights the problems associated with the abuse and diversion of OxyContin.
OxyContin, like morphine, has a high potential for abuse. It is supplied in a controlled-release dosage form and is intended to provide up to 12 hours of relief from moderate to severe pain. The tablet must be taken whole and only by mouth. When the tablet is crushed and its contents are injected intravenously or snorted into the nostrils, the controlled release mechanism is defeated and a potentially lethal dose of oxycodone is released immediately.
FDA has worked with Purdue to make specific changes to the OxyContin labeling. The new labeling is intended to change prescription practices as well as increase the physicians' focus on the potential for abuse, misuse, and diversion.
Changes include a "black box warning", the strongest type of warning for an FDA-approved drug. The new warnings are intended to lessen the chance that OxyContin will be prescribed inappropriately for pain of lesser severity than the approved use or for other disorders or conditions inappropriate for a Schedule II narcotic.
The FDA-approved indication for OxyContin is for the treatment of patients with moderate to severe pain who are expected to need continuous opioids for an extended time. An important factor that must be considered in prescribing OxyContin is the severity of the pain that is being treated, not simply the disease causing the painful symptoms.
FDA continues to recommend that appropriate pain control be provided to patients who are living with severe pain. Although abuse, misuse, and diversion are potential problems for all opioids, including OxyContin, opioids are a very important part of the medical armamentarium for the management of pain when used appropriately under the careful supervision of a physician.
Because of the ongoing problem of OxyContin abuse and diversion, FDA has met with DEA, the Substance Abuse and Mental Health Service Agency, the National Institute on drug Abuse, Purdue, Inc., and others. FDA will continue to monitor reports of abuse, misuse, and diversion of OxyContin and other opioids and will work with other federal agencies and drug manufacturers to help ensure that these important drugs remain available to appropriate patients.
Since all opioids are subject to abuse, misuse, and diversion, FDA is encouraging all manufacturers of opioids sold in the U.S. to review voluntarily, and revise as necessary, their product's labeling to provide adequate warnings and precautions regarding these risks and to promote responsible prescribing practices.
For more information, patients and healthcare providers can call Purdue Pharmaceuticals at 1-888-726-7535, or go to FDA's website at www.fda.gov/cder/drug/infopage/oxycontin/.
|
|
Top
|
|
|
|
|
|
|
|
|
|
|
|
|
|
#83947 - 05/10/04 06:20 PM
OxyContin Diversion and Abuse
|
Administrator
GRAND Pooh-Bah
Registered: 11/18/01
Posts: 6596
Loc: DrugBuyers.Com
|
LINK
OxyContin Diversion and Abuse
Overview
Diversion and abuse of the prescription pain reliever OxyContin is a major problem, particularly in the eastern United States. The drug Enforcement Administration (DEA) reports that, in the United States, oxycodone products, including OxyContin, are frequently abused pharmaceuticals. The pharmacological effects of OxyContin make it a suitable substitute for heroin; therefore, it is attractive to the same abuser population. Law enforcement reports indicate heroin abusers are obtaining OxyContin because the pharmaceutical drug offers reliable strength and dosage levels. In addition, if the abusers' health insurance covers an illness that the drug treats, the insurance provider may cover the cost of the drug. Conversely, OxyContin abusers who have never used heroin may be attracted to the lower priced heroin when their health insurance no longer pays for OxyContin prescriptions or when they cannot afford the high street-level price of OxyContin. For example the West Virginia, Hancock-Brooke-Weirton drug Task Force reports that a local couple, recently sentenced for conspiracy to sell heroin, turned to heroin after their doctor refused to continue prescribing OxyContin and they could not afford the street price of the pharmaceutical. OxyContin abusers sometimes commit theft, armed robbery, and fraud to sustain their habits.
The illegal diversion, distribution, and abuse of oxycodone products, particularly OxyContin, appear to be concentrated most heavily in the East, according to respondents to the National drug Intelligence Center (NDIC) National drug Threat Survey 2000 and DEA reporting. OxyContin Tablet, commonly referred to as OxyContin, has become the oxycodone product of choice in Maine, Ohio, and West Virginia, and in portions of eastern Kentucky, Maryland, western Pennsylvania, and rural southwestern Virginia.
Background
OxyContin is a trade name product for the generic narcotic oxycodone hydrochloride, an opiate agonist. Opiate agonists provide pain relief by acting on opioid receptors in the spinal cord, brain, and possibly in the tissues directly. Opioids, natural or synthetic classes of drugs that act like morphine, are the most effective pain relievers available. Oxycodone is manufactured by modifying thebaine, an alkaloid found in opium. Oxycodone has a high abuse potential and is prescribed for moderate to high pain relief associated with injuries, bursitis, dislocation, fractures, neuralgia, arthritis, and lower back and cancer pain. It is also used postoperatively and for pain relief after childbirth. Percocet, Percodan, and Tylox are other trade name oxycodone products.
Oxycodone is a central nervous system depressant. Oxycodone's action appears to work through stimulating the opioid receptors found in the central nervous system that activate responses ranging from analgesia to respiratory depression to euphoria. People who take the drug repeatedly can develop a tolerance or resistance to the drug's effects. Thus, a cancer patient can take a dose of oxycodone on a regular basis that would be fatal in a person never exposed to oxycodone or another opioid. Most individuals who abuse oxycodone seek to gain the euphoric effects, mitigate pain, and avoid withdrawal symptoms associated with oxycodone or heroin abstinence.
OxyContin is an oral, controlled-release oxycodone that acts for 12 hours, making it the longest lasting oxycodone on the market. Patients taking shorter acting oxycodone products, such as Percocet, may need to take the product every 4 to 6 hours. While drug doses vary by individual, the typical OxyContin dose prescribed by physicians ranges from two to four tablets per day. OxyContin was developed and patented in 1996 by Purdue Pharma L.P. and was originally available in 10 milligram (mg), 20 mg, 40 mg, and 80 mg tablets. A 160 mg tablet became available in July 2000. By comparison, Percocet and Tylox contain 5 mg of oxycodone and Percodan-Demi contains just 2.25 mg. The strength, duration, and known dosage of OxyContin are the primary reasons the drug is attractive to both abusers and legitimate users.
Abuse
The abuse of oxycodone products in general has increased in recent years. In April 2000, The Journal of the American Medical Association (JAMA) published a study, which examined two data collection sources. The DEA Automation of Reports and Consolidated Orders System (ARCOS) data tracks the distribution of oxycodone and other opioid analgesics and the drug Abuse Warning Network (DAWN) Medical Examiner (ME) and Emergency Department (ED) data ascertained the health consequences associated with its abuse from 1990 to 1996. The JAMA study found a 23 percent increase in the medical use of oxycodone with no corresponding increase in the illicit abuse of the drug. However, 1998 DAWN ME data reported a 93 percent increase in oxycodone mentions between 1997 and 1998 and the number of oxycodone-related DAWN ED mentions increased 32.4 percent from 1997 (4,857) to 1999 (6,429).
Opioids, Pain, and Addiction
Addiction to opioids used for legitimate medical purposes under a qualified physician's care is rare. According to the National Institute on drug Abuse, however, many physicians limit prescribing powerful opioid pain medications because they believe patients may become addicted to the drugs. Recent evidence suggests that, unlike opioid abusers, most healthy, nondrug-abusing patients do not report euphoria after being administered opioids, possibly because their level of pain may reduce some of the opioid's euphoric effects making patients less likely to become abusers. (Source: NIDA INFOFAX Pain Medications)
Several deaths have resulted specifically from the abuse of OxyContin in Kentucky, Ohio, Virginia, and West Virginia. The Pike County, Kentucky, Coroner reported 19 OxyContin-related deaths during calendar year 2000. In December 2000, seven OxyContin overdose deaths were reported in Southeastern Kentucky by two Kentucky State Police posts. The Logan Daily News reported in October 2000 that four Hocking County, Ohio, residents overdosed on OxyContin over an 18-day period. Two of the four died. There have been at least four OxyContin overdose deaths in Pulaski, Virginia, since 1998. In July 2000, The Williamson Daily reported five OxyContin-related overdose deaths in southwestern West Virginia since May 2000
Related Criminal Activity
and Diversion
OxyContin abuse has led to an increased number of pharmacy robberies, thefts, shoplifting incidents, and health care fraud incidents, as illustrated by the following:
Maine-In June 2000, the Bangor Daily News reported the arrest of an individual charged with selling approximately $8,000 worth of OxyContin weekly. The OxyContin was prescribed to the individual's wife to control cancer-related pain. The husband illegally diverted some of the pills, which allegedly were paid for by Medicaid, for a substantial profit.
Maine-In August 2000, the Portland Press Herald reported that law enforcement authorities dismantled a drug ring accused of obtaining OxyContin by forging prescriptions, having them filled at pharmacies in southern Maine and New Hampshire, and covering the costs with their Medicaid cards.
Ohio-A heroin addict who learned about OxyContin at a methadone clinic committed at least seven aggravated robberies in early 2000 attempting to finance his 800-mg-a-day OxyContin habit.
Pennsylvania-The Cambria County drug Task Force views prescription fraud as the fastest growing crime in Cambria County; an increase in the number of pharmacy burglaries in the county is directly related to OxyContin abuse. For example, on January 1, 2001, a robber stole more than $1,000 worth of OxyContin from a local pharmacy.
Pennsylvania-In December 2000, the Pennsylvania State Police reported an attempted armed robbery at a pharmacy in Clearfield County, where the suspect sought OxyContin.
Virginia-The Police Chief in Pulaski reported in October 2000 that approximately 90 percent of all thefts, burglaries, and shoplifting incidents in the area were linked to the OxyContin trade.
Virginia-Prosecutors in Tazewell County reported in October 2000 that more than 150 people have been charged with felonies associated with OxyContin abuse. Since February 1999, thieves reportedly demanded only OxyContin in at least 10 pharmacy robberies. The high number of robberies prompted some pharmacies in Tazewell County to discontinue selling OxyContin and post signs stating they no longer would carry the drug.
Sentencing and Legislation
Oxycodone, including OxyContin, are Schedule II drugs under the Federal Comprehensive drug Abuse Prevention and Control Act. Federal sentencing guidelines for diverted Schedule II pharmaceuticals are determined by the total weight of the tablets, not strength. Similar drugs of lower strength like Percocet and Tylox may weigh more than OxyContin, thus distributing the same quantities may result in stiffer penalties than for distributing OxyContin.
Authorities in Maine, in conjunction with the U.S. Government, launched a new initiative in 2000 regarding OxyContin abuse. The Maine Attorney General's Office has proposed legislation seeking to make possession of a large number of OxyContin tablets a felony; such possession is currently a misdemeanor.
Outlook
Continued increases in the diversion and abuse of OxyContin are likely. Reliable strength, potential prescription cost coverage, and significant profit potential make OxyContin attractive to both illicit distributors and abusers. Authorities have recognized the increasing problems associated with diversion of the drug. Law enforcement officials, physicians, pharmacists, and representatives of Purdue Pharma L.P. are working together to find methods to limit diversion and abuse. Legislative initiatives are also being drafted to make OxyContin distribution less appealing by creating more stringent penalties.
|
|
Top
|
|
|
|
|
|
|
|
|
|
|
|
|
#83948 - 05/10/04 06:28 PM
Re: Oxycodone - Oxycontin
|
Stranger
Registered: 01/23/04
Posts: 9
Loc: SF Bay Area
|
just for the record, oxycontin should not be confused with the medication called PERCOCET which is (like norco and vicodine) a compound of two pain medications.
percocet is made of oxycodone and acetaminophen and comes in tablets of 5/325, 10/325, etc.
i've used it for long-term back pain and have had no problems with it. like any strong pain meds, you have to counter the possability of constipation appropriately.
personally, i would like to see some of our OP's offer it.
for more information, see www.endo.com which is a major producer of the generic tablets called endocet.
~zazen~
Edited by zazen (05/10/04 07:01 PM)
|
|
Top
|
|
|
|
|
|
|
|
|
|
|
|
|
|
#83955 - 05/15/04 09:40 AM
Oxycodone - Tylox, Percodan, Oxycontin
|
Administrator
GRAND Pooh-Bah
Registered: 11/18/01
Posts: 6596
Loc: DrugBuyers.Com
|
Deav Diversion - Drugs of concern - Oxicodone Quote:
Oxycodone
(Trade Names: Tylox, Percodan, Oxycontin)
Introduction
Oxycodone abuse has been a continuing problem in the United States since the early 1960's. In passing the Controlled Substances Act of 1970, Congress placed oxycodone in Schedule II (CII). In spite of its CII status, oxycodone continued to be abused. The abuse of a new sustained-release formulation of oxycodone, known as Oxycontin7, has escalated over the last year. drug abuse treatment centers, law enforcement personnel, and health care professionals have reported a dramatic increase in the abuse of these sustained release products in Maine, Virginia, West Virginia, Ohio, Kentucky and Maryland. Recently, abuse has spread to other states such as Pennsylvania and Florida. The estimated number of emergency department (ED) episodes involving oxycodone were stable from 1990 through 1996. However, the number of ED episodes more than trippled from 1996 to 2000: 3,190 episodes in 1996 to 10,825 in 2000.
Licit Uses
Oxycodone is an effective analgesic for mild to moderate pain control, chronic pain syndromes, and for the treatment of terminal cancer pain. Five mg of oxycodone is equivalent to 30 mg of codeine when administered orally. Oxycodone and morphine are equipotent for pain control in the normal population; 10 mg of orally-administered oxycodone is equivalent to 10 mg of subcutaneously administered morphine. Oxycodone is considered to be similar to morphine, in all respects, including its abuse & dependence liabilties. Oxycodone in dosages of 5 to 10 mg in combination with acetaminophen or aspirin are abused orally. High dose single entity sustained release formulations containing 10 to 80 mg of oxycodone are abused by crushing or chewing the tablet and then swallowing, snorting or injecting the drug.
Chemistry/Pharmacology
Oxycodone [4,5a-epoxy-14-hydroxy-3-methoxy-17-methylmorphinan-6-one, dihydrohydroxycodeinone] is a semisynthetic opioid structurally related to codeine and is approximately equipotent to morphine in producing opiate-like effects. The first report that oxycodone, sold under the brand name Eukodal, produced a "striking euphoria" and habituation symptoms was published in Germany in the 1920's. While oxycodone is metabolized by the liver to oxymorphone, the physiological and behavioral effects are not related to, nor dependent on, the formation of this metabolic by-product.
Oxycodone will test positive for an opiate in the available field test kits.
Illicit Uses
Oxycodone is abused for its opiate-like effects. In addition to its equipotency to morphine in analgesic effects, it is also equipotent to morphine in relieving abstinence symptoms from chronic opiate (heroin, morphine) administration.For this reason, it is often used to alleviate or prevent the onset of opiate withdrawal by street users of heroin and methadone. In early studies by the Addiction Research Center in Lexington, Kentucky in the 1960's, it was discovered that the subjective and physiological effects of oxycodone were greater than an equivalent dose of morphine in opiate substance abusers. Many dosage forms are available. Oxycodone’s behavioral effects can last up to 5 hours. The drug is most often administered orally. The sustained-release formula has a longer duration of action (8-12 hours). A recent study comparing controlled released products containing oxycodone (Oxycontin) and morphine (MS Contin) reported that Oxycontin was twice as potent as MS Contin.
As with most opiates, the adverse effects of oxycodone abuse are dependence and tolerance development. Oxycodone’s co-formulation with acetaminophen has also increased the likelihood of acetaminophen-induced hepatic necrosis with chronic dosing. Its availability in sustained release formulations has increased the dosage forms from 10 to 160 mg per tablet making it more attractive than oxycodone to opiate abusers and doctor-shoppers. The original idea of polymer-formulations of oxycodone was to reduce the likelihood of misuse with high dose formulations. Opiate abusers quickly learned the ease of extraction of the molecule from the polymer formula and have been injecting or snorting the crushed and/or dissolved tablets because of its’ higher dosage formulations.
User Population
Every age-group has been affected by the relative ease of oxycodone availability and the perceived safety of these products by professionals. Sometimes seen as a "white-collar" addiction, oxycodone abuse has increased among all ethnic and economic groups.
Illicit Distribution
Oxycodone-containing products are in tablet, capsule and liquid forms. A variety of colors, markings, and packaging are available.
The major source of oxycodone to the street has been through forged prescriptions, professional diversion through unscrupulous pharmacists, doctors, and dentists, "doctor-shopping", and large-scale thefts. Oxycontin7 sells for $0.50 to $1.00 per milligram. A 40 mg tablet is sold for $25-$40, and the 80 mg tablets are being sold for $65-$80. The manufacturer has recently discontinued marketing the 160 mg tablets.
Control Status
Oxycodone products are in Schedule II of the Controlled Substances Act of 1970.
Comments and additional information are welcomed by the drug and Chemical Evaluation Section, FAX 202-307-8570 or telephone 202-307-7183.
August, 2001
|
|
Top
|
|
|
|
|
|
|
|
|
|
|
|
|
|
#83960 - 05/28/04 08:30 PM
Re: Oxycodone - Oxycontin
|
Registered: 04/25/04
Posts: 111
Loc: Tampa, FL
|
I have been on the Avinza 120mgs for a month now and so far so good. The best part about it is the even keel it keeps you on all day. No ups and downs like with the oxycotin. I really hated that about the oxycotin.
The pain relief is moderate but with my situation, my doctor has drilled it into my head that no amount of medication will get me pain free. So, I have come to accept that. I have the Percocet10mgs (I take two at a time)for breakthrough when needed and I have probably cut down 50% on them since switching to the Avinza. My doc also gave me Axert for Migraines, so far no effect at all, and Lidoderm Patches. I really like the Lidoderm Patches. They just numb the tissue and some of the muscle in my knee. They certainly are not enough pain relief for use by them selves but they are nice to put on after physical therapy while watching television.
BTW..I have MS, Brittle Bone Disease, deg everything..etc..I have had a knee replacement and a hip replacement, among other orthopedic junk. My knee replacement was a mess. I developed Celulitis soon after and it just never healed. So a lot of my pain is mechanical, which my doc says can not be relieved with pain killers. I need to have the knee done over, as well as the other knee replaced. I am an orthopedic mess.
So I am very happy with the Avinza so far. Like I said, taking only 4 percocet a day instead of 8, and only 2 on a few days. And Only one Avinza instead of 3 oxycotins. So overall, it has been a good experience.
I will keep ya'll updated. (My very first southern experssion!..LOL Moved from NJ to FL right after knee replacement to be with family for assistance).
Thanks to everyone for listening and offering advice..I really like this board. Everyone is so knowledgable.
Luv,
Cami
PS> Everyone have a Happy and Safe Memorial Day weekend!
_________________________
Fighting for peace is like screwing for virginity.
|
|
Top
|
|
|
|
|
|
|
|
|
|
|
|
|
|
#83963 - 08/06/04 06:49 PM
Re: Oxycodone - Oxycontin
|
Stranger
Registered: 07/16/04
Posts: 10
|
|
|
Top
|
|
|
|
|
|
|
|
|
|
|
|
|
|
#83972 - 08/25/04 10:34 AM
Re: Oxycodone - Oxycontin
|
Journeyman
Registered: 05/22/04
Posts: 38
Loc: southeast US
|
hey gang 
oxycontin and morphine are chemical structures that are so similar to your brains very own DOPAMINE endorphins, that the receptor areas in your body will glady accept the opiate immitators.
the down side is that the most powerful opitates (pure tar from an Afghani poppa-reaver, per say, opium, pure synthesized chemically pefect morphine, etc.) are still FAR FAR less powerful then your brains very own DOPAMINE! it only makes sense for the natural endorphin to be more powerful.
The problem is that for dopamine to work right you have to be very, very healthy. Preferrably physically active, strong root chakra, excellent diet, etc. Pretty much every person on a opiate is not in a state of body or mind where they can undertake physical activity, and the opiate therapy can have an effect on your diet and digestion process. And if you live in the united states there is a 80% chance you arent getting the essential fatty acids and ameeno acids your body needs for dopamine production. fast food and tv dinners and cruddy diets leads to instant intolerance of pain and people due to lack of endorphins. in addition your body becomes slack when it sees it neither has the fuel nor the need for the dopamine endorphin, because something else is agonising the receptors (oxy/morphine/opiate) it decides to save the much needed energy for other natural processes.
so until you can become regularly physically active, or drmatically change a regularly monitor your diet, my personal and non professional opinion and advice to you is this :
check out an online or otherwise herbal supplement store (my personal favorite is iherb.com because they also have links to an online encyclopedia of health conditions and proposed herbal/mineral/ameeno/suplment remedies and they are usually quie honest about effects and trials ) and get yourself some of this :
L-tyrosine (dopamine/norepinephrine synthesis)
SAMe (clinically proven anti depressant, liver detox)
GABA (bodys natural CNS depressant, blocks larger pain messages)
your body will thank you and with regular supplement intake your body will be able to resume natural processes and become less dependant on the chemical substitues and agitators because of the presence of the readily available and more powerful natural endorphins.
you are still going to need to carefully maintain intake of medicines and supplements, and if you see a health professional who is worth anything discuss this with them first. many health professionals are unaware of herbal remidies and treatments but they know what ameeno acids do if they paid attention while attaining their degree.
just a suggestion for those of you who are sick and tired of getting ripped off and fighting doctors for stronger pain medicines and really just tired of living in pain and suffering, all the while being persecuted as a schedule 2 narcotics user and looked down upon for your contion. You have tried chemical replacement and agitation to no avail, why not try using your bodys natural abilities to heal and maintain itself given proper fuels?
may you be well.
|
|
Top
|
|
|
|
|
|
|
|
|
|
|
|
|
|
#83974 - 08/25/04 12:18 PM
Re: Oxycodone - Oxycontin
|
Journeyman
Registered: 05/22/04
Posts: 38
Loc: southeast US
|
you have my sympathies friend. my best friends dad has 3 crushed vertebrae and missing cartilege.
you also have my sympathies because you seem very addicted to your medicine. you cant live without it. you are so addicted to your medicine you believe that it is better then the naturally occuring systems. does that really make sense to you? If that was so, why were you not born with oxycontin production glands in your brain? The chemicals only interact in the system that is already there. If you had sufficient dopamine the pain messages would be blocked and you would not be so easily agitated, because dopamine is 100x more powerful at providing pain relief then oxycontin or any other opiate.
if you dont believe me please feel free to contact NIMH, Johns Hopkins University Bayview Medical center, University of Maryland medical program and research studies involving endoraphins and the processes in the brain. I'm not doubting your need for the medicine at all, and I am not suggesting you stop taking it, however you immediately defended your sacred medicine, does this not show you how dependant you are? Do you really like that?
I am suggesting that if you would take care of your body by providing the essential vitamins, minerals, and ammeno acids it needs to fuel its natural processes including relieving pain and healing itself, that perhaps your suffering would be eased.
So please, continue to worship and depend on your sacred medicine, while it slowly but surely groes less and less effective and you must increase the doses more and more. please, be my guest to continue along that path and have toxic liver shock from opiate overdose because you are so doped up you forget you already took your medicine today. It might not happen to you but it has happened to millions of opiate patients in the world.
And finally, if the medicine were truly good for you, do you think you liver would be fighting it constantly processing it out of your body as a TOXIC POISON?
In the universe I live in, natural processes are the result of inconcievable eons of evolution, precisely designed to be the way they are.
May you be well
|
|
Top
|
|
|
|
|
|
|
|
|
|
|
|
|
|
#83975 - 08/25/04 01:42 PM
Re: Oxycodone - Oxycontin
|
Pooh-Bah
Registered: 05/23/03
Posts: 1079
Loc: ID
|
|
|
Top
|
|
|
|
|
|
|
|
|
|
|
|
|
|
#83976 - 08/25/04 03:38 PM
Re: Oxycodone - Oxycontin
|
Enthusiast
Registered: 07/10/04
Posts: 175
|
Quote:
YEs reading up on how the various dopamine receptors (primaririly mu(u) and kappa(k1) plus 12 others are BLOCKED by pain killers like oxy and morphine makes for good reading. the main difference between oxy and morph is that oxy is not rendered 70-80% into inert or ineffective substances like morphine is , when taken orally.
and i AM ABSOLUTELY SURE THAT NO AMOUNT OF SUPPLIMENT/CLEAN LIVING WILL PUT CARTALIGE BACK INBETWEEN MY VERTEBREA.
lOOK UP "pRINCIPLES OF drug ACTION 2, fALL 2000" BY jACK dErUITER. Sorry caps. I found if from a link on the DB last week
Yikes, guys, endorphins are different than dopamine! Endorphins are small polypeptides that bind to opiate receptors (mu, delta, kappa). Binding to opiate receptors inhibits the neurons that carry the receptors. In a part of the brain called the ventral tegmental area, there are neurons that inhibit dopamine input to a place called the nucleus accumbens. Opiates and endorphins shut down this inhibition and let dopamine flow freely, which gets you high or at least makes you want to take more.
|
|
Top
|
|
|
|
|
|
|
|
|
|
|
|
|
|
#83978 - 08/26/04 03:19 PM
Re: Oxycodone - Oxycontin
|
Stranger
Registered: 02/25/04
Posts: 3
|
What you say about Dopamine levels make no sense. You are comparing apples to oranges. Yes, opiate impact the dopamine neurotransitters, but they don't INCREASE the production of them; rather, they DECREASE the production as the feedback loop from the receptors to the production system are fooled by the optiates blocking the receptors.
Naturally increasing neurotransmitters (taking 5HTP for boosting serotonin production) won't have the effect of narcotics, because there's no drug artificially blocking the receptors (which in turn increases the dopamine in the synapse..THAT causes the high from opiates).
According to what you are saying, the production of additional Dopamine will fill the receptors...you're right, that will reduce pain. However, the dopamine production will decrease because the feedback look is telling the production system that there is too much dopamine present - stop producing more dopamine. In opiate users, this marks the beginning of tolerance, since the system continues to adapt and build tolerance to the outside agent (the opiate). Chronic pain relief from natural endorphins and dopamine production is not possible, since the system will adapt, and reduce neurotransmitter levels. What you say may be true with short term pain relief, but that doesn't help with those suffering from chronic pain (and it doesn't help those who are rationalizing opiate use with any pain they might have).
|
|
Top
|
|
|
|
|
|
|
|
|
|
|
|
|
|
#83985 - 10/27/04 02:59 PM
Re: Oxycodone - Oxycontin
|
Enthusiast
Registered: 08/05/02
Posts: 96
|
Hi all,
I have been bouncing around to different medications..from Kadian...to oxycontin to methadone and now MS contin. I am trying to find the right meds to help with pain. The Methadone did help but, I just couldn't concentrate on it no matter what.
One thing, is I find myself nowhere near how I used to be. I find that I am depressed not only because VERY bad things and bad luck has been in my life the past 3 years. But, I read everyone saying with the proper amount of vitamins, amino acids, etc would help fight pain better, but can help with shall I say "feeling" better. Not being as depressed, and I used to work out and have energy so, having that back as well would be great.
Can anyone or does anyone have what amount of the above one should take to help get all those things back? I have stayed away from anti-depressants because I believe they screw you up more in the long run than help...
I am on the medication because I have 1 herniated disc that has now almost completely collapsed, no disc...bone against bone. Also, a bulging disc which I am sure is herniated now one disc abover the other...L4-L5 blown disc at L5-S1 with severe arthritis. Also,having same pain at mid thorax which I have not addressed yet.
Thanks in advance.
|
|
Top
|
|
|
|
|
|
|
|
|
|
|
|
|
#83992 - 07/10/05 10:49 PM
Re: Oxycodone - Oxycontin
|
Newbie
Registered: 12/15/04
Posts: 38
Loc: Pluto
|
I take oxycodone, for appx 2 years now . Have also always struggled w/ depression & fatigue. I began taking Omega Fish-fatty acid supplements about a year ago, on advice from Chiropractor. The Fish oil supplements made me very sick, severely nauseated. One doc insisted it was the oxy, but i've been on oxy without nausea in the past. No one knew it was the Fish oils,,, I was pukeing for months till I figured it out, the day i stopped taking them, i stopped throwing up. Question: I want to take the vitamin for it's excellent benefits, But is there a way to take them or a better brand that will stop the nausea?
|
|
Top
|
|
|
|
|
|
|
|
|
|
|
|
|
|
#83997 - 08/03/05 06:41 AM
Re: Oxycodone - Oxycontin
|
GRAND Pooh-Bah
Registered: 10/27/03
Posts: 2169
Loc: Bearing Strait Ice/Land Bridge
|
Quote:
Can anyone direct me to an OP that sells oxycontin/oxycodone? I cant find it anywhere. please help.
Besides email sources within the U.S. - which can be very costly and very frustrating - you'll do better getting this from the couple of IOP's that offer it...namely yourpharmastore.com and a few others that I don't know their names...sorry
|
|
Top
|
|
|
|
|
|
|
|
|
|
|
|
|
|
#83998 - 08/03/05 08:24 AM
Re: Oxycodone - Oxycontin
|
GRAND Pooh-Bah
Registered: 04/02/02
Posts: 2113
Loc: Southwest U.S.
|
i believe that dopamine is not a true analgesic. dopaminergics are adjunctive, for the same reason that caffeine is added to some analgesic compounds.
the no-longer-sold mostly-selective dopaminergic ADs such as Cantor (minaprine) and Survector (amineptine) were probably very effective as adjunctive analgesics for opiate therapy ... much more so than the "very dirty" TCAs that are still used for the purpose. The FDA got rid of those evil drugs ... God Bless Them!
read Shulgin and Ott to try to understand the profound anhedonic bias that takes drugs like those two name brand ADs off the market because they made people "feel good."
feeling good is bad, and if reported it will cause most doctors will reduce opiate doses in patients with severe chronic pain due to clinically observable causes. if a patient is prescribed those drugs they're supposed to get only as much as needed to relieve most of the pain, and no more.
back on point, dopamine is *not* analgesic in and of itself. you need to distinguish between the chicken and the egg.
if dopamine was an effective analgesic, doctors would find that the psychostimulants relieved pain by themselves. they don't.
the dopamine release in the nucleus accumbens from opiates referred to is a secondary effects of those drugs which is reponsible for much of feeling of pleasure that makes opiates addicting. it's a side effect secondary to opiate effects on the mu receptor system where the analgesic effect occurs.
dopamine is readily available, but how many people inject it into their nucleus accumbens? if it was the super-potent euphoric analgesic you suggest it is, people would be doing that. dopamine is not a clean euphorant by any means because of its psychomotor stimulant effects.
probably the most potent and selective dopaminergic available now is Cabergol, but it's used recreationally for its boosting effect on the libido, and is not very euphoric unless it leads to good sex.
mu receptor peptides like dynorphin similarly have limited value because they require injection (to the blood) and apparently very little crosses the BBB.
i've never heard of anyone injecting dopamine. if it were psychoactive that way (with all its psychomotor stimulation as well as its euphoriant effects), people could obtain a lifetime supply for less than $100.
Almost all of the dopamine creation that makes opiates and psychostimulants drugs of abuse occurs in the brain and it cannot be introduced by blood injection, much less by oral intake of dopamine.
|
|
Top
|
|
|
|
|
|
|
|
|
|
|
|
|
|
#84005 - 10/19/05 01:56 PM
Re: Oxycodone - Oxycontin
|
Board Addict
Registered: 08/25/04
Posts: 270
Loc: So-Cal
|
Quote:
What you say about Dopamine levels make no sense. You are comparing apples to oranges. Yes, opiate impact the dopamine neurotransitters, but they don't INCREASE the production of them; rather, they DECREASE the production as the feedback loop from the receptors to the production system are fooled by the optiates blocking the receptors.
Naturally increasing neurotransmitters (taking 5HTP for boosting serotonin production) won't have the effect of narcotics, because there's no drug artificially blocking the receptors (which in turn increases the dopamine in the synapse..THAT causes the high from opiates).
According to what you are saying, the production of additional Dopamine will fill the receptors...you're right, that will reduce pain. However, the dopamine production will decrease because the feedback look is telling the production system that there is too much dopamine present - stop producing more dopamine. In opiate users, this marks the beginning of tolerance, since the system continues to adapt and build tolerance to the outside agent (the opiate). Chronic pain relief from natural endorphins and dopamine production is not possible, since the system will adapt, and reduce neurotransmitter levels. What you say may be true with short term pain relief, but that doesn't help with those suffering from chronic pain (and it doesn't help those who are rationalizing opiate use with any pain they might have).
ACTUALLY, your body will produce more receptors for which the Mu-opiates to attach to. Its a common problem and one which compounds the whole physical addiction thing.
_________________________
"To live life without suffering is the ultimate achievment."
-The Buddha
|
|
Top
|
|
|
|
|
|
|
|
|
|
|
|
|
|
#84011 - 01/25/06 09:49 AM
Re: Oxycodone - Oxycontin
|
Member
Registered: 01/14/06
Posts: 154
Loc: City of Brotherly Love
|
Oxycodone HCl is an immediate release tablet, which is given every 3-6 hours as needed, often supplementing an extended release form of the same drug, or another narcotic drug. It is made by various manufacturers, Roxane being my favorite, andn is available in 5mg., 10 mg., and 15 mg. It should be noted , with respect to OxyContin, that a good deal of the generic product is, in fact, manufactured by Purdue-Frederick, the makers of OxyContin (the labeler is either Watson or Ivax). So it is EXACTLY as the same as OxyContin and hence is just as good. So, if you are having problems with Endo, ask the pharmacist what generic they use before you have the prescription filled. Then perhaps they may order it for you, but if they refuse, you can always go to another pharmacy.
_________________________
ANYBODY but Giuliani in 2008.
|
|
Top
|
|
|
|
|
|
|
|
|
|
|
|
|
|
#84013 - 04/24/06 02:30 PM
Re: Oxycodone - Oxycontin
|
Veteran
Registered: 07/18/05
Posts: 568
Loc: Mass-Hole
|
Hey Everyone,
I just found out on Friday, that I DONT have MS, but insted Fibro, so I am relived in a way, but them pain has been pure hell to say the least, and my medication was changed, and I am now on oxycontin 10mg, but I was given the generic form of it, and I am wondering how that stacks up to the name brand of it? It doesn't seem to be doing much for the pain, I was taking the 10/325 percs before, and was taking about 4 a day for the pain. Anyone had a simliar experience? Cheers!
_________________________
Everyone should belive in something, I believe I'll have another beer.........
|
|
Top
|
|
|
|
|
|
|
|
|
|
|
|
|
|
#84014 - 04/24/06 02:32 PM
Re: Oxycodone - Oxycontin
|
Veteran
Registered: 07/18/05
Posts: 568
Loc: Mass-Hole
|
Quote:
MY DR JUST RX'D ME OXYCODONE 10MG-AND WHEN i GOT THEM FILLED,I got ROXYcodone,5mg. The pharmascist said they dont make oxycodone in 10 mg,and that they "couldnt get" oxycodone anyway,and this was "almost the same" WTH?? Is it the same,or not??
Thanks for any help-would be nice to know what I am taking 
Lisa
Hey Lisa, I had the same prob, I have some issues with the ttylenol in the percs, so I was given a script for the oxycodone, but they told me at my pharm that they dont even manufacture it in 10mg, only 5.
_________________________
Everyone should belive in something, I believe I'll have another beer.........
|
|
Top
|
|
|
|
|
|
|
|
|
|
|
|
|
|
#84017 - 04/24/06 03:24 PM
Re: Oxycodone - Oxycontin
|
Banned: too many disturbing off topic posts
Registered: 03/05/06
Posts: 494
Loc: Zeta Reticuli
|
Quote:
Hey Everyone,
I just found out on Friday, that I DONT have MS, but insted Fibro, so I am relived in a way, but them pain has been pure hell to say the least, and my medication was changed, and I am now on oxycontin 10mg, but I was given the generic form of it, and I am wondering how that stacks up to the name brand of it? It doesn't seem to be doing much for the pain, I was taking the 10/325 percs before, and was taking about 4 a day for the pain. Anyone had a simliar experience? Cheers!
If you've been taking 10mg perc's then the time released OC isnt going to do much, they should have started you on the 20's. I have taken name brand and generic and the difference is negligable, although I'm sure other members will disagree. By the way OC does come in 10, 20, 40, 80, and they used to make a 160mg, but it was removed from the market. Perc's, roxi's and so on start at 5 mg and go up from there in 5mg increments. I havent seen a 7.5 but that doesnt mean it doesnt exist.
_________________________
Fortune Favors The Bold
|
|
Top
|
|
|
|
|
|
|
|
|
|
|
|
|
|
#84019 - 04/24/06 03:32 PM
Re: Oxycodone - Oxycontin
|
Pooh-Bah
Registered: 10/24/04
Posts: 813
Loc: west/midwest
|
--------------------------------------------------------------------------------
MY DR JUST RX'D ME OXYCODONE 10MG-AND WHEN i GOT THEM FILLED,I got ROXYcodone,5mg. The pharmascist said they dont make oxycodone in 10 mg,and that they "couldnt get" oxycodone anyway,and this was "almost the same" WTH?? Is it the same,or not??
Thanks for any help-would be nice to know what I am taking
Lisa
--------------------------------------------------------------------------------
Hey Lisa, I had the same prob, I have some issues with the ttylenol in the percs, so I was given a script for the oxycodone, but they told me at my pharm that they dont even manufacture it in 10mg, only 5.
--------------------
Everyone should belive in something, I believe I'll have another beer.........
That was the post I read. It sounded like the pharmacist was uninformed, since those formulations do exist. I'm not sure what you're taking offense to. Oxycodone exists in several fomulations including the ones mentioned. As far as I know, oxycontin does not exist in a 5 mg formulation. I hope you find the one that works best 4 U. Have a nice day. J
|
|
Top
|
|
|
|
|
|
|
|
|
|
|
|
|
|
#84020 - 04/24/06 07:27 PM
Re: Oxycodone - Oxycontin
|
Veteran
Registered: 07/18/05
Posts: 568
Loc: Mass-Hole
|
Quote:
Quote:
Hey Everyone,
I just found out on Friday, that I DONT have MS, but insted Fibro, so I am relived in a way, but them pain has been pure hell to say the least, and my medication was changed, and I am now on oxycontin 10mg, but I was given the generic form of it, and I am wondering how that stacks up to the name brand of it? It doesn't seem to be doing much for the pain, I was taking the 10/325 percs before, and was taking about 4 a day for the pain. Anyone had a simliar experience? Cheers!
If you've been taking 10mg perc's then the time released OC isnt going to do much, they should have started you on the 20's. I have taken name brand and generic and the difference is negligable, although I'm sure other members will disagree. By the way OC does come in 10, 20, 40, 80, and they used to make a 160mg, but it was removed from the market. Perc's, roxi's and so on start at 5 mg and go up from there in 5mg increments. I havent seen a 7.5 but that doesnt mean it doesnt exist.
Thanks DaveMatrix, I appreciate the feedback, I was looking for something a little longer lasting, as the bad days are out numbering the good ones. Kinda stinks, I am wondering if there is something out there that would help with the Fibro pain. Thanks!
_________________________
Everyone should belive in something, I believe I'll have another beer.........
|
|
Top
|
|
|
|
|
|
|
|
|
|
|
|
|
|
#84030 - 04/27/06 09:59 PM
Re: Oxycodone - Oxycontin
|
Newbie
Registered: 04/17/06
Posts: 21
|
Lets try discussing something other than views on drug laws: This is a little off the going topic but was curious of what peoples experiences have been. Of course it is no mystery that Oxycodone is stronger than Hydrocodone. So by nature it should be more effective and work better. Hydrocodone has always been a great medication for me for back pain, and stiff neck pain. I tried everything else over the counter, and otherwise. Tramadol helps but it disrupts my sleep so bad even an Ambien can’t get me to sleep, I have no idea why? I started out originally taking 5/500 of course like most. That lasted for about a year or so of taking it off and on as needed with a few months off here and there when the pain was less. Eventually I worked up to needing 10 or 15 mg to get the same relief. However I have noticed that the more you take off it, that you don’t necessarily get any additional pain relief, perhaps you get higher than a kite, but the pain level really doesn’t drop. Anyone noticed that? Also when you are taking anything over 10mg, when the Hydrocodone wears off it just drops you flat on your head, you can go from relief and feeling pretty good to everything that hurt before hurting again, but NOW it seems like the pain is WORSE than when you started the medications in the first place? Have others experienced this? However my doctor just recently switched from me taking 2 7.5/325 Hydrocodone pills to 1 to 2 10/325mb OXYCODONE (finally). There is just no comparison between the 2. The Hydrocodone hits you a lot faster 15-20 mins tops, and it does work very well, until you get to close to the edge of that cliff. Has anyone else noticed this? The Oxycodone hits you MUCH slower, seems to take around 45mins to an hour for me before it kicks in. Once it does though it works extremely well. The part I find most surprising about it, is not that it works well, I would expect it to. The part that surpises me is that when it wears off it gently lets go, unlike Hydrocodone which drops you on your head. Oxycodone also lasts much longer, as long as 8 hours for me from a single 10/325. I couldn’t imagine 20mg, that would be too much for me. Someone mentioned if you should drive while taking them or not. I guess that would depend in the individual a lot. Opiates don’t make me drowsy at all, yet I see others that take them and it renders them useless (although happy usually) So for me it has never been a problem. It isn’t illegal to drive with them far as I know. The warnings say USE CAUTION when operating a vehicle or machinery, not AVOID or DON’T do it. It may make a comment staying NOT to until you KNOW how it will effect you, that’s pretty good common sense. Has anyone else had noticed similar comparisons between Hydrocodone and Oxycodone? Wizzy
|
|
Top
|
|
|
|
|
|
|
|
|
|
|
|
|
|
#84034 - 06/12/06 01:25 PM
Re: Oxycodone - Oxycontin
|
Stranger
Registered: 01/16/06
Posts: 2
|
***this is a copy of my post in prescription discussion*** I was not sure which to post in, so i went with both. If a Moderator would delete the incorrect post if there is a problem...or just leave it if there is not problem...thanks/sorry whatever the case may be. Just a question. How does a 20mg oxycontin compare to oxycodone immidiate release pills. I used to take 15-20mg of the instant and wanted to know how these compare strenth wise. My previous doctor prescribed the instant release oxycodone, this worked well and made things decent in the pain area...I've had 43 surgeries and problems all over my body. She got me to try oxycontin twice but it wasn't good because it lasted too long and was just bad. She left the area for another position and my new doctor had no problem writing a new script for me, the problem is he asked what I had taken before and i told him, and told him the only problem I'd had was with oxycontin....and he perscribed oxycontin. I had it filled before i noticed the problem, and his office says they will not prescribe something weaker since they just prescribed this, and I can't return them to the pharmacy or to the office. So i have them, and just them for now. I used to have higher mg oxycodone tabs that i used to break for a lower dose, but i know that shouldn't be done with oxycontin.... Basically, can anyone give me info on this stuff, how I can keep it from lasting for 12 hours, that type of thing. My pain comes and goes through the day, so the instant is better for me so I'm not on heavy medicene when not in pain. sorry, I know I get long winded...and thanks in advance for any help/suggestions Da bum
|
|
Top
|
|
|
|
|
|
|
|
|
|
|
|
|
|
#84040 - 12/05/06 05:27 PM
Re: Oxycodone - Oxycontin
|
Administrator
GRAND Pooh-Bah
Registered: 11/18/01
Posts: 6596
Loc: DrugBuyers.Com
|
http://www.washingtonmonthly.com/features/2005/0506.roth.html
Quote:
In 1993, Purdue Pharmaceuticals of Stamford, Conn. applied for the first in a series of patents on a drug it called Oxycontin—a painkiller to which Rush Limbaugh would later become addicted. The U.S. Patent and Trademark Office (PTO) granted those patents based on the manufacturer's contention that the drug contained a novel innovation: It had been engineered so that only a very small dose—between 10 and 40 milligrams—was required for the drug to be effective for 90 percent of patients. On the strength of those patents, which in essence granted the company a monopoly license, Purdue went on to reap over $1 billion in annual revenue from sales of Oxycontin.
Seven years later, a generic drug maker, Endo Pharmaceuticals, applied to the FDA for permission to sell its own, lower-priced version of Oxycontin. Purdue sued Endo, claiming patent infringement. During the trial, Endo's attorneys argued that Purdue had conducted no clinical studies, and in fact had no evidence whatsoever to support the claim that the drug worked in small doses for 90 percent of patients, an assertion which had been crucial to its patent application. The judge agreed, and invalidated Purdue's patent, allowing Endo to introduce its own version of Oxycontin in January 2004. By law, however, Purdue was allowed to keep the billions of dollars in monopoly profits it had garnered with patents it should never have won.
How did the patent office wind up agreeing to give Purdue the patent in the first place? It simply took Purdue's word for it that the assertions it made about its drug were accurate. As Purdue noted archly in its press release about the court decision, “Purdue never made the claim in the patent application that it had done experiments to establish this property and the patent examiner never asked for such information.”
The Oxycontin patent was just one of thousands of instances of lax scrutiny at the patent office in recent years. Paxil and Prozac are two other multibillion dollar drugs that earned monopoly profits for their makers before their patents were struck down. And the office's errors range far beyond the pharmaceutical industry to include everything from software to biotechnology to e-commerce. Greg Aharonian, a Bay-Area patent consultant who sends out an almost-daily email newsletter on every patent-related development under the sun (an item from February was headed, “Kazakhstan Patent Office Runs Out of Paper”) highlighted one recently granted patent, which included a “graphical traceroute”—a technology used to map online traffic events to physical locations. As he points out, had examiners simply Googled “graphical traceroute,” they would have found, under the first entry, an excellent example of the technology, along with a link to an explanatory paper, published by a different team of technologists in November 1999—more than two years before the patent application was filed.
...
I would also like to mention an obvious place to visit for info on Oxycontin:
Opiods.com - http://opioids.com/oxycodone/oxycontin.htm
|
|
Top
|
|
|
|
|
|
|
|
|
|
|
|
|
|
#84043 - 12/17/06 02:02 AM
Re: Oxycodone - Oxycontin
|
Member
Registered: 11/13/06
Posts: 157
Loc: Right here *points to ground*
|
Oxycontin is not something that doctors start@80mg's with.... At least not normally and if they did I/many would consider it careless/irresponsible as you have to know how each patient will react to it. When I started Oxycontin, I was placed on 40mgs right away but that was after more than a year of Percs and then Oxy IR. You start low and go up... starting at 120mg's a day with even more for b/t is a very high calculation. Just because an opiod conversion chart states the strength of one compared to another, does NOT mean that this is the strength you should start at said drug. Different drugs will impact different people in different ways, and you have to know how YOUR body will react before you get uppped sky high on something.. Again (cuz I LUV repeating myself lol). Just because a person needs a lot of one med doesn't mean they will need exactly the same of another through chart conversion. Chances are that you would need more than a beginning dosage (due to having been on opiods before), but still this is something to approach carefully. Again, your body may react differently to one drug than another. Reality is too that tolerance is something that can go up quickly and you will find very quickly with your doctor if you need to up the dosage. This is not a "happy" drug to cut down on (FYI.. Unless done through a slow taper) any more than some others so be careful. I understand totally that you want the pain gone (me too), but for myself I really dont want to take it higher than 2 x 40s *oc* a day plus 5 x 10s *oxy ir*. I'm at the tolerance limit to go up and instead I'm cycling to try and stay away from doing that. You will how ever find what works best for you. Know though like I said that the other side of this medication is not nice once (as with so many)you've been on it for a while. If you're on straight release/time released in large amounts for a long time and you forget/have a slightly better day/decide for what ever reason not to take it, your body will let you know and after 12-24 hours it will be LOUD about letting you know. If your decision is like mine that it's better than the pain, then go for it and I wish you luck and a lack of pain.
_________________________
They called me crazy, I called them crazy, and d@rn them! They outvoted me! Nathaniel Lee, on being consigned to a mental institution, C 17th century ;p
|
|
Top
|
|
|
|
|
|
|
|
|
|
|
|
|
|
#84047 - 06/05/07 08:27 AM
Re: Oxycodone - Oxycontin
|
Banned. Troll with multiple ID's. Netmeds, buzzed, krypt, and others...
Registered: 05/26/07
Posts: 194
|
My doctor gives me a coupon for $50.00 off a script of Oxycontin so my insurance pays the rest. I only pay a $10.00 co-payment for a months supply of OxyContin. He said the coupon is for 5 uses, then he'll give me another coupon!!! So I don't think it's just a money issue at stake. I also take Oxycodone as a booster which is also $10.00 per script but without the need for any coupons. All I can say is, if you are really in a lot of pain, this is a great drug if you can control yourself on it and not abuse it. I respect it, and it works, what more could I ask for? There aren't any side effect for me whatsoever. I don't know if you build tolerance to Oxycontin, but I haven't had even the smallest of problems in that area after 6 months.
_________________________
The Pill Nazi Says, "NO PILLS FOR YOU!" - Seinfeld Twist
[I'm not a Doctor, I just act like one]
|
|
Top
|
|
|
|
|
|
|
|
|
|
|
|
|
|
#575529 - 10/05/07 12:43 PM
Re: Oxycodone - Oxycontin
[Re: rockystuart]
|
Administrator
GRAND Pooh-Bah
Registered: 11/18/01
Posts: 6596
Loc: DrugBuyers.Com
|
|
|
Top
|
|
|
|
|
|
|
|
|
|
|
|
|
|
#643768 - 02/04/08 04:54 PM
Re: Oxycodone - Oxycontin
[Re: DanielWA]
|
GRAND Pooh-Bah
Registered: 01/24/04
Posts: 2254
Loc: |20(|-|3||35|\/|6 1$ 6@`/
|
Honestly, the only reliable place, would be from your doctor/pharmacy.
If you search through the many posts from people looking for this online like you are, you will find that "if" it is listed on some websites, you will most likely loose all your money because it is a sham.
But, that would not actually be the worst thing that happend...it is illegal to buy Schedule II meds online, and I would think ending up in jail would be worse.
Not trying to rain on your parade, just trying to save you some time, engery, money and maybe heartache. Good advice  if you require a pain med that strong, you need to see a doctor face to face!
_________________________
When the Boogeyman goes to sleep every night, he checks his closet for Chuck Norris.
|
|
Top
|
|
|
|
|
|
|
|
|
|
|
|
|
|
#898658 - 06/20/09 02:14 PM
Re: Oxycontin - FDA STRENGTHENS WARNINGS
[Re: Strawberry]
|
Board Addict
Registered: 10/02/07
Posts: 320
|
Hi Wizzy,
I like you, have noticed a BIG difference! I have degenerative disc disease, and spondelysis (I think I spelled that wrong)!
I injured my back a long time ago, I have a fantastic doctor, had to have MRI'S, etc., so I saw him recently and changed my meds from hydro to percocet, Thank God! Now, I'll be going to Physical Therapy, and he did mention something about "injections" (?) Do you, or maybe one of the other poster's knows about those shots? I am so afraid of needles, I almost have a anxiety attack thinking about it!
fisher
|
|
Top
|
|
|
|
|
|
|
|
|
|
|
|
|
|
#907718 - 07/14/09 06:00 AM
Re: Oxycodone - Oxycontin
[Re: bernie131]
|
Threadhead
Registered: 08/08/07
Posts: 824
|
No Bernie, they aren't.
Avina and Kadian are versions of Mophine, either extended release or immediate (I think both of those versions are extended). Opana is oxymorphone. Think of oxycodone, but one step up. It works well as long as the dosage you are given is right. I was on it for a year and it worked fine along with my breakthrough medicine, but my doctor was stingy and my medicines never seemed to quite cut it. I spent several years on the couch gaining weight. When I got out of pain management (how many shots can you handle?) I found that I hurt less in the mornings than I did with all the medicines they were giving me, which was 5 different ones.
If you can, try to take less than the prescribed amount and see if you wake up in less pain than normal.
Now, I hurt bad, every single day, and by 3:00pm I don't feel like I can do anything else but sit on the couch. I don't use a heating pad anymore because the doctors said I had scarred my back for life by using a heating pad for so many years and I only used it on the "2" out of 5 setting! Luckily my Beemer has a heated seat and heated butt setting, so when my back gets really bad, I go riding and turn on the heat. It hits my back and butt and helps a lot without causing the scarring that the heating pad did.
Anyway, if given the choose, try the Opana, but get the 20 mg to start. They will only give it to you twice a day and it starts to wear off a little earlier than that, but as long as you have breakthough medicine it's fine. There is no "high" associated with it that I could see; it simply stopped the pain. I was put on the morphine ER for a short period and it sent me into a panic because it wasn't helping the pain at all. But morphine does help other people so don't rule it out. It just didnt work on me, but my dosage was 30mg 2x a day. Way too low for my back and sciatic problems.
Good Luck!
|
|
Top
|
|
|
|
|
|
|
|
|
|
|
|
|
|
#908369 - 07/15/09 09:45 PM
Re: Oxycodone - Oxycontin
[Re: bernie131]
|
GRAND Pooh-Bah
Registered: 06/29/08
Posts: 1618
|
Sounds like your dr is fairly indifferent or uninterested enough to not be concerned. The only thing that these drugs have in common is the basic chemical structure of which they are all cloned from or copied synthetically.The Poppy plant has its flower thats used for one drug, its skin for another and its juice as another. It seems that there are slight chemical differences in the various parts of the plant and every one has been copied synthetically as well. some are natural forms of the base drug. some are synthetic copies. One even works on brain perception and not the blocking of pain signals. They all have different properties and act differently on different people. One person may get knocked out by oxycodone, the next gets an idiosyncratic reaction that makes them want to run laps... they all act differently on people. personally, Opana lasted the longest of all that I tried in the oral med form. I cannot say anything about patches. Most pills I have tried. I can tell you that the change to ER type meds can take some getting used to. You will almost always need a rescue med thats IR when you begin Extended Release or time release meds. The goal is to build a level of the med that does the job, and maintain that level around the clock. It takes time to do that and an Instant release med for rescue is required at least for the first month or 2 until the level gets adjusted to suit the individual. What many people dont "get" is that none of these meds are meant to make you feel good. they are meant to relieve pain, or at least reduce it to a tolerable level so that normal life can resume. If someone is trying one drug after another and waiting for something that feels good, then they are searching in the wrong class of drugs. When a pain med has done its job well, and taken as directed, the only difference in the way the patient should feel is the absense of pain. thats all anyone with chronic pain really wants, just make it go away. I can find ways to feel good on my own, on my terms, when I want. all I want the pill to do is remove the pain that is the horror of living somedays.thats when there can be no fun, when the pain is there and nothing works to relieve it. the thought of tomorrow being just like today can be too much for some people. good luck, and I kind of miss the waveless WB myself...:~)
|
|
Top
|
|
|
|
|
|
|
|
|
|
|
|
|
|
#912440 - 07/28/09 08:54 PM
Re: Oxycodone - Oxycontin
[Re: Melody]
|
Stranger
Registered: 07/28/09
Posts: 1
|
Oxycodone HCl WARNING OxyContin® is an opioid agonist and a Schedule II controlled substance with an abuse liability similar to morphine. Oxycodone can be abused in a manner similar to other opioid agonists, legal or illicit. This should be considered when prescribing or dispensing OxyContin® in situations where the physician or pharmacist is concerned about an increased risk of misuse, abuse, or diversion. OxyContin® tablets are a controlled-release oral formulation of oxycodone hydrochloride indicated for the management of moderate to severe pain when a continuous, around-the-clock analgesic is needed for an extended period of time. OxyContin® tablets are NOT intended for use as a prn analgesic. OxyContin® 80 mg and 160 mg Tablets ARE FOR USE IN OPIOID TOLERANT PATIENTS ONLY. These tablet strengths may cause fatal respiratory depression when administered to patients not previously exposed to opioids. OxyContin® (oxycodone hydrochloride controlled-release) TABLETS ARE TO BE SWALLOWED WHOLE AND ARE NOT TO BE BROKEN, CHEWED, OR CRUSHED. TAKING BROKEN, CHEWED, OR CRUSHED OxyContin® TABLETS LEADS TO RAPID RELEASE AND ABSORPTION OF A POTENTIALLY FATAL DOSE OF OXYCODONE. OxyContin® (oxycodone hydrochloride controlled-release) tablets are an opioid analgesic supplied in 10 mg, 20 mg, 40 mg, 80 mg, and 160 mg tablet strengths for oral administration. The tablet strengths describe the amount of oxycodone per tablet as the hydrochloride salt. Its molecular formula is C18H21NO4 · HCl. Its molecular weight is 351.83. The chemical formula is 4, 5-epoxy-14-hydroxy-3-methoxy-17-methylmorphinan-6-one hydrochloride. Oxycodone is a white, odorless crystalline powder derived from the opium alkaloid, thebaine. Oxycodone hydrochloride dissolves in water (1 g in 6 to 7 mL). It is slightly soluble in alcohol (octanol water partition coefficient 0.7). The tablets contain the following inactive ingredients: ammonio methacrylate copolymer, hydroxypropyl methylcellulose, lactose, magnesium stearate, povidone, red iron oxide (20 mg strength tablet only), stearyl alcohol, talc, titanium dioxide, triacetin, yellow iron oxide (40 mg strength tablet only), yellow iron oxide with FD&C blue No.2 (80 mg strength tablet only), FD&C blue No.2 (160 mg strength tablet only) and other ingredients. INDICATIONS OxyContin® tablets are a controlled-release oral formulation of oxycodone hydrochloride indicated for the management of moderate to severe pain when a continuous, around-the-clock analgesic is needed for an extended period of time. OxyContin® is NOT intended for use as a prn analgesic. Physicians should individualize treatment in every case, initiating therapy at the appropriate point along a progression from non-opioid analgesics, such as nonsteroidal anti-inflammatory drugs and acetaminophen to opioids in a plan of pain management such as outlined by the World Health Organization, the Agency for Health Research and Quality (formerly known as the Agency for Health Care Policy and Research), the Federation of State Medical Boards Model Guidelines, or the American Pain Society. OxyContin® is not indicated for pain in the immediate post-operative period (the first 12-24 hours following surgery), or if the pain is mild, or not expected to persist for an extended period of time. OxyContin® is only indicated for post-operative use if the patient is already receiving the drug prior to surgery or if the postoperative pain is expected to be moderate to severe and persist for an extended period of time. Physicians should individualize treatment, moving from parenteral to oral analgesics as appropriate. (See American Pain Society guidelines.) DOSAGE AND ADMINISTRATION General Principles OxyContin® IS AN OPIOID AGONIST AND A SCHEDULE II CONTROLLED SUBSTANCE WITH AN ABUSE LIABILITY SIMILAR TO MORPHINE. OXYCODONE, LIKE MORPHINE AND OTHER OPIOIDS USED IN ANALGESIA, CAN BE ABUSED AND IS SUBJECT TO CRIMINAL DIVERSION. OxyContin® (oxycodone hydrochloride controlled-release) TABLETS ARE TO BE SWALLOWED WHOLE, AND ARE NOT TO BE BROKEN, CHEWED OR CRUSHED. TAKING BROKEN, CHEWED OR CRUSHED OxyContin® TABLETS LEADS TO THE RAPID RELEASE AND ABSORPTION OF A POTENTIALLY FATAL DOSE OF OXYCODONE. One OxyContin® 160 mg tablet is comparable to two 80 mg tablets when taken on an empty stomach. With a high fat meal, however, there is a 25% greater peak plasma concentration following one 160 mg tablet. Dietary caution should be taken when patients are initially titrated to 160 mg tablets (see Special Instructions for OxyContin® 80 mg and 160 mg Tablets). In treating pain it is vital to assess the patient regularly and systematically. Therapy should also be regularly reviewed and adjusted based upon the patient's own reports of pain and side effects and the health professional's clinical judgment. OxyContin® tablets are a controlled-release oral formulation of oxycodone hydrochloride indicated for the management of moderate to severe pain requiring treatment with a strong opioid for continuous, around-the-clock analgesia for an extended period of time. The controlled-release nature of the formulation allows OxyContin® to be effectively administered every 12 hours (see CLINICAL PHARMACOLOGY: PHARMACOKINETICS AND METABOLISM). While symmetric (same dose AM and PM), around-the-clock, q12h dosing is appropriate for the majority of patients, some patients may benefit from asymmetric (different dose given in AM than in PM) dosing, tailored to their pain pattern. It is usually appropriate to treat a patient with only one opioid for around-the-clock therapy. Physicians should individualize treatment using a progressive plan of pain management such as outlined by the World Health Organization, the American Pain Society and the Federation of State Medical Boards Model Guidelines. Health care professionals should follow appropriate pain management principles of careful assessment and ongoing monitoring [See BOXED WARNING]. Initiation of Therapy It is critical to initiate the dosing regimen for each patient individually, taking into account the patient's prior opioid and non-opioid analgesic treatment. Attention should be given to: (1) the general condition and medical status of the patient; (2) the daily dose, potency, and kind of the analgesic(s) the patient has been taking; (3) the reliability of the conversion estimate used to calculate the dose of oxycodone; (4) the patient's opioid exposure and opioid tolerance (if any); (5) special safety issues associated with conversion to OxyContin® doses at or exceeding 160 mg q12h (see Special Instructions for OxyContin® 80 mg and 160 mg Tablets); and (6) the balance between pain control and adverse experiences. Care should be taken to use low initial doses of OxyContin® in patients who are not already opioid-tolerant, especially those who are receiving concurrent treatment with muscle relaxants, sedatives, or other CNS active medications (see drug INTERACTIONS). For initiation of OxyContin® therapy for patients previously taking opioids, the conversion ratios from Foley, KM. [NEJM, 1985; 313:84-95], found below, are a reasonable starting point, although not verified in well-controlled, multiple-dose trials. Experience indicates a reasonable starting dose of OxyContin® for patients who are taking non-opioid analgesics and require continuous around-the-clock therapy for an extended period of time is 10 mg q12h. If a non-opioid analgesic is being provided, it may be continued. OxyContin® should be individually titrated to a dose that provides adequate analgesia and minimizes side effects. 1. Using standard conversion ratio estimates (see Table 4 below), multiply the mg/day of the previous opioids by the appropriate multiplication factors to obtain the equivalent total daily dose of oral oxycodone. 2. When converting from oxycodone, divide the 24-hour oxycodone dose in half to obtain the twice a day (q12h) dose of OxyContin®. 3. Round down to a dose which is appropriate for the tablet strengths available (10 mg, 20 mg, 40 mg, 80 mg, and 160 mg tablets). 4. Discontinue all other around-the-clock opioid drugs when OxyContin® therapy is initiated. 5. No fixed conversion ratio is likely to be satisfactory in all patients, especially patients receiving large opioid doses. The recommended doses shown in Table 4 are only a starting point, and close observation and frequent titration are indicated until patients are stable on the new therapy. Table 4 Multiplication Factors for Converting the Daily Dose of Prior Opioids to the Daily Dose of Oral Oxycodone* (Mg/Day Prior Opioid x Factor = Mg/Day Oral Oxycodone) Oral Prior Opioid Parenteral Prior Opioid Oxycodone 1 — Codeine 0.15 — Hydrocodone 0.9 — Hydromorphone 4 20 Levorphanol 7.5 15 Meperidine 0.1 0.4 Methadone 1.5 3 Morphine 0.5 3 To be used only for conversion to oral oxycodone. For patients receiving high-dose parenteral opioids, a more conservative conversion is warranted. For example, for high-dose parenteral morphine, use 1.5 instead of 3 as a multiplication factor. In all cases, supplemental analgesia (see below) should be made available in the form of a suitable short-acting analgesic. OxyContin® can be safely used concomitantly with usual doses of non-opioid analgesics and analgesic adjuvants, provided care is taken to select a proper initial dose (see PRECAUTIONS). Conversion from Transdermal Fentanyl to OxyContin® Eighteen hours following the removal of the transdermal fentanyl patch, OxyContin® treatment can be initiated. Although there has been no systematic assessment of such conversion, a conservative oxycodone dose, approximately 10 mg q12h of OxyContin®, should be initially substituted for each 25 µg/hr fentanyl transdermal patch. The patient should be followed closely for early titration, as there is very limited clinical experience with this conversion. Managing Expected Opioid Adverse Experiences Most patients receiving opioids, especially those who are opioid-naive, will experience side effects. Frequently the side effects from OxyContin® are transient, but may require evaluation and management. Adverse events such as constipation should be anticipated and treated aggressively and prophylactically with a stimulant laxative and/or stool softener. Patients do not usually become tolerant to the constipating effects of opioids. Other opioid-related side effects such as sedation and nausea are usually self-limited and often do not persist beyond the first few days. If nausea persists and is unacceptable to the patient, treatment with anti-emetics or other modalities may relieve these symptoms and should be considered. Patients receiving OxyContin® may pass an intact matrix "ghost" in the stool or via colostomy. These ghosts contain little or no residual oxycodone and are of no clinical consequence. Individualization of Dosage Once therapy is initiated, pain relief and other opioid effects should be frequently assessed. Patients should be titrated to adequate effect (generally mild or no pain with the regular use of no more than two doses of supplemental analgesia per 24 hours). Patients who experience breakthrough pain may require dosage adjustment or rescue medication. Because steady-state plasma concentrations are approximated within 24 to 36 hours, dosage adjustment may be carried out every 1 to 2 days. It is most appropriate to increase the q12h dose, not the dosing frequency. There is no clinical information on dosing intervals shorter than q12h. As a guideline, except for the increase from 10 mg to 20 mg q12h, the total daily oxycodone dose usually can be increased by 25% to 50% of the current dose at each increase. If signs of excessive opioid-related adverse experiences are observed, the next dose may be reduced. If this adjustment leads to inadequate analgesia, a supplemental dose of immediate-release oxycodone may be given. Alternatively, non-opioid analgesic adjuvants may be employed. Dose adjustments should be made to obtain an appropriate balance between pain relief and opioid-related adverse experiences. If significant adverse events occur before the therapeutic goal of mild or no pain is achieved, the events should be treated aggressively. Once adverse events are under control, upward titration should continue to an acceptable level of pain control. During periods of changing analgesic requirements, including initial titration, frequent contact is recommended between physician, other members of the healthcare team, the patient and the caregiver/family. Special Instructions for OxyContin® 80 mg and 160 mg Tablets (For use in opioid-tolerant patients only) OxyContin® 80 mg and 160 mg Tablets are for use only in opioid-tolerant patients requiring daily oxycodone equivalent dosages of 160 mg or more for the 80 mg tablet and 320 mg or more for the 160 mg tablet. Care should be taken in the prescribing of these tablet strengths. Patients should be instructed against use by individuals other than the patient for whom it was prescribed, as such inappropriate use may have severe medical consequences, including death. One OxyContin® 160 mg tablet is comparable to two 80 mg tablets when taken on an empty stomach. With a high fat meal, however, there is a 25% greater peak plasma concentration following one 160 mg tablet. Dietary caution should be taken when patients are initially titrated to 160 mg tablets. Supplemental Analgesia Most patients given around-the-clock therapy with controlled-release opioids may need to have immediate-release medication available for exacerbations of pain or to prevent pain that occurs predictably during certain patient activities (incident pain). Maintenance of Therapy The intent of the titration period is to establish a patient-specific q12h dose that will maintain adequate analgesia with acceptable side effects for as long as pain relief is necessary. Should pain recur then the dose can be incrementally increased to re-establish pain control. The method of therapy adjustment outlined above should be employed to re-establish pain control. During chronic therapy, especially for non-cancer pain syndromes, the continued need for around-the-clock opioid therapy should be reassessed periodically (e.g., every 6 to 12 months) as appropriate. Cessation of Therapy When the patient no longer requires therapy with OxyContin® tablets, doses should be tapered gradually to prevent signs and symptoms of withdrawal in the physically dependent patient. Conversion from OxyContin® to Parenteral Opioids To avoid overdose, conservative dose conversion ratios should be followed. SAFETY AND HANDLING OxyContin® (oxycodone HCl controlled-release) tablets are solid dosage forms that contain oxycodone which is a controlled substance. Like morphine, oxycodone is controlled under Schedule II of the Controlled Substances Act. OxyContin® has been targeted for theft and diversion by criminals. Healthcare professionals should contact their State Professional Licensing Board or State Controlled Substances Authority for information on how to prevent and detect abuse or diversion of this product. HOW SUPPLIED OxyContin® (oxycodone hydrochloride controlled-release) 10 mg tablets are round, unscored, white-colored, convex tablets bearing the symbol OC on one side and 10 on the other. They are supplied as follows: NDC 59011-100-10: child-resistant closure, opaque plastic bottles of 100 NDC 59011-100-25: unit dose packaging with 25 individually numbered tablets per card; one card per glue end carton OxyContin® (oxycodone hydrochloride controlled-release) 20 mg tablets are round, unscored, pink-colored, convex tablets bearing the symbol OC on one side and 20 on the other. They are supplied as follows: NDC 59011-103-10: child-resistant closure, opaque plastic bottles of 100 NDC 59011-103-25: unit dose packaging with 25 individually numbered tablets per card; one card per glue end carton OxyContin® (oxycodone hydrochloride controlled-release) 40 mg tablets are round, unscored, yellow-colored, convex tablets bearing the symbol OC on one side and 40 on the other. They are supplied as follows: NDC 59011-105-10: child-resistant closure, opaque plastic bottles of 100 NDC 59011-105-25: unit dose packaging with 25 individually numbered tablets per card; one card per glue end carton OxyContin® (oxycodone hydrochloride controlled-release) 80 mg tablets are round, unscored, green-colored, convex tablets bearing the symbol OC on one side and 80 on the other. They are supplied as follows: NDC 59011-107-10: child-resistant closure, opaque plastic bottles of 100 NDC 59011-107-25: unit dose packaging with 25 individually numbered tablets per card; one card per glue end carton OxyContin® (oxycodone hydrochloride controlled-release) 160 mg tablets are caplet-shaped, unscored, blue-colored, convex tablets bearing the symbol OC on one side and 160 on the other. They are supplied as follows: NDC 59011-109-10: child-resistant closure, opaque plastic bottles of 100 NDC 59011-109-25: unit dose packaging with 25 individually numbered tablets per card; one card per glue end carton Store at 25°C (77 F); excursions permitted between 15°-30°C (59°-86°F). Dispense in tight, light-resistant container. Healthcare professionals can telephone Purdue Pharma’s Medical Services Department (1-888-726-7535) for information on this product. PATIENT INFORMATION If clinically advisable, patients receiving OxyContin® (oxycodone hydrochloride controlled-release) tablets or their caregivers should be given the following information by the physician, nurse, pharmacist, or caregiver: 1. Patients should be aware that OxyContin® tablets contain oxycodone, which is a morphine-like substance. 2. Patients should be advised that OxyContin® tablets were designed to work properly only if swallowed whole. OxyContin® tablets will release all their contents at once if broken, chewed, or crushed, resulting in a risk of fatal overdose. 3. Patients should be advised to report episodes of breakthrough pain and adverse experiences occurring during therapy. Individualization of dosage is essential to make optimal use of this medication. 4. Patients should be advised not to adjust the dose of OxyContin® without consulting the prescribing professional. 5. Patients should be advised that OxyContin® may impair mental and/or physical ability required for the performance of potentially hazardous tasks (e.g., driving, operating heavy machinery). 6. Patients should not combine OxyContin® with alcohol or other central nervous system depressants (sleep aids, tranquilizers) except by the orders of the prescribing physician, because dangerous additive effects may occur, resulting in serious injury or death. 7. Women of childbearing potential who become, or are planning to become, pregnant should be advised to consult their physician regarding the effects of analgesics and other drug use during pregnancy on themselves and their unborn child. 8. Patients should be advised that OxyContin® is a potential drug of abuse. They should protect it from theft, and it should never be given to anyone other than the individual for whom it was prescribed. 9. Patients should be advised that they may pass empty matrix "ghosts" (tablets) via colostomy or in the stool, and that this is of no concern since the active medication has already been absorbed. 10. Patients should be advised that if they have been receiving treatment with OxyContin® for more than a few weeks and cessation of therapy is indicated, it may be appropriate to taper the OxyContin® dose, rather than abruptly discontinue it, due to the risk of precipitating withdrawal symptoms. Their physician can provide a dose schedule to accomplish a gradual discontinuation of the medication. 11. Patients should be instructed to keep OxyContin® in a secure place out of the reach of children. When OxyContin® is no longer needed, the unused tablets should be destroyed by flushing down the toilet.
|
|
Top
|
|
|
|
|
|
|
|
|
|
|
|
|
|
#932679 - 09/21/09 01:35 PM
Re: Oxycodone - Oxycontin
[Re: Melody]
|
Stranger
Registered: 09/18/09
Posts: 1
|
Oxycodone HCl WARNING OxyContin® is an opioid agonist and a Schedule II controlled substance with an abuse liability similar to morphine. Oxycodone can be abused in a manner similar to other opioid agonists, legal or illicit. This should be considered when prescribing or dispensing OxyContin® in situations where the physician or pharmacist is concerned about an increased risk of misuse, abuse, or diversion. OxyContin® tablets are a controlled-release oral formulation of oxycodone hydrochloride indicated for the management of moderate to severe pain when a continuous, around-the-clock analgesic is needed for an extended period of time. OxyContin® tablets are NOT intended for use as a prn analgesic. OxyContin® 80 mg and 160 mg Tablets ARE FOR USE IN OPIOID TOLERANT PATIENTS ONLY. These tablet strengths may cause fatal respiratory depression when administered to patients not previously exposed to opioids. OxyContin® (oxycodone hydrochloride controlled-release) TABLETS ARE TO BE SWALLOWED WHOLE AND ARE NOT TO BE BROKEN, CHEWED, OR CRUSHED. TAKING BROKEN, CHEWED, OR CRUSHED OxyContin® TABLETS LEADS TO RAPID RELEASE AND ABSORPTION OF A POTENTIALLY FATAL DOSE OF OXYCODONE. OxyContin® (oxycodone hydrochloride controlled-release) tablets are an opioid analgesic supplied in 10 mg, 20 mg, 40 mg, 80 mg, and 160 mg tablet strengths for oral administration. The tablet strengths describe the amount of oxycodone per tablet as the hydrochloride salt. Its molecular formula is C18H21NO4 · HCl. Its molecular weight is 351.83. The chemical formula is 4, 5-epoxy-14-hydroxy-3-methoxy-17-methylmorphinan-6-one hydrochloride. Oxycodone is a white, odorless crystalline powder derived from the opium alkaloid, thebaine. Oxycodone hydrochloride dissolves in water (1 g in 6 to 7 mL). It is slightly soluble in alcohol (octanol water partition coefficient 0.7). The tablets contain the following inactive ingredients: ammonio methacrylate copolymer, hydroxypropyl methylcellulose, lactose, magnesium stearate, povidone, red iron oxide (20 mg strength tablet only), stearyl alcohol, talc, titanium dioxide, triacetin, yellow iron oxide (40 mg strength tablet only), yellow iron oxide with FD&C blue No.2 (80 mg strength tablet only), FD&C blue No.2 (160 mg strength tablet only) and other ingredients. INDICATIONS OxyContin® tablets are a controlled-release oral formulation of oxycodone hydrochloride indicated for the management of moderate to severe pain when a continuous, around-the-clock analgesic is needed for an extended period of time. OxyContin® is NOT intended for use as a prn analgesic. Physicians should individualize treatment in every case, initiating therapy at the appropriate point along a progression from non-opioid analgesics, such as nonsteroidal anti-inflammatory drugs and acetaminophen to opioids in a plan of pain management such as outlined by the World Health Organization, the Agency for Health Research and Quality (formerly known as the Agency for Health Care Policy and Research), the Federation of State Medical Boards Model Guidelines, or the American Pain Society. OxyContin® is not indicated for pain in the immediate post-operative period (the first 12-24 hours following surgery), or if the pain is mild, or not expected to persist for an extended period of time. OxyContin® is only indicated for post-operative use if the patient is already receiving the drug prior to surgery or if the postoperative pain is expected to be moderate to severe and persist for an extended period of time. Physicians should individualize treatment, moving from parenteral to oral analgesics as appropriate. (See American Pain Society guidelines.) DOSAGE AND ADMINISTRATION General Principles OxyContin® IS AN OPIOID AGONIST AND A SCHEDULE II CONTROLLED SUBSTANCE WITH AN ABUSE LIABILITY SIMILAR TO MORPHINE. OXYCODONE, LIKE MORPHINE AND OTHER OPIOIDS USED IN ANALGESIA, CAN BE ABUSED AND IS SUBJECT TO CRIMINAL DIVERSION. OxyContin® (oxycodone hydrochloride controlled-release) TABLETS ARE TO BE SWALLOWED WHOLE, AND ARE NOT TO BE BROKEN, CHEWED OR CRUSHED. TAKING BROKEN, CHEWED OR CRUSHED OxyContin® TABLETS LEADS TO THE RAPID RELEASE AND ABSORPTION OF A POTENTIALLY FATAL DOSE OF OXYCODONE. One OxyContin® 160 mg tablet is comparable to two 80 mg tablets when taken on an empty stomach. With a high fat meal, however, there is a 25% greater peak plasma concentration following one 160 mg tablet. Dietary caution should be taken when patients are initially titrated to 160 mg tablets (see Special Instructions for OxyContin® 80 mg and 160 mg Tablets). In treating pain it is vital to assess the patient regularly and systematically. Therapy should also be regularly reviewed and adjusted based upon the patient's own reports of pain and side effects and the health professional's clinical judgment. OxyContin® tablets are a controlled-release oral formulation of oxycodone hydrochloride indicated for the management of moderate to severe pain requiring treatment with a strong opioid for continuous, around-the-clock analgesia for an extended period of time. The controlled-release nature of the formulation allows OxyContin® to be effectively administered every 12 hours (see CLINICAL PHARMACOLOGY: PHARMACOKINETICS AND METABOLISM). While symmetric (same dose AM and PM), around-the-clock, q12h dosing is appropriate for the majority of patients, some patients may benefit from asymmetric (different dose given in AM than in PM) dosing, tailored to their pain pattern. It is usually appropriate to treat a patient with only one opioid for around-the-clock therapy. Physicians should individualize treatment using a progressive plan of pain management such as outlined by the World Health Organization, the American Pain Society and the Federation of State Medical Boards Model Guidelines. Health care professionals should follow appropriate pain management principles of careful assessment and ongoing monitoring [See BOXED WARNING]. Initiation of Therapy It is critical to initiate the dosing regimen for each patient individually, taking into account the patient's prior opioid and non-opioid analgesic treatment. Attention should be given to: (1) the general condition and medical status of the patient; (2) the daily dose, potency, and kind of the analgesic(s) the patient has been taking; (3) the reliability of the conversion estimate used to calculate the dose of oxycodone; (4) the patient's opioid exposure and opioid tolerance (if any); (5) special safety issues associated with conversion to OxyContin® doses at or exceeding 160 mg q12h (see Special Instructions for OxyContin® 80 mg and 160 mg Tablets); and (6) the balance between pain control and adverse experiences. Care should be taken to use low initial doses of OxyContin® in patients who are not already opioid-tolerant, especially those who are receiving concurrent treatment with muscle relaxants, sedatives, or other CNS active medications (see drug INTERACTIONS). For initiation of OxyContin® therapy for patients previously taking opioids, the conversion ratios from Foley, KM. [NEJM, 1985; 313:84-95], found below, are a reasonable starting point, although not verified in well-controlled, multiple-dose trials. Experience indicates a reasonable starting dose of OxyContin® for patients who are taking non-opioid analgesics and require continuous around-the-clock therapy for an extended period of time is 10 mg q12h. If a non-opioid analgesic is being provided, it may be continued. OxyContin® should be individually titrated to a dose that provides adequate analgesia and minimizes side effects. 1. Using standard conversion ratio estimates (see Table 4 below), multiply the mg/day of the previous opioids by the appropriate multiplication factors to obtain the equivalent total daily dose of oral oxycodone. 2. When converting from oxycodone, divide the 24-hour oxycodone dose in half to obtain the twice a day (q12h) dose of OxyContin®. 3. Round down to a dose which is appropriate for the tablet strengths available (10 mg, 20 mg, 40 mg, 80 mg, and 160 mg tablets). 4. Discontinue all other around-the-clock opioid drugs when OxyContin® therapy is initiated. 5. No fixed conversion ratio is likely to be satisfactory in all patients, especially patients receiving large opioid doses. The recommended doses shown in Table 4 are only a starting point, and close observation and frequent titration are indicated until patients are stable on the new therapy. Table 4 Multiplication Factors for Converting the Daily Dose of Prior Opioids to the Daily Dose of Oral Oxycodone* (Mg/Day Prior Opioid x Factor = Mg/Day Oral Oxycodone) Oral Prior Opioid Parenteral Prior Opioid Oxycodone 1 — Codeine 0.15 — Hydrocodone 0.9 — Hydromorphone 4 20 Levorphanol 7.5 15 Meperidine 0.1 0.4 Methadone 1.5 3 Morphine 0.5 3 To be used only for conversion to oral oxycodone. For patients receiving high-dose parenteral opioids, a more conservative conversion is warranted. For example, for high-dose parenteral morphine, use 1.5 instead of 3 as a multiplication factor. In all cases, supplemental analgesia (see below) should be made available in the form of a suitable short-acting analgesic. OxyContin® can be safely used concomitantly with usual doses of non-opioid analgesics and analgesic adjuvants, provided care is taken to select a proper initial dose (see PRECAUTIONS). Conversion from Transdermal Fentanyl to OxyContin® Eighteen hours following the removal of the transdermal fentanyl patch, OxyContin® treatment can be initiated. Although there has been no systematic assessment of such conversion, a conservative oxycodone dose, approximately 10 mg q12h of OxyContin®, should be initially substituted for each 25 µg/hr fentanyl transdermal patch. The patient should be followed closely for early titration, as there is very limited clinical experience with this conversion. Managing Expected Opioid Adverse Experiences Most patients receiving opioids, especially those who are opioid-naive, will experience side effects. Frequently the side effects from OxyContin® are transient, but may require evaluation and management. Adverse events such as constipation should be anticipated and treated aggressively and prophylactically with a stimulant laxative and/or stool softener. Patients do not usually become tolerant to the constipating effects of opioids. Other opioid-related side effects such as sedation and nausea are usually self-limited and often do not persist beyond the first few days. If nausea persists and is unacceptable to the patient, treatment with anti-emetics or other modalities may relieve these symptoms and should be considered. Patients receiving OxyContin® may pass an intact matrix "ghost" in the stool or via colostomy. These ghosts contain little or no residual oxycodone and are of no clinical consequence. Individualization of Dosage Once therapy is initiated, pain relief and other opioid effects should be frequently assessed. Patients should be titrated to adequate effect (generally mild or no pain with the regular use of no more than two doses of supplemental analgesia per 24 hours). Patients who experience breakthrough pain may require dosage adjustment or rescue medication. Because steady-state plasma concentrations are approximated within 24 to 36 hours, dosage adjustment may be carried out every 1 to 2 days. It is most appropriate to increase the q12h dose, not the dosing frequency. There is no clinical information on dosing intervals shorter than q12h. As a guideline, except for the increase from 10 mg to 20 mg q12h, the total daily oxycodone dose usually can be increased by 25% to 50% of the current dose at each increase. If signs of excessive opioid-related adverse experiences are observed, the next dose may be reduced. If this adjustment leads to inadequate analgesia, a supplemental dose of immediate-release oxycodone may be given. Alternatively, non-opioid analgesic adjuvants may be employed. Dose adjustments should be made to obtain an appropriate balance between pain relief and opioid-related adverse experiences. If significant adverse events occur before the therapeutic goal of mild or no pain is achieved, the events should be treated aggressively. Once adverse events are under control, upward titration should continue to an acceptable level of pain control. During periods of changing analgesic requirements, including initial titration, frequent contact is recommended between physician, other members of the healthcare team, the patient and the caregiver/family. Special Instructions for OxyContin® 80 mg and 160 mg Tablets (For use in opioid-tolerant patients only) OxyContin® 80 mg and 160 mg Tablets are for use only in opioid-tolerant patients requiring daily oxycodone equivalent dosages of 160 mg or more for the 80 mg tablet and 320 mg or more for the 160 mg tablet. Care should be taken in the prescribing of these tablet strengths. Patients should be instructed against use by individuals other than the patient for whom it was prescribed, as such inappropriate use may have severe medical consequences, including death. One OxyContin® 160 mg tablet is comparable to two 80 mg tablets when taken on an empty stomach. With a high fat meal, however, there is a 25% greater peak plasma concentration following one 160 mg tablet. Dietary caution should be taken when patients are initially titrated to 160 mg tablets. Supplemental Analgesia Most patients given around-the-clock therapy with controlled-release opioids may need to have immediate-release medication available for exacerbations of pain or to prevent pain that occurs predictably during certain patient activities (incident pain). Maintenance of Therapy The intent of the titration period is to establish a patient-specific q12h dose that will maintain adequate analgesia with acceptable side effects for as long as pain relief is necessary. Should pain recur then the dose can be incrementally increased to re-establish pain control. The method of therapy adjustment outlined above should be employed to re-establish pain control. During chronic therapy, especially for non-cancer pain syndromes, the continued need for around-the-clock opioid therapy should be reassessed periodically (e.g., every 6 to 12 months) as appropriate. Cessation of Therapy When the patient no longer requires therapy with OxyContin® tablets, doses should be tapered gradually to prevent signs and symptoms of withdrawal in the physically dependent patient. Conversion from OxyContin® to Parenteral Opioids To avoid overdose, conservative dose conversion ratios should be followed. SAFETY AND HANDLING OxyContin® (oxycodone HCl controlled-release) tablets are solid dosage forms that contain oxycodone which is a controlled substance. Like morphine, oxycodone is controlled under Schedule II of the Controlled Substances Act. OxyContin® has been targeted for theft and diversion by criminals. Healthcare professionals should contact their State Professional Licensing Board or State Controlled Substances Authority for information on how to prevent and detect abuse or diversion of this product. HOW SUPPLIED OxyContin® (oxycodone hydrochloride controlled-release) 10 mg tablets are round, unscored, white-colored, convex tablets bearing the symbol OC on one side and 10 on the other. They are supplied as follows: NDC 59011-100-10: child-resistant closure, opaque plastic bottles of 100 NDC 59011-100-25: unit dose packaging with 25 individually numbered tablets per card; one card per glue end carton OxyContin® (oxycodone hydrochloride controlled-release) 20 mg tablets are round, unscored, pink-colored, convex tablets bearing the symbol OC on one side and 20 on the other. They are supplied as follows: NDC 59011-103-10: child-resistant closure, opaque plastic bottles of 100 NDC 59011-103-25: unit dose packaging with 25 individually numbered tablets per card; one card per glue end carton OxyContin® (oxycodone hydrochloride controlled-release) 40 mg tablets are round, unscored, yellow-colored, convex tablets bearing the symbol OC on one side and 40 on the other. They are supplied as follows: NDC 59011-105-10: child-resistant closure, opaque plastic bottles of 100 NDC 59011-105-25: unit dose packaging with 25 individually numbered tablets per card; one card per glue end carton OxyContin® (oxycodone hydrochloride controlled-release) 80 mg tablets are round, unscored, green-colored, convex tablets bearing the symbol OC on one side and 80 on the other. They are supplied as follows: NDC 59011-107-10: child-resistant closure, opaque plastic bottles of 100 NDC 59011-107-25: unit dose packaging with 25 individually numbered tablets per card; one card per glue end carton OxyContin® (oxycodone hydrochloride controlled-release) 160 mg tablets are caplet-shaped, unscored, blue-colored, convex tablets bearing the symbol OC on one side and 160 on the other. They are supplied as follows: NDC 59011-109-10: child-resistant closure, opaque plastic bottles of 100 NDC 59011-109-25: unit dose packaging with 25 individually numbered tablets per card; one card per glue end carton Store at 25°C (77 F); excursions permitted between 15°-30°C (59°-86°F). Dispense in tight, light-resistant container. Healthcare professionals can telephone Purdue Pharma’s Medical Services Department (1-888-726-7535) for information on this product. PATIENT INFORMATION If clinically advisable, patients receiving OxyContin® (oxycodone hydrochloride controlled-release) tablets or their caregivers should be given the following information by the physician, nurse, pharmacist, or caregiver: 1. Patients should be aware that OxyContin® tablets contain oxycodone, which is a morphine-like substance. 2. Patients should be advised that OxyContin® tablets were designed to work properly only if swallowed whole. OxyContin® tablets will release all their contents at once if broken, chewed, or crushed, resulting in a risk of fatal overdose. 3. Patients should be advised to report episodes of breakthrough pain and adverse experiences occurring during therapy. Individualization of dosage is essential to make optimal use of this medication. 4. Patients should be advised not to adjust the dose of OxyContin® without consulting the prescribing professional. 5. Patients should be advised that OxyContin® may impair mental and/or physical ability required for the performance of potentially hazardous tasks (e.g., driving, operating heavy machinery). 6. Patients should not combine OxyContin® with alcohol or other central nervous system depressants (sleep aids, tranquilizers) except by the orders of the prescribing physician, because dangerous additive effects may occur, resulting in serious injury or death. 7. Women of childbearing potential who become, or are planning to become, pregnant should be advised to consult their physician regarding the effects of analgesics and other drug use during pregnancy on themselves and their unborn child. 8. Patients should be advised that OxyContin® is a potential drug of abuse. They should protect it from theft, and it should never be given to anyone other than the individual for whom it was prescribed. 9. Patients should be advised that they may pass empty matrix "ghosts" (tablets) via colostomy or in the stool, and that this is of no concern since the active medication has already been absorbed. 10. Patients should be advised that if they have been receiving treatment with OxyContin® for more than a few weeks and cessation of therapy is indicated, it may be appropriate to taper the OxyContin® dose, rather than abruptly discontinue it, due to the risk of precipitating withdrawal symptoms. Their physician can provide a dose schedule to accomplish a gradual discontinuation of the medication. 11. Patients should be instructed to keep OxyContin® in a secure place out of the reach of children. When OxyContin® is no longer needed, the unused tablets should be destroyed by flushing down the toilet.
|
|
Top
|
|
|
|
|
|
|
|
|
|
|
|
|
|
#932695 - 09/21/09 02:01 PM
Re: Oxycodone - Oxycontin
[Re: bridgetg843]
|
Pooh-Bah
Registered: 01/11/05
Posts: 1159
Loc: Earth - Usually
|
|
|
Top
|
|
|
|
|
|
|
|
|
|
|
|
|
|
#981622 - 12/19/09 06:43 PM
Re: Oxycodone - Oxycontin
[Re: Melody]
|
Stranger
Registered: 12/19/09
Posts: 2
|
Oxycodone HCl WARNING OxyContin® is an opioid agonist and a Schedule II controlled substance with an abuse liability similar to morphine. Oxycodone can be abused in a manner similar to other opioid agonists, legal or illicit. This should be considered when prescribing or dispensing OxyContin® in situations where the physician or pharmacist is concerned about an increased risk of misuse, abuse, or diversion. OxyContin® tablets are a controlled-release oral formulation of oxycodone hydrochloride indicated for the management of moderate to severe pain when a continuous, around-the-clock analgesic is needed for an extended period of time. OxyContin® tablets are NOT intended for use as a prn analgesic. OxyContin® 80 mg and 160 mg Tablets ARE FOR USE IN OPIOID TOLERANT PATIENTS ONLY. These tablet strengths may cause fatal respiratory depression when administered to patients not previously exposed to opioids. OxyContin® (oxycodone hydrochloride controlled-release) TABLETS ARE TO BE SWALLOWED WHOLE AND ARE NOT TO BE BROKEN, CHEWED, OR CRUSHED. TAKING BROKEN, CHEWED, OR CRUSHED OxyContin® TABLETS LEADS TO RAPID RELEASE AND ABSORPTION OF A POTENTIALLY FATAL DOSE OF OXYCODONE. OxyContin® (oxycodone hydrochloride controlled-release) tablets are an opioid analgesic supplied in 10 mg, 20 mg, 40 mg, 80 mg, and 160 mg tablet strengths for oral administration. The tablet strengths describe the amount of oxycodone per tablet as the hydrochloride salt. Its molecular formula is C18H21NO4 · HCl. Its molecular weight is 351.83. The chemical formula is 4, 5-epoxy-14-hydroxy-3-methoxy-17-methylmorphinan-6-one hydrochloride. Oxycodone is a white, odorless crystalline powder derived from the opium alkaloid, thebaine. Oxycodone hydrochloride dissolves in water (1 g in 6 to 7 mL). It is slightly soluble in alcohol (octanol water partition coefficient 0.7). The tablets contain the following inactive ingredients: ammonio methacrylate copolymer, hydroxypropyl methylcellulose, lactose, magnesium stearate, povidone, red iron oxide (20 mg strength tablet only), stearyl alcohol, talc, titanium dioxide, triacetin, yellow iron oxide (40 mg strength tablet only), yellow iron oxide with FD&C blue No.2 (80 mg strength tablet only), FD&C blue No.2 (160 mg strength tablet only) and other ingredients. INDICATIONS OxyContin® tablets are a controlled-release oral formulation of oxycodone hydrochloride indicated for the management of moderate to severe pain when a continuous, around-the-clock analgesic is needed for an extended period of time. OxyContin® is NOT intended for use as a prn analgesic. Physicians should individualize treatment in every case, initiating therapy at the appropriate point along a progression from non-opioid analgesics, such as nonsteroidal anti-inflammatory drugs and acetaminophen to opioids in a plan of pain management such as outlined by the World Health Organization, the Agency for Health Research and Quality (formerly known as the Agency for Health Care Policy and Research), the Federation of State Medical Boards Model Guidelines, or the American Pain Society. OxyContin® is not indicated for pain in the immediate post-operative period (the first 12-24 hours following surgery), or if the pain is mild, or not expected to persist for an extended period of time. OxyContin® is only indicated for post-operative use if the patient is already receiving the drug prior to surgery or if the postoperative pain is expected to be moderate to severe and persist for an extended period of time. Physicians should individualize treatment, moving from parenteral to oral analgesics as appropriate. (See American Pain Society guidelines.) DOSAGE AND ADMINISTRATION General Principles OxyContin® IS AN OPIOID AGONIST AND A SCHEDULE II CONTROLLED SUBSTANCE WITH AN ABUSE LIABILITY SIMILAR TO MORPHINE. OXYCODONE, LIKE MORPHINE AND OTHER OPIOIDS USED IN ANALGESIA, CAN BE ABUSED AND IS SUBJECT TO CRIMINAL DIVERSION. OxyContin® (oxycodone hydrochloride controlled-release) TABLETS ARE TO BE SWALLOWED WHOLE, AND ARE NOT TO BE BROKEN, CHEWED OR CRUSHED. TAKING BROKEN, CHEWED OR CRUSHED OxyContin® TABLETS LEADS TO THE RAPID RELEASE AND ABSORPTION OF A POTENTIALLY FATAL DOSE OF OXYCODONE. One OxyContin® 160 mg tablet is comparable to two 80 mg tablets when taken on an empty stomach. With a high fat meal, however, there is a 25% greater peak plasma concentration following one 160 mg tablet. Dietary caution should be taken when patients are initially titrated to 160 mg tablets (see Special Instructions for OxyContin® 80 mg and 160 mg Tablets). In treating pain it is vital to assess the patient regularly and systematically. Therapy should also be regularly reviewed and adjusted based upon the patient's own reports of pain and side effects and the health professional's clinical judgment. OxyContin® tablets are a controlled-release oral formulation of oxycodone hydrochloride indicated for the management of moderate to severe pain requiring treatment with a strong opioid for continuous, around-the-clock analgesia for an extended period of time. The controlled-release nature of the formulation allows OxyContin® to be effectively administered every 12 hours (see CLINICAL PHARMACOLOGY: PHARMACOKINETICS AND METABOLISM). While symmetric (same dose AM and PM), around-the-clock, q12h dosing is appropriate for the majority of patients, some patients may benefit from asymmetric (different dose given in AM than in PM) dosing, tailored to their pain pattern. It is usually appropriate to treat a patient with only one opioid for around-the-clock therapy. Physicians should individualize treatment using a progressive plan of pain management such as outlined by the World Health Organization, the American Pain Society and the Federation of State Medical Boards Model Guidelines. Health care professionals should follow appropriate pain management principles of careful assessment and ongoing monitoring [See BOXED WARNING]. Initiation of Therapy It is critical to initiate the dosing regimen for each patient individually, taking into account the patient's prior opioid and non-opioid analgesic treatment. Attention should be given to: (1) the general condition and medical status of the patient; (2) the daily dose, potency, and kind of the analgesic(s) the patient has been taking; (3) the reliability of the conversion estimate used to calculate the dose of oxycodone; (4) the patient's opioid exposure and opioid tolerance (if any); (5) special safety issues associated with conversion to OxyContin® doses at or exceeding 160 mg q12h (see Special Instructions for OxyContin® 80 mg and 160 mg Tablets); and (6) the balance between pain control and adverse experiences. Care should be taken to use low initial doses of OxyContin® in patients who are not already opioid-tolerant, especially those who are receiving concurrent treatment with muscle relaxants, sedatives, or other CNS active medications (see drug INTERACTIONS). For initiation of OxyContin® therapy for patients previously taking opioids, the conversion ratios from Foley, KM. [NEJM, 1985; 313:84-95], found below, are a reasonable starting point, although not verified in well-controlled, multiple-dose trials. Experience indicates a reasonable starting dose of OxyContin® for patients who are taking non-opioid analgesics and require continuous around-the-clock therapy for an extended period of time is 10 mg q12h. If a non-opioid analgesic is being provided, it may be continued. OxyContin® should be individually titrated to a dose that provides adequate analgesia and minimizes side effects. 1. Using standard conversion ratio estimates (see Table 4 below), multiply the mg/day of the previous opioids by the appropriate multiplication factors to obtain the equivalent total daily dose of oral oxycodone. 2. When converting from oxycodone, divide the 24-hour oxycodone dose in half to obtain the twice a day (q12h) dose of OxyContin®. 3. Round down to a dose which is appropriate for the tablet strengths available (10 mg, 20 mg, 40 mg, 80 mg, and 160 mg tablets). 4. Discontinue all other around-the-clock opioid drugs when OxyContin® therapy is initiated. 5. No fixed conversion ratio is likely to be satisfactory in all patients, especially patients receiving large opioid doses. The recommended doses shown in Table 4 are only a starting point, and close observation and frequent titration are indicated until patients are stable on the new therapy. Table 4 Multiplication Factors for Converting the Daily Dose of Prior Opioids to the Daily Dose of Oral Oxycodone* (Mg/Day Prior Opioid x Factor = Mg/Day Oral Oxycodone) Oral Prior Opioid Parenteral Prior Opioid Oxycodone 1 — Codeine 0.15 — Hydrocodone 0.9 — Hydromorphone 4 20 Levorphanol 7.5 15 Meperidine 0.1 0.4 Methadone 1.5 3 Morphine 0.5 3 To be used only for conversion to oral oxycodone. For patients receiving high-dose parenteral opioids, a more conservative conversion is warranted. For example, for high-dose parenteral morphine, use 1.5 instead of 3 as a multiplication factor. In all cases, supplemental analgesia (see below) should be made available in the form of a suitable short-acting analgesic. OxyContin® can be safely used concomitantly with usual doses of non-opioid analgesics and analgesic adjuvants, provided care is taken to select a proper initial dose (see PRECAUTIONS). Conversion from Transdermal Fentanyl to OxyContin® Eighteen hours following the removal of the transdermal fentanyl patch, OxyContin® treatment can be initiated. Although there has been no systematic assessment of such conversion, a conservative oxycodone dose, approximately 10 mg q12h of OxyContin®, should be initially substituted for each 25 µg/hr fentanyl transdermal patch. The patient should be followed closely for early titration, as there is very limited clinical experience with this conversion. Managing Expected Opioid Adverse Experiences Most patients receiving opioids, especially those who are opioid-naive, will experience side effects. Frequently the side effects from OxyContin® are transient, but may require evaluation and management. Adverse events such as constipation should be anticipated and treated aggressively and prophylactically with a stimulant laxative and/or stool softener. Patients do not usually become tolerant to the constipating effects of opioids. Other opioid-related side effects such as sedation and nausea are usually self-limited and often do not persist beyond the first few days. If nausea persists and is unacceptable to the patient, treatment with anti-emetics or other modalities may relieve these symptoms and should be considered. Patients receiving OxyContin® may pass an intact matrix "ghost" in the stool or via colostomy. These ghosts contain little or no residual oxycodone and are of no clinical consequence. Individualization of Dosage Once therapy is initiated, pain relief and other opioid effects should be frequently assessed. Patients should be titrated to adequate effect (generally mild or no pain with the regular use of no more than two doses of supplemental analgesia per 24 hours). Patients who experience breakthrough pain may require dosage adjustment or rescue medication. Because steady-state plasma concentrations are approximated within 24 to 36 hours, dosage adjustment may be carried out every 1 to 2 days. It is most appropriate to increase the q12h dose, not the dosing frequency. There is no clinical information on dosing intervals shorter than q12h. As a guideline, except for the increase from 10 mg to 20 mg q12h, the total daily oxycodone dose usually can be increased by 25% to 50% of the current dose at each increase. If signs of excessive opioid-related adverse experiences are observed, the next dose may be reduced. If this adjustment leads to inadequate analgesia, a supplemental dose of immediate-release oxycodone may be given. Alternatively, non-opioid analgesic adjuvants may be employed. Dose adjustments should be made to obtain an appropriate balance between pain relief and opioid-related adverse experiences. If significant adverse events occur before the therapeutic goal of mild or no pain is achieved, the events should be treated aggressively. Once adverse events are under control, upward titration should continue to an acceptable level of pain control. During periods of changing analgesic requirements, including initial titration, frequent contact is recommended between physician, other members of the healthcare team, the patient and the caregiver/family. Special Instructions for OxyContin® 80 mg and 160 mg Tablets (For use in opioid-tolerant patients only) OxyContin® 80 mg and 160 mg Tablets are for use only in opioid-tolerant patients requiring daily oxycodone equivalent dosages of 160 mg or more for the 80 mg tablet and 320 mg or more for the 160 mg tablet. Care should be taken in the prescribing of these tablet strengths. Patients should be instructed against use by individuals other than the patient for whom it was prescribed, as such inappropriate use may have severe medical consequences, including death. One OxyContin® 160 mg tablet is comparable to two 80 mg tablets when taken on an empty stomach. With a high fat meal, however, there is a 25% greater peak plasma concentration following one 160 mg tablet. Dietary caution should be taken when patients are initially titrated to 160 mg tablets. Supplemental Analgesia Most patients given around-the-clock therapy with controlled-release opioids may need to have immediate-release medication available for exacerbations of pain or to prevent pain that occurs predictably during certain patient activities (incident pain). Maintenance of Therapy The intent of the titration period is to establish a patient-specific q12h dose that will maintain adequate analgesia with acceptable side effects for as long as pain relief is necessary. Should pain recur then the dose can be incrementally increased to re-establish pain control. The method of therapy adjustment outlined above should be employed to re-establish pain control. During chronic therapy, especially for non-cancer pain syndromes, the continued need for around-the-clock opioid therapy should be reassessed periodically (e.g., every 6 to 12 months) as appropriate. Cessation of Therapy When the patient no longer requires therapy with OxyContin® tablets, doses should be tapered gradually to prevent signs and symptoms of withdrawal in the physically dependent patient. Conversion from OxyContin® to Parenteral Opioids To avoid overdose, conservative dose conversion ratios should be followed. SAFETY AND HANDLING OxyContin® (oxycodone HCl controlled-release) tablets are solid dosage forms that contain oxycodone which is a controlled substance. Like morphine, oxycodone is controlled under Schedule II of the Controlled Substances Act. OxyContin® has been targeted for theft and diversion by criminals. Healthcare professionals should contact their State Professional Licensing Board or State Controlled Substances Authority for information on how to prevent and detect abuse or diversion of this product. HOW SUPPLIED OxyContin® (oxycodone hydrochloride controlled-release) 10 mg tablets are round, unscored, white-colored, convex tablets bearing the symbol OC on one side and 10 on the other. They are supplied as follows: NDC 59011-100-10: child-resistant closure, opaque plastic bottles of 100 NDC 59011-100-25: unit dose packaging with 25 individually numbered tablets per card; one card per glue end carton OxyContin® (oxycodone hydrochloride controlled-release) 20 mg tablets are round, unscored, pink-colored, convex tablets bearing the symbol OC on one side and 20 on the other. They are supplied as follows: NDC 59011-103-10: child-resistant closure, opaque plastic bottles of 100 NDC 59011-103-25: unit dose packaging with 25 individually numbered tablets per card; one card per glue end carton OxyContin® (oxycodone hydrochloride controlled-release) 40 mg tablets are round, unscored, yellow-colored, convex tablets bearing the symbol OC on one side and 40 on the other. They are supplied as follows: NDC 59011-105-10: child-resistant closure, opaque plastic bottles of 100 NDC 59011-105-25: unit dose packaging with 25 individually numbered tablets per card; one card per glue end carton OxyContin® (oxycodone hydrochloride controlled-release) 80 mg tablets are round, unscored, green-colored, convex tablets bearing the symbol OC on one side and 80 on the other. They are supplied as follows: NDC 59011-107-10: child-resistant closure, opaque plastic bottles of 100 NDC 59011-107-25: unit dose packaging with 25 individually numbered tablets per card; one card per glue end carton OxyContin® (oxycodone hydrochloride controlled-release) 160 mg tablets are caplet-shaped, unscored, blue-colored, convex tablets bearing the symbol OC on one side and 160 on the other. They are supplied as follows: NDC 59011-109-10: child-resistant closure, opaque plastic bottles of 100 NDC 59011-109-25: unit dose packaging with 25 individually numbered tablets per card; one card per glue end carton Store at 25°C (77 F); excursions permitted between 15°-30°C (59°-86°F). Dispense in tight, light-resistant container. Healthcare professionals can telephone Purdue Pharma’s Medical Services Department (1-888-726-7535) for information on this product. PATIENT INFORMATION If clinically advisable, patients receiving OxyContin® (oxycodone hydrochloride controlled-release) tablets or their caregivers should be given the following information by the physician, nurse, pharmacist, or caregiver: 1. Patients should be aware that OxyContin® tablets contain oxycodone, which is a morphine-like substance. 2. Patients should be advised that OxyContin® tablets were designed to work properly only if swallowed whole. OxyContin® tablets will release all their contents at once if broken, chewed, or crushed, resulting in a risk of fatal overdose. 3. Patients should be advised to report episodes of breakthrough pain and adverse experiences occurring during therapy. Individualization of dosage is essential to make optimal use of this medication. 4. Patients should be advised not to adjust the dose of OxyContin® without consulting the prescribing professional. 5. Patients should be advised that OxyContin® may impair mental and/or physical ability required for the performance of potentially hazardous tasks (e.g., driving, operating heavy machinery). 6. Patients should not combine OxyContin® with alcohol or other central nervous system depressants (sleep aids, tranquilizers) except by the orders of the prescribing physician, because dangerous additive effects may occur, resulting in serious injury or death. 7. Women of childbearing potential who become, or are planning to become, pregnant should be advised to consult their physician regarding the effects of analgesics and other drug use during pregnancy on themselves and their unborn child. 8. Patients should be advised that OxyContin® is a potential drug of abuse. They should protect it from theft, and it should never be given to anyone other than the individual for whom it was prescribed. 9. Patients should be advised that they may pass empty matrix "ghosts" (tablets) via colostomy or in the stool, and that this is of no concern since the active medication has already been absorbed. 10. Patients should be advised that if they have been receiving treatment with OxyContin® for more than a few weeks and cessation of therapy is indicated, it may be appropriate to taper the OxyContin® dose, rather than abruptly discontinue it, due to the risk of precipitating withdrawal symptoms. Their physician can provide a dose schedule to accomplish a gradual discontinuation of the medication. 11. Patients should be instructed to keep OxyContin® in a secure place out of the reach of children. When OxyContin® is no longer needed, the unused tablets should be destroyed by flushing down the toilet.
|
|
Top
|
|
|
|
|
|
|
|
|
|
|
|
|
|
#998447 - 01/31/10 03:45 PM
Re: Oxycodone - Oxycontin
[Re: owwmyback]
|
Stranger
Registered: 09/18/09
Posts: 3
Loc: Tampa, Florida USA
|
Question:
I have Behcet's Syndrome a Chronic and often very painful disease in many forms, joints, muscles, ulcers, migraines. I was on Oxycontin 80, but my Dr. has stopped it and is in favor of keeping me on Marinol(The THC'Pot' Pill) now and not use Oxy at all. I get Epi. block treatments around every 3 months. For some reason, I think it may be a financial thing that he's keeping me off the Oxy, so I have a reason then to see him more often so he gains financially from Tricare and my small co-pay.
I live in the Tampa area and am under Tricare Prime for insurance. Anyone know of any Dr's in the Tampa, Florida area that is a little more favorable to actually helping the patient deal with the pain? With a favorable medication that works for the patient as in my case Oxycontin 80 really helps and lets me feel human again, though I admit slightly euphoric at first.
Thanks!
|
|
Top
|
|
|
|
|
|
|
|
|
|
|
|
|
|
#998745 - 02/01/10 11:21 AM
Re: Oxycodone - Oxycontin
[Re: martind]
|
Stranger
Registered: 09/18/09
Posts: 3
Loc: Tampa, Florida USA
|
He's a D.O. so does acupuncture, massages, therapy sessions and such. So more profitable I'd think to keep me coming in for that and general weaker meds, than writing me a script for Oxy and seeing me less often. Ergo, I'm going to track down a more medicine oriented Doc. who will give me the correct drugs I need such as Oxy. When I was taking Oxy 80's for a month I felt GREAT (Almost NO)pain, true I was also euphoric at first, but it really did the miracle of helping me cope with the pain throughout my body. The drying out was a bit tough, but I manage to get clean after 4 days of sweating, chills, nausea. Valium helped with that at least.
Lou
|
|
Top
|
|
|
|
|
|
|
|
|
|
|
.jpg "476121-anglegir(2).jpg")
I am not clear on what is required for a consultation (other than the fee) or what kind of medical records are needed. I have three years worth with one doctor and none from my first doctor. The free clinic I went to was shut down years ago due to lack of funding so no records there. My Dr. was prescribing Lortab 10 every 8 hrs. Being jobless and eventually homeless I started going to my Sister's Dr. because she gave her discounts on self-pay patients. Well she must not have liked me much because I only got the discount of $50 twice. After that it was $75 just to be seen. Then I had to find any public health org. to help pay for the measley meds she grudgingly prescribed. Long story short, after 3 yrs. in her care, and I use the term loosley, I have developed high blood pressure, anxiety disorder and have gaind 35#. I finally won my disability case and have medicare and medicaid now and she wants to order all kinds of standard tests for me now, but will still not budge on the Vicodin 5/500 one pill a night that she has been prescribing for 3 years (every 6 months mandatory). She even admits that I will have chronic pain all my life due to my conditions, but will not prescribe anything stronger or even any more than 1 a day. I have to continue this later, I need to lie down for now. 
Previous Topic
Index