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Oxycodone in palliative care

Oxycodone is a medicine like morphine that works as a strong pain reliever (painkiller). When used correctly at the right dose, there's no evidence that it either shortens or prolongs life. The name sounds similar to codeine, but it isn't the same.

How is oxycodone taken?

These are two common ways of taking oxycodone:

Controlled-release (slow-acting) tablets

Controlled-release tablets usually last for 12 hours. They come in different strengths from 5 mg through to 80 mg. Because they last for 12 hours, you need to take them every 12 hours, for example 8 am and 8 pm or 9 am and 9 pm.

These tablets don't help with sudden sharp pain or bouts of pain that happen between the morning and night-time doses. You need to swallow the tablets whole – don't chew or crush any of them. Your doctor may need to prescribe a combination of tablet strengths to get the right dose for you.

Immediate-release (fast-acting) capsules or liquid (elixir)

The brand name is OxyNorm, and it also comes in different strengths. The medicine starts to work within half to one hour of being taken and lasts for four to six hours.

Fast-acting OxyNorm is suitable for sudden pain that happens despite regular pain relief. This pain is known as breakthrough pain or incident pain. You can also use it occasionally before you start taking long-acting medications.

Does oxycodone work for all pain?

No. Oxycodone only helps some types of pain, and you may need to take other pain relief medicine as well. Your doctor will discuss this with you.

Will I need more and more to control the pain?

You may need to steadily increase the dose of oxycodone, particularly when starting it, to work out the right dose. Your doctor will do this slowly and steadily over a few days – it may take up to two weeks to get the right dose. As your illness progresses, you may need to increase the dose, but this usually happens because the pain is getting worse. It doesn't mean that the oxycodone is losing its effect.

What side effects might I get?

Constipation

Although oxycodone is a good pain reliever, almost everybody who takes it gets constipated. You should make sure your doctor routinely prescribes a good laxative, which you need to take regularly. You can also help to ease this by eating more fruit, vegetables, brown bread, bran-based breakfast cereals and drinking plenty of liquids.

Nausea and vomiting

About a third of people starting oxycodone can feel sick, or even throw up in the first week to 10 days. Fortunately, this usually goes away. If this is a problem for you, your doctor can prescribe an anti-sickness tablet. Bear in mind that other things might be causing the vomiting and nausea – it may not be the oxycodone. Talk to your doctor or nurse if you're having problems.

Drowsiness

Sometimes people feel more sleepy or drowsy than usual for a few days after starting oxycodone or increasing the dose. This usually wears off quickly. If it affects you in this way, you must not drive or operate dangerous machinery.

Less common side effects when taking oxycodone include unsteadiness, confusion and hallucinations, sweating, blurred vision, and a dry mouth.

Will I become addicted to oxycodone?

When oxycodone is used to relieve pain, it's very unlikely to cause addiction. You may be able to reduce or even stop oxycodone if you can use another treatment to reduce or take away the pain. If you need to reduce or stop your oxycodone, make sure you talk about it with a doctor as it's best to reduce the dose gradually to decrease the risk of having withdrawal symptoms.

What about driving?

Taking oxycodone doesn't automatically mean you can't drive. You need to talk to your doctor about this. However, if you have difficulty staying alert or concentrating, or if you're physically weak or ill, it isn't wise to drive. If your doctor says driving is OK, follow these general guidelines:

Remember – ultimately the risk lies with you. If you're involved in an accident, you'll be questioned closely if you seem to be under the influence of drugs.

Can I drink alcohol?

The combination of oxycodone and alcohol will probably make you feel sleepy or drunk much sooner than usual, so it's sensible to drink less than you're used to until you know what sort of effect it has on you.

Does taking oxycodone mean I'm near the end?

Oxycodone is a strong pain reliever. Doctors prescribe it when someone has strong pain. This might be after a serious accident or after an operation, as well as for cancer pain or other serious conditions that simpler pain relievers don't work for.

The time to start using oxycodone is when the pain is bad enough. It doesn't mean that you're dying.

My oxycodone dose

My dose of oxycodone (BNM) (controlled-release) is:

 

mg every 12 hours.

If you get pain despite taking slow-release oxycodone, you can safely take OxyNorm four-hourly as necessary. It will work within half to one hour and can last for up to six hours. If you need more than two doses a day, please consult your doctor.

My dose of OxyNorm Elixir or capsules is:

 

mg every

 

hours.

Note: The OxyNorm dose will change if the oxycodone (BNM) dose is changed.

Who do I contact if I get pain?

My community nurse:

 

My GP:

 

Other contacts:

 

 

 

Keep a diary of the doses and times of any medications you take for breakthrough pain and any changes to your controlled-release oxycodone. Have this available for your community nurse or GP each time you see them. In the diary, also keep note of how often you pass a bowel motion (poo).

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Written by Christchurch Hospital Palliative Care Service. Adapted by HealthInfo clinical advisers. Last reviewed September 2017. Last updated August 2018.

Page reference: 59259

Review key: HIPAL-17434