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Fast Fact and Concept #80: Oxycontin

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Title: Fast Fact and Concept #80: Oxycontin

Author(s): Weissman, David E.

Educational Objective(s)

  1. Learn two indications for using Oxycontin ®.
  2. Review pharmacological features of Oxycontin.

Controlled release oxycodone (Oxycontin) has received considerable attention in the lay press over the past two years. Unfortunately most of the coverage has been negative, related to the illicit use of Oxycontin due to diversion outside of legitimate medical practice. Within legitimate medical practice, Oxycontin is an effective long-acting oral opioid product, very similar to Oramorph ® SR and MS Contin ®. What distinguishes Oxycodone CR from these other products is that it is the only long-acting opioid to be marketed for use as a treatment for post-operative pain, when moderate to severe pain is expected to persist for an extended period of time.

Currently available data suggests that there is no major difference between Oxycontin and other long-acting oral opioids with respect to: Chronic Pain Equianalgesia

The product information for Oxycontin indicates a dose conversion ratio from morphine at: 30 mg oral morphine = 15 mg Oxycontin (2:1). This conversion factor has been controversial since the equianalgesic conversion value of short-acting oxycodone to oral morphine has been published at 1:1. Since all equianalgesic values are felt to be rough guidelines, prescribers need to use their clinical judgment in determining the most appropriate starting dose.

Cost

Oxycontin is more expensive than other long-acting oral opioids; the Veteran Affairs Pharmacy Benefits Management Oxycontin Clinical Guideline indicates that Oxycontin is 6.5-10 times more expensive than controlled release morphine products.

References

Criteria for use of controlled-release Oxycodone; Veteran Affairs Pharmacy Benefits Management; www.vapbm.org - Physicians Desk Reference, 2002

Disclaimer: Fast Facts provide educational information, this information is not medical advice. Health care providers should exercise their own independent clinical judgment. Some Fast Fact information cites the use of a product in dosage, for an indication, or in a manner other than that recommended in the product labeling. Accordingly, the official prescribing information should be consulted before any such product is used.

Creation Date: 12/2002

Format: Handouts

Purpose: Instructional Aid, Self-Study Guide, Teaching

Audience(s)
Training: Fellows, 3rd/4th Year Medical Students, PGY1 (Interns), PGY2-6, Physicians in Practice
Specialty: Anesthesiology, Emergency Medicine, Family Medicine, General Internal Medicine, Geriatrics, Hematology/Oncology, Neurology, OB/GYN, Ophthalmology, Pulmonary/Critical Care, Pediatrics, Psychiatry, Surgery
Non-Physician: Nurses

ACGME Competencies: Medical Knowledge, Patient Care

Keyword(s):Oxycontin, Oxycodone, Oramorph, MS Contin, Addiction, Chronic non-malignant pain, Controlled substance regulations, Pain, Pain assessment, Pain treatment


The Fast Facts series is distributed for educational use only and does not constitute medical advice. For the most current version of Fast Facts visit the EPERC web site at www.eperc.mcw.edu. This mirror version is provided subject to copyright restrictions for educational use within the Inter-Instutional Collaborating Network on End-of-Life Care (IICN).