What is the difference between oxycodone and Oxycontin?

Oxycodone and Oxycontin are essentially the same substance, but the main difference is that Oxycontin is a long-acting form of oxycodone. Oxycontin releases oxycodone slowly and continuously over 12 hours and only needs to be given twice a day. Oxycodone is short-acting and relieves pain for about 4 to 6 hours so needs to be given four to six times a day to provide all-day pain relief. Oxycodone is usually given for acute pain, such as that following surgery or trauma, whereas Oxycontin may be given for chronic or long-term pain, such as that caused by cancer. Oxycontin should only be considered in those with chronic severe pain that have already found a trial of oxycodone to be beneficial.

Oxycontin may also be called a controlled-release or extended-release tablet. It has been designed so that the active drug, oxycodone, is released in two phases. The first layer allows for the initial rapid release of oxycodone from the surface of the tablet, providing pain relief within about 20 minutes. The inner layer slowly releases the remainder of the oxycodone over 12 hours.

The decision to prescribe oxycodone and Oxycontin should not be taken lightly because these medications have been associated with long-term physical and psychological dependence, even when prescribed for conditions as innocuous as dental pain.

What are the similarities between oxycodone and Oxycontin?

• Because oxycodone and Oxycontin are the same medication, just in a different formulation, they both work in the same way, and that is to bind to specific receptors in the brain called opioid receptors. They are relatively selective for one type of opioid receptor, which is the mu-opioid receptor.
• Oxycodone and Oxycontin are full agonists at the mu receptor. This means that they do not have a ceiling effect for pain relief, so higher dosages are associated with increased pain relief. However, the risk of side effects, such as respiratory and CNS depression, increases with higher dosages, as does the risk of overdosage.
• Both oxycodone and Oxycontin may be given to relieve moderate-to-severe pain, but Oxycontin should only be considered in those with chronic severe pain that have already found a trial of oxycodone to be beneficial.
• Both belong to the class of medicines known as opioids or opioid analgesics. They may also be called narcotic analgesics.
• Both oxycodone and Oxycontin are addictive and there is a risk of physical dependence and abuse with these drugs.
• Neither oxycodone nor Oxycontin are recommended during pregnancy or breastfeeding.

Which is more effective? Oxycodone or Oxycontin?

The effectiveness of oxycodone and Oxycontin depends on what a doctor has prescribed the medicine for. For people with chronic, severe pain, that lasts all day, Oxycontin may be preferred because with twice-daily dosing its effects can last for 24 hours. For people with acute pain, such as that following surgery or trauma, oxycodone is preferred, because it works quickly and is available in combination with other pain-relieving medicines, such as acetaminophen or ibuprofen.

Oxycodone may be used to treat severe pain which is uncontrolled by alternative, nonopioid, analgesics, such as that caused by:

• Cancer
• Certain medical conditions (such as shingles)
• Injuries
• Trauma
• Break-through pain that occurs during regular dosing of Oxycontin.

Oxycontin may be used to treat pain that is severe enough to require daily, around-the-clock, long-term treatment, and for which no other treatment (such as nonopioid medications or immediate-release opioids) has proved adequate. It should not be used on an “as needed” basis. There is a greater risk of overdose and death with long-acting opioid formulations (also called extended-release or controlled-release) formulations such as Oxycontin.

Are there any differences in side effects between oxycodone and Oxycontin?

Because oxycodone and Oxycontin contain the same medicinal ingredient, they have similar side effects, such as:

• Addiction
• Constipation
• Dependence
• Dizziness
• Difficulty sleeping (insomnia) or abnormal dreams
• Drowsiness
• Dry mouth
• Flushing
• Headache
• Itching or an itchy rash
• Low blood pressure, which may increase your risk of falling
• Low energy or fatigue
• Nausea and vomiting
• Red eyes
• Respiratory depression (slow and ineffective breathing)
• Sweating

Oxycodone and Oxycontin may also increase the risk of seizures in people with seizure disorders.

Respiratory depression is more likely to happen during the first 1 to 3 days of oxycodone or Oxycontin treatment, after a dosage increase, or if too much oxycodone or Oxycontin is taken. Children, the elderly, the frail, or those with pre-existing respiratory conditions are more at risk. Respiratory depression can be life-threatening or cause death.

Stopping either oxycodone or Oxycontin suddenly in a person who has been taking it a while and become physically dependent on it may lead to withdrawal symptoms such as restlessness, pupil dilation, watery eyes and a runny nose, sweating, muscle aches, insomnia, irritability, and gastrointestinal complaints, such as abdominal pain, nausea, vomiting, or diarrhea. Babies born to mothers who are physically dependent on oxycodone or Oxycontin will also be physically dependent.

Which has more drug interactions? Oxycodone or Oxycontin?

Because oxycodone and Oxycontin contain the same medicinal ingredient, they have similar interactions, such as:

• antibiotics, such as clarithromycin and erythromycin
• antidepressants, such as tricyclic antidepressants (eg, amitriptyline), monoamine oxidase inhibitors (eg, isocarboxazid, phenelzine, and tranylcypromine), or SSRIs (eg, fluoxetine, sertraline)
• antifungal agents, such as itraconazole and ketoconazole
• anticonvulsants, such as carbamazepine, phenytoin, phenobarbital, or primidone
• antipsychotics (such as butyrophenones, phenothiazines, or thioxanthenes) and atypical antipsychotics (eg, olanzapine, quetiapine, ziprasidone)
• any medication that may cause drowsiness, such as benzodiazepines (eg, diazepam, lorazepam), first-generation antihistamines (such as doxylamine or promethazine), metoclopramide, or opioids (such as codeine, morphine)
• buprenorphine
• migraine medications, such as almotriptan, eletriptan, or sumatriptan
• muscle relaxants, such as cyclobenzaprine
• rifampin
• any other medication that inhibits hepatic enzymes CYP3A4 or CYP2D6 or induces CYP3A4
• other medications that affect serotonin, such as amphetamines, fentanyl, lithium, tramadol, triptans (eg, almotriptan, eletriptan, or sumatriptan), or St. John's Wort.