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OxyContin (Oxycodone) at a glance: schedule, half-life, and class

Generic nameOxycodone hydrochloride

Brand namesOxyContin, Roxicodone, Oxaydo, Xtampza ER; with acetaminophen: Percocet

Drug classOpioid agonist

US legal statusSchedule II, prescription only

Approved usesPain severe enough to require an opioid, when alternatives are inadequate

FormsImmediate-release tablets, capsules, and oral solution; extended-release tablets and capsules

Onset10 to 30 minutes (immediate release)

Half-lifeAbout 3 to 4.5 hours

Broken down byLiver enzymes CYP3A4 and CYP2D6

Reversal agentNaloxone

OxyContin uses: what oxycodone is prescribed for

Oxycodone is FDA-approved for pain severe enough to require an opioid and for which other treatments, such as non-opioid pain relievers, are inadequate. Extended-release forms such as OxyContin are only for severe, persistent pain that needs daily, around-the-clock opioid treatment over a long period.[1]

It works by activating mu-opioid receptors in the brain and spinal cord, which reduces how pain signals are felt. The same receptors control breathing, which is why too much can stop a person breathing.

Combination products such as Percocet also contain acetaminophen, which has its own daily limit and can damage the liver in high doses.

OxyContin dosage: how oxycodone is usually prescribed

The figures below come from the FDA-approved label and describe how prescribers typically use oxycodone. They are not personal dosing advice. A prescriber sets the dose for each person and adjusts it over time.[1]

The CDC recommends immediate-release opioids at the lowest effective dose for acute pain, usually for three days or less and rarely more than seven, and careful reassessment before any dose increase.

Extended-release tablets must be swallowed whole. Crushing, chewing, or dissolving them releases a potentially fatal dose all at once.

OxyContin (oxycodone) side effects and risks

FDA boxed warnings

• Oxycodone exposes users to risks of addiction, misuse, and abuse, which can lead to overdose and death.
• Life-threatening slowed breathing can occur, especially when starting treatment or after a dose increase.
• Accidental ingestion, especially by children, can cause a fatal overdose.
• Use with benzodiazepines or other central nervous system depressants, including alcohol, can cause profound sedation, slowed breathing, coma, and death.
• Prolonged use during pregnancy can cause neonatal opioid withdrawal syndrome, which may be life-threatening if not recognized and treated.
• Drugs that block CYP3A4, or stopping drugs that speed it up, can raise oxycodone levels and cause a fatal overdose.

Common side effects include constipation, nausea, drowsiness, dizziness, itching, headache, dry mouth, and sweating.

Serious risks include slowed or stopped breathing, severe low blood pressure, adrenal insufficiency, serotonin syndrome with some antidepressants, and increased sensitivity to pain (opioid-induced hyperalgesia).