Opioids · Pain & inflammation
Oxycodone
OxyNEO® · Percocet (with acetaminophen)®(brand names vary by market)
Reliable oral absorption, and a combination product that hides a second drug.
Also: modified release, oral liquid
Mechanism
Mu opioid receptor agonist with higher and more predictable oral bioavailability than morphine.
Indications
- Moderate to severe pain
- Post-operative pain
- Cancer pain
Formulations
Dosing concepts
Combination products
Frequently combined with acetaminophen, which places a hard ceiling on the dose that has nothing to do with the opioid. Escalating the opioid then risks hepatotoxicity from the other half.
Modified release
Long-acting forms are for stable background pain, never for acute or breakthrough use, and are swallowed whole.
Concepts, not prescribing instructions. Practice numbers live in current references and local protocols.
Pharmacokinetics
- Bioavailability
- ~60 to 87%, the highest of the common oral opioids
- Half-life
- 3 to 5 h
- Elimination
- hepatic: CYP3A4 and CYP2D6; strong CYP3A4 inhibitors raise exposure
- Protein binding
- ~45%
Adverse effects
- Constipationcommon
- Sedationcommon & serious
- Nauseacommon
- Respiratory depressionserious
- Dependence and use disorderseriousIts abuse liability is a matter of public record and shapes how it is prescribed.
Contraindications & precautions
Contraindications
- Respiratory depression
- Paralytic ileus
- Acute severe asthma without support
Precautions
- Combination products containing acetaminophen
- Concurrent CYP3A4 inhibitors
- History of substance use disorder
Interactions
Monitoring
Total acetaminophen dose from all sources
The combination product is a hidden acetaminophen prescription
Sedation and bowel function
Class effects
Duration and quantity supplied
Prescribing practice is itself a safety intervention here
Counselling points
- If your tablets contain acetaminophen as well, do not take any other product containing it.
- Swallow long-acting tablets whole.
- Take a laxative regularly.
- Keep it locked away and return unused tablets to a pharmacy.
Clinical pearls
- Combination oxycodone-acetaminophen tablets are a leading route to accidental acetaminophen overdose, because the patient counts opioid tablets and adds a separate acetaminophen on top.
- Its high oral bioavailability makes the oral route genuinely reliable, which is a real advantage over morphine outside hospital.
References & review
- Oxycodone product monograph (consult the current version for your market) (monograph)
- Goodman & Gilman's The Pharmacological Basis of Therapeutics, 14th ed. (reference-work)
Last reviewed 2026-08-16 · jurisdiction: global · drug information changes; verify against current references before practice use.