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Paul Glare

and Mellar P. Davis

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date: 24 September 2021

Chapter 10 discusses Oxycodone (14-hydroxy-7,8-di-hydrocodeinone), a semi-synthetic derivative of the opium alkaloid thebaine. Oxycodone has been in clinical use for almost 100 years and is classified as a step 2 or weak opioid. In 1981, single-agent oxycodone became available in the USA. The availability of oxycodone without a NSAID enabled escalation of the dose and use for more severe pain, and it was reclassified as a step 3 strong opioid without dose limitations. In 1996, a sustained-release (SR) doublematrix product became commercially available for patient convenience and compliance was improved. The SR formulation has led to a rapid increase in the prescribing of oxycodone as an alternative to morphine. The studies of oxycodone undertaken in the 1990s indicate that it is as effective as morphine, and there has been speculation that it has a better adverse effect profile. Few new clinical studies of this old drug have been published in recent years, but its pharmacology is becoming better understood.

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