Oxycodone Hydrochloride Formulations
Yes, oxycodone hydrochloride is available in immediate-release (IR) formulations, as clearly stated in multiple clinical guidelines. 1
Available Formulations of Oxycodone
Oxycodone is an opioid analgesic with agonist activity at mu-, delta-, and kappa-opioid receptors that comes in two main formulations:
Immediate-Release (IR) formulations:
- Available as standalone tablets/capsules
- Available in combination with acetaminophen (must monitor acetaminophen dose to avoid hepatic toxicity)
- Designed to provide rapid onset of analgesia
- FDA-approved for immediate release with pharmacokinetic data showing peak concentrations within 1-2 hours 2
Extended-Release (ER) formulations:
- Designed for twice-daily dosing (every 12 hours)
- Indicated for chronic pain management
- Not recommended for acute pain or "as-needed" dosing
- Should not be crushed, broken, or chewed 1
Pharmacokinetic Characteristics
The immediate-release formulation of oxycodone hydrochloride has these key properties:
- Onset of action: Begins within 1 hour of administration 1
- Half-life: 3-5 hours (shorter than morphine's half-life) 3
- Bioavailability: 60-87% oral bioavailability 2
- Dosing interval: Typically dosed every 4-6 hours as needed for pain 1
- Metabolism: Primarily hepatic via CYP3A4 and CYP2D6 pathways 2
Clinical Applications
The NCCN guidelines specifically mention that oxycodone is available in both immediate-release and extended-release formulations 1. The immediate-release formulation is appropriate for:
- Initial titration of opioid therapy
- Management of breakthrough pain
- Acute pain management
- Starting dose typically ranges from 5-15 mg every 4-6 hours as needed 2
Important Clinical Considerations
- For acute pain: The immediate-release formulation is preferred over extended-release formulations 1
- Caution: Extended-release oxycodone (OxyContin) should not be used for acute pain or on an as-needed basis 1
- Combination products: When oxycodone is combined with acetaminophen, the acetaminophen component is now limited to 325 mg or less per pill 1
- Regulatory classification: Oxycodone and oxycodone combination products are Schedule II controlled substances 1
Comparative Efficacy
Clinical trials have demonstrated that:
- IR oxycodone provides similar analgesic effects to morphine with potentially fewer side effects like hallucinations 3
- When comparing IR and CR formulations, both can achieve stable pain control, but they serve different clinical purposes 4
Understanding the availability of both immediate-release and extended-release formulations of oxycodone hydrochloride allows clinicians to select the appropriate formulation based on the clinical scenario, pain characteristics, and patient needs.