Are oxycodone and OxyContin (oxycodone) the same?

Oxycodone vs. OxyContin: Understanding the Difference

No, oxycodone and OxyContin are not the same, although OxyContin is a brand name for extended-release oxycodone. Oxycodone is the active ingredient, while OxyContin is a specific formulation of oxycodone designed for extended release 1, 2, 3.

Key Differences

• Oxycodone: The generic name for a semi-synthetic opioid analgesic that is the active ingredient
• OxyContin: A brand name for extended-release (ER) oxycodone formulation designed to release the medication over 12 hours 1, 2

Formulation Differences

Immediate-Release Oxycodone

• Available as standard tablets, capsules, or oral solution
• Onset of action within 1 hour
• Duration of effect: 4-6 hours
• Typically dosed every 4-6 hours as needed for pain 1, 2, 3
• Plasma half-life of 3-5 hours 3, 4

Extended-Release OxyContin

• Designed for controlled release over 12 hours
• Indicated for chronic pain management, not acute pain
• Dosed twice daily (every 12 hours)
• Should not be crushed, broken, or chewed as this would destroy the extended-release mechanism and potentially lead to overdose 1, 2

Clinical Implications

Appropriate Use

• Immediate-release oxycodone is appropriate for:

  • Acute pain management
  • Breakthrough pain
  • Initial dose titration 1, 2

• OxyContin (extended-release) is appropriate for:

  • Chronic pain requiring around-the-clock analgesia
  • Only for opioid-tolerant patients when used at higher doses
  • Not intended for "as-needed" pain relief 1, 2

Safety Considerations

• Guidelines explicitly state that extended-release products like OxyContin should not be used for acute pain 1
• Both formulations are Schedule II controlled substances with high abuse potential 2
• OxyContin carries higher risk if misused (crushed or chewed) due to the higher dose intended for extended release 2, 5

Pharmacological Properties

• Both contain oxycodone, which acts primarily on mu-opioid receptors
• Bioavailability: 60-87% for oral oxycodone 3, 4
• Metabolized primarily in the liver to noroxycodone and oxymorphone 3, 4
• Excreted primarily via kidneys 3

Common Pitfalls in Prescribing

• Prescribing OxyContin for acute pain instead of immediate-release oxycodone 1
• Failing to recognize that crushing or breaking OxyContin tablets can lead to rapid release and potential overdose 2
• Not accounting for the extended half-life when switching between formulations 4
• Underestimating the abuse potential of both formulations 5

Remember that both formulations contain the same active ingredient (oxycodone) but differ in their release mechanism, intended use, and dosing schedule. This distinction is crucial for appropriate prescribing and patient safety.