Oxycodone Equivalent of Xtampza ER 36mg
Xtampza ER 36mg is equivalent to 36mg of standard oxycodone. Unlike some other opioid conversions, Xtampza ER has a 1:1 conversion ratio with standard oxycodone, despite its unique abuse-deterrent formulation.
Understanding Xtampza ER
Xtampza ER is a novel, microsphere-in-capsule extended-release opioid formulation designed with abuse-deterrent properties 1. Key characteristics include:
- Formulated as oxycodone myristate salt in microspheres 2
- Designed for twice-daily (every 12 hours) dosing 1
- Retains its extended-release properties even when physically manipulated (crushed or chewed) 3
- Can be administered via sprinkle-dosing or enteral tubes for patients with difficulty swallowing 2
Dosing Equivalence
When considering opioid conversions:
- Xtampza ER uses a 1:1 conversion ratio with standard oxycodone
- For comparison with morphine, oxycodone is approximately 1.5-2 times more potent than oral morphine 4, 5
- This means 36mg of Xtampza ER would be equivalent to approximately 54-72mg of oral morphine
Clinical Considerations
When prescribing Xtampza ER, clinicians should be aware of several important factors:
- Xtampza ER is indicated for management of pain severe enough to require daily, around-the-clock, long-term opioid treatment when alternative treatments are inadequate 2
- The formulation provides consistent analgesia over the entire 12-hour dosing interval without end-of-dose failure 1
- Like all opioids, Xtampza ER carries risks of addiction, abuse, and misuse 2
- Common side effects include nausea, constipation, and drowsiness 5
Important Distinctions from Other Oxycodone Formulations
Xtampza ER differs from other oxycodone formulations in several ways:
- Unlike OxyContin (another ER oxycodone formulation), Xtampza ER maintains its extended-release profile even when crushed or chewed 3
- Studies show that manipulated Xtampza ER remains bioequivalent to intact Xtampza ER, while crushed OxyContin becomes bioequivalent to immediate-release oxycodone 3
- This property may reduce the risk of oral abuse through manipulation 3
Prescribing Cautions
When prescribing any opioid, including Xtampza ER:
- Use the lowest effective dose for the shortest duration possible 4
- Consider checking prescription drug monitoring programs to assess risk for opioid misuse 4
- Avoid co-prescribing with other central nervous system depressants, particularly benzodiazepines 4
- Monitor patients for efficacy and adverse effects 4
In summary, Xtampza ER 36mg is equivalent to 36mg of standard oxycodone, with the added benefits of abuse-deterrent properties and consistent 12-hour pain relief.