From the Guidelines
Oxycodone use is associated with a high risk of opioid-induced constipation, nausea, vomiting, and other gastrointestinal adverse effects, as well as serious risks such as respiratory depression, overdose, and opioid use disorder, as highlighted in the 2022 CDC clinical practice guideline for prescribing opioids for pain 1. The most frequent side effects of oxycodone include:
- Constipation
- Nausea
- Vomiting
- Drowsiness
- Dizziness
- Headache
- Dry mouth
- Itching More serious side effects can include:
- Respiratory depression (slowed or shallow breathing)
- Physical dependence and addiction
- Tolerance
- Urinary retention
- Reduced testosterone levels with long-term use
- Increased sensitivity to pain (hyperalgesia)
- Sleep-disordered breathing
- Mood changes According to the American Gastroenterological Association Institute guideline on the medical management of opioid-induced constipation, opioid-induced constipation (OIC) occurs primarily via activation of enteric m-receptors, which results in increased tonic non-propulsive contractions in the small and large intestine, increased colonic fluid absorption, and stool desiccation 1. To minimize these effects, patients should:
- Take oxycodone exactly as prescribed
- Avoid alcohol and other sedatives while using it
- Use stool softeners for constipation
- Never adjust dosage without medical supervision
- Increase hydration and fiber intake and maintain or increase physical activity to prevent constipation associated with opioid use
- Consider prophylactic pharmacologic therapy, such as a stimulant laxative, to ensure regular bowel movements if opioids are taken regularly If experiencing severe side effects, especially difficulty breathing, extreme drowsiness, or confusion, medical attention should be sought immediately.
From the FDA Drug Label
6 ADVERSE REACTIONS Most common adverse reactions (≥3%) were nausea, constipation, vomiting, headache, pruritus, insomnia, dizziness, asthenia, and somnolence.
The common adverse reactions seen on initiation of therapy with oxycodone hydrochloride tablets are dose related and are typical opioid-related adverse reactions The most frequent of these included nausea, constipation, vomiting, headache, pruritus, insomnia, dizziness, asthenia, and somnolence. Other less frequently observed adverse reactions from opioid analgesics, including oxycodone hydrochloride tablets included: Blood and lymphatic system disorders: anemia, leukopenia Cardiac disorders: cardiac failure, palpitation, tachycardia Gastrointestinal disorders: abdominal pain, dry mouth, diarrhea, dyspepsia, dysphagia, glossitis, nausea, vomiting Injury, poisoning and procedural complications: injury Metabolism and nutrition disorders: decreased appetite, gout, hyperglycemia Musculoskeletal and connective tissue disorders: arthralgia, arthritis, back pain, bone pain, myalgia, neck pain, pathological fracture Nervous system disorders: hypertonia, hypoesthesia, migraine, neuralgia, tremor, vasodilation Psychiatric disorders: agitation, anxiety, confusional state, nervousness, personality disorder Respiratory, thoracic and mediastinal disorders: cough, dyspnea, epistaxis, laryngospasm, lung disorder Skin and subcutaneous tissue disorders: photosensitivity reaction, rash, hyperhidrosis, urticaria Vascular disorders: thrombophlebitis, hemorrhage, hypotension, vasodilatation The possible side effects of oxycodone hydrochloride tablets are: constipation, nausea, sleepiness, vomiting, tiredness, headache, dizziness, abdominal pain
The side effects of Oxycodone (OxyContin) include:
- Common adverse reactions: nausea, constipation, vomiting, headache, pruritus, insomnia, dizziness, asthenia, and somnolence
- Less frequent adverse reactions:
- Blood and lymphatic system disorders: anemia, leukopenia
- Cardiac disorders: cardiac failure, palpitation, tachycardia
- Gastrointestinal disorders: abdominal pain, dry mouth, diarrhea, dyspepsia, dysphagia, glossitis
- Injury, poisoning and procedural complications: injury
- Metabolism and nutrition disorders: decreased appetite, gout, hyperglycemia
- Musculoskeletal and connective tissue disorders: arthralgia, arthritis, back pain, bone pain, myalgia, neck pain, pathological fracture
- Nervous system disorders: hypertonia, hypoesthesia, migraine, neuralgia, tremor, vasodilation
- Psychiatric disorders: agitation, anxiety, confusional state, nervousness, personality disorder
- Respiratory, thoracic and mediastinal disorders: cough, dyspnea, epistaxis, laryngospasm, lung disorder
- Skin and subcutaneous tissue disorders: photosensitivity reaction, rash, hyperhidrosis, urticaria
- Vascular disorders: thrombophlebitis, hemorrhage, hypotension, vasodilatation
- Other possible side effects: constipation, nausea, sleepiness, vomiting, tiredness, headache, dizziness, abdominal pain 2, 2
From the Research
Side Effects of Oxycodone (OxyContin)
The side effects of oxycodone are similar to those of other opioids, including:
- Nausea 3, 4, 5, 6
- Constipation 3, 4, 5, 7, 6
- Drowsiness 3, 4, 5
- Vomiting 3, 5, 6
- Pruritus (itching) 3, 4, 5
- Dizziness 3, 4, 5
- Lightheadedness 5
- Headache 5
Severity and Impact of Side Effects
The severity and impact of these side effects can vary, with some patients experiencing:
- Mild side effects that decrease over time 3
- Bothersome side effects that impact adherence to prescribed dosing regimens and quality of life 5
- Serious toxicity, although rare, which can be managed with dose reduction 6
Comparison to Other Opioids
Oxycodone has been compared to morphine in several studies, with findings suggesting: