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Oxycodone for treatment of moderate to severe pain fact sheet

Oxycodone for treatment of moderate to severe pain

This fact sheet has been written for parents and carers about how to use this medicine in children. This information sometimes differs from that provided by the manufacturers, because their information is usually aimed at adult patients. Please read this information carefully and keep it somewhere safe so that you can read it again.

Oxycodone is available as:

Oxycodone is the name of the medicine (drug). It is only available on prescription from your doctor. It is available as several different products and brand names. The common products you will be given for use at home for your child are:

Short acting brand name Contains
Endone tablets Oxycodone 5 mg
OxyNorm liquid Oxycodone 1 mg/ml in 250 ml or Oxycodone 1 mg/ml in 20 ml
Long acting brand name Contains
OxyContin tablets Oxycodone in varying strengths
Targin tablets Oxycodone and Naloxone, varying combination strengths

The product supplied to you is:

___________________________________________________________________________________

Why is it important for my child to take this medicine?

Oxycodone is a strong opioid pain medicine like morphine.

Oxycodone may be used in combination with paracetamol and/or ibuprofen when they don’t give enough pain relief alone. It may be prescribed for pain after an operation, injury or due to an illness.

When should I give oxycodone?

Short acting products

Short acting oxycodone is usually given “when required” to control your child’s pain, usually every 4 – 6 hours, if your child is in pain. Give your child a dose when they complain of pain and write down the time you gave it. The next dose can be given 4 to 6 hours later if needed.

When treating pain after an operation, your doctor or anaesthetist may recommend giving doses more regularly in the first one to three days after the operation. Use your child’s pain and activity levels as an indication of how much and how often you give them pain relief. If they are in pain and not doing much, give pain relief. If they seem happy and are active, they may not need pain relief. If there is a sudden increase in frequency or severity of pain or pain is lasting longer than expected, contact your doctor.

As your child’s pain improves, slowly increase the time between doses of short acting oxycodone.

Long acting tablets

The long acting tablets provide pain relief over a longer period. They are usually given twice a day (every 12 hours). This may vary and will be decided and prescribed by your doctor. This form of oxycodone should not be given on an ‘as needed’ basis.

Some children may be prescribed a long acting oxycodone tablet to be given at a regular time and additional short acting oxycodone to be given “as needed” for severe pain. The short acting and long acting oxycodone products are not interchangeable and should not be used in place of each other.

If your child has been using oxycodone regularly for a long time, your doctor or pharmacist will guide you on how to reduce the dose over time. This is done slowly – do not stop the medicine suddenly.

How much should I give?

Your child’s doctor will work out the dose of oxycodone that is right for your child based on their weight, age and reason for pain. The dose will be shown on the medicine label. It is important to follow your doctor’s instructions about how much to give and how often it can be given in a 24 hour period.

How should I give oxycodone?

Oxycodone can be given with or without food.

Oxycodone liquid should be accurately measured using a measuring device. It can be mixed with a small amount of juice or milk if your child doesn’t like the taste but ensure they take the entire amount.

The long acting or sustained release tablets should only be given as prescribed by your doctor and swallowed whole with a glass of water. Do not crush or allow your child to chew these tablets.

OxyContin® and Targin® tablets swell when wet. If your child has difficulty swallowing tablets quickly with an adequate amount of water, these may not be suitable as there is a risk of choking. Talk to your doctor about other options.

When should the medicine start working and how will I know?

The short acting or immediate release tablets, capsules or liquid usually starts to work within half an hour and should give up to 4 to 6 hours of pain relief.

The long acting or sustained release tablets are to be given at set times in the day as directed by your doctor to provide ongoing pain relief over the day.

What if my child is sick (vomits)?

  • If your child vomits less than 15 minutes after having a dose of oxycodone and you think they have vomited the medicine out, you can repeat the dose of oxycodone ( once only). If you are unsure, give alternative pain relief until the next normal dose of oxycodone is due. This is to prevent the side-effects of a large dose of oxycodone such as excessive drowsiness.
  • If your child vomits more than 15 minutes after having a dose of oxycodone, you do not need to give them another dose.

What if I forget to give it?

Do not give a double dose to make up for the dose that your child missed. For long acting or sustained release products:

  • If it is almost time for the next dose, wait to give the next dose at the usual time.
  • If it is less than 4 hours overdue, give the missed dose (make sure you allow a gap of at least 8 hours in between doses).

If you are unsure, ask your doctor or pharmacist.

What if I give too much?

If you think you may have given your child too much oxycodone, contact you doctor or call the Poisons Information Centre on 13 11 26. Monitor your child for any of the following: excessive drowsiness or very sleepy and difficult to wake, breathing difficulties, pale complexion or confusion. If they occur call the ambulance on 000.

Are there any possible side effects?

This list is for your information. Your child may not experience any of these side effects.

Side effects you must do something about immediately

  • Excessive drowsiness, difficulty waking your child or trouble breathing – can be a sign of respiratory depression, call an ambulance on 000 immediately.
  • Constipation (difficulty doing a poo) – ensure your child is receiving adequate water and enough ­fibre in their diet. Foods such as prune or pear juice may help to keep the stools soft. Talk to your pharmacist or doctor about the use of suitable stool softeners or laxatives (medicines to relieve constipation and help them to go to the toilet without straining). If your child requires long term regular use of oxycodone then regular stool softeners or laxatives may be necessary. If your child has had abdominal/gut or bowel surgery, please check with your doctor or surgeon before using laxatives.

Other side effects you need to know about

  • Nausea and vomiting, itchy skin or rash, flushing of the face, mild drowsiness, dizziness or confusion – these effects can happen when starting the medication or increasing the dose, they should settle over time. If excessive or not settling, contact your doctor.

Everyone responds differently to medicines and it is important to monitor your child when starting a new medicine. There may, sometimes, be other side-effects that are not listed above. If you notice anything unusual and are concerned, contact your GP or hospital doctor, pharmacist or local hospital.

Can other medicines be given at the same time as oxycodone?

  • Simple analgesics or pain relievers such as paracetamol and ibuprofen treat pain very effectively and can be used with oxycodone (unless your child cannot have these types of medicines). Your doctor will advise on this.
  • Combination medicines such as Panadeine®, Panadeine Forte®, Painstop®, Mersyndol® or Nurofen Plus® should not be given while they are taking oxycodone. These products contain codeine which is the same type of medicine as oxycodone.
  • Oxycodone should not be taken with some prescription or over the counter medicines from your pharmacy or health food store. Tell your doctor and pharmacist about any other medicines your child is taking before starting new medicines and always check with your doctor or pharmacist before giving any other medicines to your child. This includes herbal or complementary medicines.

Is there anything else I need to know about oxycodone?

  • Oxycodone can make your child sleepy or drowsy. For your child’s safety, it is best for your child to avoid activities requiring concentration and alertness, unless they are closely supervised. For example, activities such as riding a bike, swimming and sleeping on the top bunk should be avoided.
  • When your child no longer requires oxycodone, the remainder should be returned to your local pharmacy for safe disposal. It is important that oxycodone is only used under the direction of your doctor for the time it is required. Returning the left over stock means there is no risk of it being taken by mistake by someone else.
  • The use of oxycodone to treat pain in children is well studied and we have lots of experience with its use in all age groups. It is one of the preferred medicines for severe pain in children and is recommended rather than codeine. It belongs to the opioid group of medicines and works the same way as morphine. When used for moderate to severe pain, as your doctor has directed, there is no need to worry about your child becoming ‘addicted’ to oxycodone. If you want more information about this, talk to your doctor or pharmacist.

Where should I keep this medicine?

  • Make sure that children cannot see or reach the medicine – keep in a secure cupboard
  • Keep oxycodone in a cool, dry place away from heat and direct sunlight. Do not keep in warm, damp places such as the bathroom as this may make the medicine less effective.
  • Keep the medicine in the container it came in.

General advice about medicines

  • Try to give the long acting oxycodone at about the same times each day. This will help you remember to give it every day.
  • Only give this medicine to your child. Never give it to anyone else, even if their condition appears to be the same, as this could cause harm.
  • If you think someone else may have taken the medicine by accident, contact your doctor straight away or contact the Poisons Information Centre on 13 11 26.
  • Make sure that the medicine has not expired; the date is on the packaging. Expired medication does not work and may even be harmful. Return out of date or unwanted medicines to your pharmacist to dispose of.

Who to contact for more information

Your doctor, pharmacist or nurse will be able to give you more information about oxycodone and about other medicines used to treat pain.

Contact us

Pharmacy Department
Queensland Children’s Hospital
Level 2, 501 Stanley Street, South Brisbane 4101
t: 07 3068 1901

In an emergency, always call 000.

Queensland Poisons Information Centre 13 11 26.

Developed by Pharmacy Department, Queensland Children’s Hospital. Updated: June 2018.

The primary source for the information in this leaflet is the Australian Medicines Handbook Children’s Dosing Companion.
For details on any other sources used to create this leaflet, please contact us via CHQMedicationSafety@health.qld.gov.au.

We take great care to make sure that the information in this leaflet is correct and up-to-date. However, medicines can be used in different ways for different patients. It is important that you ask the advice of your doctor or pharmacist if you are not sure about something.
This leaflet is about the use of these medicines in Australia, and may not apply to other countries. Children’s Health Queensland Hospital and Health Service cannot be held responsible for the accuracy of information, omissions of information, or any actions that may be taken as a consequence of reading this leaflet.

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