Opioid analgesics are often prescribed to patients who require round-the-clock pain management. Multiple forms of these analgesics are available under different brand names.
This article is dedicated to Roxicodone, an immediate-release tablet form of Oxycodone.
What Is Roxicodone?
Roxicodone is an opioid analgesic available as immediate-release tablets. It is reserved for specific cases of moderate-to-severe pain management where other analgesics prove inadequate.
Roxicodone acts on the brain’s opioid receptors and alters the way a person perceives pain, thereby reducing the intensity of pain perception.
The active ingredient of Roxicodone – oxycodone hydrochloride – is a white, crystalline powder derived from thebaine, which is an opium alkaloid. Chemically, the innocent looking oxycodone hydrochloride is referred to as 4, 5α-epoxy-14-hydroxy-3-methoxy-17methylmorphinan-6-one hydrochloride.
It is soluble in water and also has slight solubility in alcohol. Other than this active ingredient, Roxicodone also contains the following inactive ingredients:
- Microcrystalline cellulose
- Sodium starch glycolate
- Stearic acid;
- D&C Yellow No. 10
- FD&C Blue No. 2
The presence of these ingredients depends on the dosage form. For example, 5 mg Roxicodone contains only microcrystalline cellulose and stearic acid as inactive ingredients.
Who Manufactures Roxicodone?
Roxicodone is a product of an integrated specialty pharmaceutical company: Xanodyne Pharmaceuticals Inc. The company has been operating since 2001 and has its headquarters in Newport, Kentucky, United States.
Is Roxicodone Prescription Only?
Roxicodone is a prescription-only drug. Due to its potential for abuse, FDA has kept it in the category of Schedule II controlled substances.
Roxicodone is used for pain management in patients who require opioid analgesics orally. Unlike some other opioid analgesics, Roxicodone is used not only for chronic pain management but also for emergency cases.
Emergency Pain Management
For emergency pain management, such as in the case of injuries and surgeries, Roxicodone is given in a dose adjusted on the basis of severity of pain, patient’s weight, and his response to the drug.
Chronic Pain Management
For severe chronic pain, Roxicodone is administered orally every 4-6 hours. The dose may range from 5 to 15 mg depending on the patient’s characteristics and the physician’s judgment.
If the given dose is not effective, it is increased gradually to a point where an analgesic effect is obtained but the benefit still outweighs the side effects.
In the case of patients who are already on opioid therapy and are given Roxicodone first time, the previous opioid dose is factored into the decision of Roxicodone dosage. Supplemental analgesia may also be required in this case.
Roxicodone: Risks and Side Effects
Roxicodone, just like all other analgesics, is not free of risks and side effects. The drug is given only when the benefit is greater than the risk. Roxicodone is associated with similar side effects as seen in the case of other opioids.
Severe side effects include respiratory depression, respiratory arrest, hypotension, cardiac depression, cardiac arrest, and shock.
Common Side Effects
The common side effects of Roxicodone are given below.
- A headache
- Weakness (asthenia)
- Sleepiness (somnolence)
Serious Side Effects
While nausea and constipation are usual issues with taking opioid analgesics, serious side effects are the real problem. They warrant an immediate visit to the doctor and so a heads-up on these effects is necessary. Serious side effects can present as one or more of the following signs and symptoms:
- Mood changes
- Severe abdominal pain
- Shallow breathing
- Severe drowsing
There are three other side effects that require a bit more explanation.
- Allergic Reaction: Although allergic reactions are rare incidents, they require immediate medical assistance. If you notice any of the following symptoms upon taking Roxicodone or any other opioid, seek emergency’s medical help.
- Swelling on face, tongue or throat
- Breathing difficulty
- Severe dizziness
- Chest tightness
- A cough
- Blue skin color
- Serotonin Syndrome: Use of Roxicodone can increase serotonin levels in the body. If not dealt, it can sometimes lead to serotonin syndrome. The symptoms include nausea, vomiting, diarrhea, fever, shivering, agitation, seizures, and abnormal muscle functioning. Serotonin syndrome develops after days of continued use and requires emergency treatment.
- Adrenal Insufficiency: Inadequate functioning of adrenal glands (adrenal insufficiency) is another rare, but serious side effect of Roxicodone. It occurs after relatively long-term use of the medicine, i.e., >1 month. Symptoms may include unusual weakness, fatigue, anorexia, low blood pressure, dizziness, nausea, and vomiting. These are not specific symptoms and may vary.
Opioid Addiction Risk
Abuse of Roxicodone can result in addiction. It is for this reason that Roxicodone is a prescription drug. The addictive potential of Roxicodone owes to dopamine, which is the main player in causing addiction.
Dopamine is the neurotransmitter related to motivation, reward, and learning. A healthy behavior, such as eating delicious food, causes a normal spike in dopamine and we learn to repeat the same behavior, i.e., eating the same food, the next time we are in a similar situation.
Similarly, taking too many Roxicodone results in increased dopamine activity leading to unnatural spikes and the brain learns to repeat the behavior in the future.
Continued abuse increases dopamine activity in a way that no other healthy activity can, and so addiction develops, in which case the user makes it his prime priority to obtain and use the drug.
CNS depressants like alcohol, must NOT be taken concomitantly with Roxicodone. The interactive effect of alcohol and oxycodone hydrochloride may result in additive CNS depression and severe side effects like respiratory depression, cardiac failure, and coma.
An overdose of a drug is not a usual occurrence in someone who’s new to the therapy. It occurs after some time when a natural tolerance develops to the administered dose of Roxicodone and the drug no longer produces the same effect.
To counter this, the user increases the dose, but soon tolerance develops even to this new dose. In the process of increasing dose, the user crosses the safety margin of the drug and enters the zone of overdose.
An overdose of Roxicodone can result in respiratory depression, stupor, somnolence, cold and clammy skin, constricted pupils, hypotension, bradycardia, skeletal muscle flaccidity, coma, and death.
An overdose usually results in the case of Roxicodone abuse or addiction. Immediately take the patient who has had an overdose to the hospital.
Opioid drugs always have a withdrawal effect. It means a set of symptoms would appear in case a person immediately quits taking opioid analgesics. Although doctors make sure to gradually taper off the dose of opioids, it is still beneficial to be aware of the withdrawal effects.
The signs and symptoms of Roxicodone withdrawal are as follows:
- Excessive sweating
- Muscle pains
- Rapid pulse
- A runny nose
The intensity of withdrawal effects depends on how long the patient had been on opioids and what does and frequency he was following. The symptoms appear within 24 hours of the last analgesic dose.
Women of reproductive age must not take opioids without effective birth control.
Use of this drug during pregnancy may result in premature birth, underweight baby, or a baby born with symptoms of withdrawal, such as respiratory distress and seizures. Also, do not breastfeed while taking this drug as it passes in breast milk.
Alternatives To Roxicodone
There are multiple alternatives to Roxicodone. These could be other opioid analgesics, non-opioid analgesics, and natural alternatives.
Opioid alternatives include Vicodin, Opana, Kadian, Codeine, Fentanyl, and Dilaudid. Non-opioid analgesic alternatives for Roxicodone are Acetaminophen and NSAIDs.
Morphine is an opioid alternative to Roxicodone. Although it shares many properties with Roxicodone, differences are still there. A comparison between Roxicodone and morphine is given below.
Tramadol is an opioid analgesic which is often combined with paracetamol. It binds on opioid receptors of neurons and has an inhibitory effect on serotonin-norepinephrine reuptake. A comparison between Roxicodone and Tramadol is given in tabular form below.
Dilaudid is also an opioid analgesic, but unlike Roxicodone, it is available as intravenous, intramuscular and subcutaneous injections. A comparison between the two drugs is given below.
CBD Is A Natural Alternative
Cannabidiol (CBD) is a cannabis compound that was initially thought to be a non-psychoactive substance.
With the discovery of its psychoactive potential, i.e., its ability to change brain functions and alter the perception, cognition, mood, and behavior in a positive way, it became a potential natural alternative for treating pain.
CBD May Be a Natural Alternative to Opiate Roxicodone
A drug named Nabiximols is approved in Canada for the treatment of neuropathic pain in multiple sclerosis and for cancer-related pain. This drug is a combination of CBD and THC, another cannabinoid.
The approval of CBD drug for pain relief shows a possibility of naturally treating pain with CBD. While Roxicodone is an attractive option in dealing with pain, the risks associated with its use are far too many for some.
Individuals looking for a natural alternative to opioid painkillers may consider CBD for pain relief. CBD is taken through oral and nasal routes and is also available as a liquid solution and CBD oil.
Bottom Line On Roxicodone
Roxicodone is an opioid analgesic reserved for moderate to severe pain and is administered in cases where opioid use is appropriate.
It shares the common side effects and abusive potential of other opioids. A natural alternative to Roxicodone maybe CBD, which has shown some potential to treat pain.
Disclaimer: The contents of this article are only for educational purpose. For more information, please consult your doctor.
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