Oxycodone

While using this medicine – Remember

• Immediately call 000 for an ambulance if your child is very drowsy, difficult to wake up or has difficulty breathing
• If a dose is missed, never give a double dose to make up for the missed dose
• If more than one person gives your child their medication, communicate or write down the times doses are given so that you don’t give extra doses by mistake
• Simple pain relievers should be given first to reduce the need for oxycodone
• Other ways to reduce pain includes distraction, fun activities, talking about favorite pets/holidays, hot and cold packs, position changes and elevating injured limbs

Giving my child oxycodone

Your doctor/nurse practitioner will work out the amount (the dose) and preparation which is best for your child. The dose and frequency will be on the medicine label. If you think the dose is not right or the medicine is not working, talk to your doctor. The aim is to use this medication for the shortest time possible.

When opioid medicines are used for a long time, tolerance develops and the dose is adjusted to give the same level of pain relief. They do not cause addiction when prescribed for severe pain.

When and how should I give oxycodone?

Oxycodone comes in fast-acting and slow-acting preparations. The two different preparations should NOT be swapped for one another.

Oxycodone does not need to be given with food.

Fast-acting or ‘immediate release’ oxycodone preparations

are usually given ‘when needed’ for severe pain. They start to work within 30 minutes and may be given every 4 to 6 hours if needed. The common brands of fast acting products are Endone® tablets or capsules and OxyNorm® liquid.

When treating pain after an operation, your child’s doctor may recommend giving doses more regularly in the first few days. As your child’s pain improves, they should need oxycodone less often.

• Oxycodone 5 mg tablets (e.g. Endone®) – Swallow whole with water. If your child is unable to swallow tablets, they dissolve in a small amount of water
• Oxycodone 1 mg/mL liquid: (e.g. OxyNorm®) – Measure the dose using the oral dispenser provided by pharmacy

Slow-acting preparations

release oxycodone slowly over a longer period and are given at set times in the day, usually once or twice a day or as directed by your doctor or nurse practitioner. Slow-acting preparations are Oxycontin® and Targin®. (Targin^® tablets contain a second medicine called naloxone which helps to reduce the constipation from oxycodone.)

• OxyContin^® Targin^® brand tablets
  • Giving the doses 12 hours apart at the same time each day gives good pain relief over the day. (e.g. 8am and 8pm).
  • Must be swallowed whole with a glass of water. Do not crush, break or allow your child to chew these tablets. Slow-acting tablets become very sticky when wet, so they must be swallowed quickly with a glass of water to avoid choking.

If your child is prescribed both fast and slow acting oxycodone – Follow the doctors instructions about how much and how often to give in 24 hour period. Usually you would give the slow-acting preparations at the set times and the fast or immediate acting preparations when pain is severe and not responding to other pain relieving measures.

What to do if a dose is missed or my child vomits

If you miss a dose of slow-acting oxycodone (e.g. OxyContin^® or Targin^®), it can be given as soon as you remember, as long as this is at least eight hours before the next dose is due. Otherwise, skip the missed dose and continue giving the medicine at the normal times.

If your child vomits up the medicine less than 15 minutes after having a dose of liquid or tablets, and/or you can see the tablet in the vomit, give the same dose again.

If your child vomits up the medicine more than 15 minutes after having a dose of liquid or tablets, and/or you cannot see the tablet in the vomit:

• For immediate release liquid or tablets: wait an hour and if they still have significant pain, give the same dose again.
• For sustained release tablets: wait 2-3 hours and if pain escalates, or other pain relievers are not relieving the dose, give the same dose again.

Never give a double dose of the medicine to catch up a missed dose as this may make your child too sleepy.

What to do if I give too much oxycodone

If you think your child has had too much oxycodone, please call Poisons Information Centre on 13 11 26 even if your child shows no effects. In an emergency (unresponsive child), call 000 for an ambulance or take your child to hospital straight away. Have the medicine packaging with you, even if it is empty, as this information will be helpful.

What about using other medicines with oxycodone?

Tell your doctor or pharmacist about any other medicines or products your child takes before starting oxycodone. These include prescription, over the counter medicines, vitamins, supplements, herbal or complementary medicines that you buy from a pharmacy, supermarket, health food shop or online. Check with your doctor or pharmacist before starting new medicines or products in your child.

You can safely give your child simple pain medicines such as paracetamol (e.g. Panadol^®, Dymadon^®) and anti-inflammatories like ibuprofen (e.g. Hedafen, Nurofen^®) with oxycodone, unless your doctor has told you not to.

Your child should not be given any medicine containing codeine or morphine while taking oxycodone, unless prescribed by the same doctor. Taking other medicines that cause drowsiness e.g. medicines that help with sleep, sedating antihistamines, diazepam, should be done very cautiously and only after discussing this with the doctor prescribing oxycodone.

Alcohol should not be consumed within 24 hours of taking oxycodone.

Possible side effects – what other effects can occur?

Side-effects you must do something about

Call 000 for an ambulance if your child is:

• Very sleepy or difficult to wake up
• Having difficulty breathing (e.g. short of breath, puffing when speaking, slow breathing)
• Showing signs of an allergic reaction like swelling of the lips, mouth or throat

Other side effects you need to know about

Some side effects go away with time or after the dose has been reduced/stopped, some do not.

• Constipation (hard or fewer stools or straining when trying to pass a stool). This is common.

To avoid constipation, encourage drinking plenty of water and eating fruits and vegetables. Prune or pear juice may help to keep stools soft. Talk to your pharmacist or doctor about the use of suitable laxatives to help move your child’s bowels.

• Mild drowsiness or dizziness
• Nausea and/or vomiting
• Itchy skin
• Flushing of the face
• Confusion or hallucinations (seeing or hearing things that are not there)
• Your child has trouble passing urine

Oxycodone can make your child feel sleepy or dizzy. Care must be taken with activities like riding a bike/scooter/skateboard, climbing, sleeping on the top bunk. For teenagers avoid driving or operating machinery.

If you notice anything unusual or are concerned about any of the side effects above or if they continue – speak to your doctor or pharmacist.

General medicine advice and disposal of pain medicines

Only give this medicine to your child who was prescribed it. Never give it to anyone else, even if their condition appears to be the same, as this could do harm. Contact Poisons Information Centre on 131126 if another person takes this medicine.

Pain medicines which are no longer needed or expired should be returned to any pharmacy and not kept for use at a later time as they can cause harm if accidentally taken or used for a different condition than first prescribed. Misuse of oxycodone can lead to addiction.

Store all medicines in original containers out of sight and where children cannot reach it and in cool, moisture free place.

For more information

This fact sheet is about using oxycodone in children. Some information may be different from the manufacturer’s Consumer Medicine Information (CMI) which is found at NPS MedicineWise.

• OxyNorm Liquid – NPS MedicineWise
• Endone – NPS MedicineWise
• Talk to your doctor, nurse practitioner, registered nurse or pharmacist
• CHQ Information for families Constipation Fact Sheet

Contact us

In an emergency, always contact 000 for immediate assistance

Pharmacy Department
Level 2, Queensland Children’s Hospital
501 Stanley Street, South Brisbane 4101
t: 07 3068 1901 (9am – 5pm Mon – Fri)
(9am – 12pm Sat – Sun/public holidays)