Monograph
N02AA05 - Oxycodone |
Propably not porphyrinogenic |
PNP |
Rationale
Oxycodone is a substrate of CYP3A4, but is not an inhibitor or an inducer of CYP3A4 or other major CYP enzymes.
Risk for gastrointestinal adverse events in the form of obstipation, nausea, vomiting, loss of appetite, abdominal pain, diarrhoea and dyspepsia motivates vigilance against insufficient intake of food, especially of carbohydrate.
Chemical description
Oxycodone is an opioid.
Therapeutic characteristics
Very common side effects that can be potentially porphyrinogenic through reduction in carbohydrate intake and that also can be confused with an acute porphyria attack are obstipation, nausea and vomiting. Other common side effects are loss of appetite, abdominal pain, diarrhoea and dyspepsia.
Metabolism and pharmacokinetics
Oxycodone is metabolised to noroxycodone and oxymorphone by CYP3A4 and CYP2D6 respectively. They are then metabolised to noroxymorphone and excreted.
Oxycodone is not an inhibitor or an inducer of CYP3A4 (Interaksjoner and Soderberg 2013) or other major CYP enzymes.
Personal communication
Andersson clinical observation (n=1): tolerated.
Published experience
Oxycodone is listed as unsafe for patients with acute porphyria (Moore 2000).
IPNet drug reports
Uneventful use reported in 2 patients with acute porphyria.
References
| # |
Citation details |
PMID |
|---|
| * | Scientific articles |
| 1. |
Moore AW 3rd, Coke JM. Acute porphyric disorders.
Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2000 Sep;90(3):257-62. |
10982942 |
| 2. |
Cytochrome p450-mediated changes in oxycodone pharmacokinetics/pharmacodynamics and their clinical implications.
Söderberg Löfdal KC, Andersson ML, Gustafsson LL. Drugs. 2013 May;73(6):533-43. |
23605691 |
| * | Drug interaction databases |
| 3. |
Interaksjoner. Oxycodone. Accessed : 14.08.2013
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| * | Summary of Product Characteristics |
| 4. |
Norwegian medicines agency. Summary of Product Characteristics (SPC). Oksykodon.
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