Oxycodone (ok-see-co-don) is a pain-relief medicine used to treat severe pain. It is often used to treat pain following an operation (surgery). It is usually given together with other pain-relief medicines such as paracetamol (e.g. Panadol) and anti-inflammatories (e.g. Nurofen).

Oxycodone is made by many different companies, and different brands of the same medicine have different names (e.g. Endone, OxyContin).

Giving your child oxycodone

Your child’s doctor will work out the amount (the dose) of oxycodone that is right for your child. The dose will be shown on the medicine label.

Oxycodone comes in fast- and slow-acting preparations and is available as tablets, capsules, liquid and suppositories. Targin-brand tablets contain oxycodone and another medicine called naloxone (a medicine that can make constipation less likely). Your doctor or pharmacist will advise which product is most suitable for your child.

When should I give oxycodone?

If your child is prescribed a fast-acting preparation, it should be given as needed when pain is not controlled by simple pain-relief medicines such as paracetamol (e.g. Panadol). Fast-acting preparations start to relieve pain within 30 minutes, and may be taken up to every four hours if needed.

• Endone tablets: can be swallowed whole with a glass of water. If your child is unable to swallow tablets, they can be dissolved in a small amount of water.
• OxyNorm capsules: can be swallowed whole with a glass of water. If your child is unable to swallow capsules, capsules may be opened and contents dissolved in a small amount of water.
• Oxycodone liquid: should be given using an oral syringe to measure the dose according to the medicine label.

Slow-acting preparations release the medicine slowly over a longer period. Slow-acting oxycodone is usually given twice each day, as directed by your doctor. You should give one dose in the morning and one dose in the evening – giving the doses 12 hours apart is best (e.g. if the morning dose is given at 8am, the evening dose should be given at 8pm).

• Novacodone, OxyContin and Targin brand tablets must be swallowed whole. Do not crush, break or chew the 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, you must not give both preparations at the same time. It’s important to allow at least one hour between giving each preparation (e.g. if your child takes a dose of slow-acting oxycodone at 8am, you must wait until after 9am to give a dose of fast-acting oxycodone). If more than one person usually gives your child their medication, make sure that you communicate and write down doses given so that you don’t give extra doses by mistake.

What to do if a dose is missed

Fast-acting oxycodone preparations should only be given when it is needed for pain.

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

• Never give a double dose to make up for a missed dose as this may make your child too sleepy and affect their breathing. 
• You do not need to wake up a sleeping child to give a missed dose.

What to do if you give too much oxycodone

If you think you may have given your child too much oxycodone, call the Poisons Information Centre on 13 11 26 as soon as possible, even if your child shows no symptoms. In the case of an emergency, call an ambulance or take your child to the nearest hospital emergency department. Have the medicine container or packaging with you, even if it is empty, as this information will be useful.

Possible side effects

Medicines are designed to make us better, but sometimes they have unwanted effects (side effects). Some side effects will go away with time, or after the dose has been changed.

Speak to your child’s doctor if you are worried about any of the following:

• constipation (hard or fewer stools (poo) or straining when trying to pass a stool)
• nausea
• dizziness 
• sleepiness 
• your child is confused or is hallucinating (they are seeing things that are not there) 
  
• itchy skin 
• if your child says they need to urinate (wee) but are not able to.

To avoid constipation, encourage your child to drink plenty of water and eat fruits and vegetables. If constipation is a problem for your child when taking oxycodone, your doctor may prescribe a medicine (laxative) to help move your child’s bowels.

Your child may feel sleepy or dizzy while taking oxycodone. Care must be taken with activities like bike riding or climbing, or, for older children, driving or operating heavy machinery.

Oxycodone should not be given with any medicine containing codeine or morphine. Also avoid alcohol and other medicines that cause drowsiness (e.g. medicines to help with sleep problems, prescription cough medicines and other strong pain-relief medicines).

You should call an ambulance immediately if your child:

• is very drowsy or difficult to wake up
• has difficulty breathing (e.g. short of breath, puffing when speaking)
• shows any signs of an allergic reaction (e.g. skin rash or swelling of the lips, mouth or throat).

There may be other side effects that are not listed in this fact sheet. If you notice anything unusual or are concerned about your child, contact your doctor.

General medicine advice

• Give oxycodone only as directed and only to the person who the medicine was prescribed for. Never give it to another person, even if their condition appears to be the same, as this could do harm.
• If your child requires surgery, you must tell the anaesthetist that your child is taking oxycodone.
• Store oxycodone capsules, liquid, suppositories and tablets at room temperature, in a cool, dry place away from heat or direct sunlight, below 25°C.
• Store all medicines out of reach of children and always keep medicine in the container or box that it came in.

Key points to remember

• Oxycodone is a pain-relief medicine used to treat severe pain and is often used to treat pain after surgery.
• Fast-acting oxycodone preparations should only be given when needed for pain, but slow-acting preparations are usually given twice a day, 12 hours apart.
• Never give a double dose to make up for a missed dose as this may make your child too sleepy and affect their breathing.
• Call an ambulance immediately if your child is very drowsy or difficult to wake up, has difficulty breathing or has any signs of an allergic reaction.

For more information 

• This fact sheet has been developed to provide practical advice about the use of this medication in children and should be read in addition to the information supplied by the manufacturer which can be found at NPS MedicineWise. 
  
• Kids Health Info fact sheet: Medicines for children and medicine reactions
  
• Talk to your doctor or pharmacist
• The Therapeutic Goods Administration: Consumers
• Kids Health Info fact sheet: Constipation
  

Developed by The Royal Children's Hospital Medication Safety Committee and Children’s Pain Management Service. We acknowledge the input of RCH consumers and carers.

Developed March 2019.

This information is awaiting routine review. Please always seek the most recent advice from a registered and practising clinician.

Kids Health Info is supported by The Royal Children’s Hospital Foundation. To donate, visit www.rchfoundation.org.au.