The use of oxycodone in cancer-related pain: a literature review

Oxycodone is a semi-synthetic opioid agonist that can be used as an alternative to morphine in controlling cancer pain. It differs from morphine in its biphasic qualities in controlled release (CR) formulation. This review of post-1995 international literature explores the use of oxycodone compared with morphine, as well as titration studies comparing CR formulation against the conventional immediate release (IR) formulation. Most studies involved small numbers and so their results cannot be generalized. Statistical tests were used inappropriately in several of the studies reviewed, which compromises the validity of the findings, but it is important to note that there was broad agreement between researchers. Studies were graded based on research quality criteria of the US Agency for Health Care Policy and Research (United States Department for Health and Human Services, 1993). Conversion ratios and side-effects are discussed and recommendations made for the use of oxycodone in opioid rotation, particularly for patients suffering morphine-induced hallucinations. Several studies also recommend the use of oxycodone in preference to morphine in patients with renal impairment.