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Related Experiment Video

Updated: Jul 16, 2026

High-throughput and Comprehensive Drug Surveillance Using Multisegment Injection-Capillary Electrophoresis-Mass Spectrometry

High-throughput and Comprehensive Drug Surveillance Using Multisegment Injection-Capillary Electrophoresis-Mass Spectrometry

Published on: April 23, 2019

Oxycodone accumulation in a hemodialysis patient.

Pamela A Foral¹, Joseph R Ineck, Kelly K Nystrom

¹Alegent Health, Bergan Mercy Medical Center, and Creighton University, Omaha, NE, USA. pforal@creighton.edu

Southern Medical Journal

|March 3, 2007

Summary

Oxycodone accumulation can cause serious adverse effects in patients with chronic kidney disease undergoing hemodialysis. Caution is advised when prescribing oxycodone to patients with renal impairment.

Related Experiment Videos

Last Updated: Jul 16, 2026

High-throughput and Comprehensive Drug Surveillance Using Multisegment Injection-Capillary Electrophoresis-Mass Spectrometry

High-throughput and Comprehensive Drug Surveillance Using Multisegment Injection-Capillary Electrophoresis-Mass Spectrometry

Published on: April 23, 2019

Area of Science:

Pharmacology
Nephrology
Clinical Toxicology

Background:

Oxycodone is a widely used opioid analgesic for pain management.
Renal dysfunction can significantly alter the pharmacokinetics of oxycodone and its metabolites.
Accumulation of opioids in patients with impaired renal clearance poses a risk of toxicity.

Observation:

A case report details a 41-year-old patient on chronic hemodialysis who received oxycodone/acetaminophen.
The patient experienced lethargy, hypotension, and respiratory depression due to medication accumulation.
Naloxone administration, including a 45-hour continuous infusion, successfully reversed the adverse effects.

Findings:

The patient's symptoms were deemed a "probable" adverse drug reaction to oxycodone, assessed via the Naranjo scale.
This case highlights the prolonged half-life of oxycodone and its metabolites in patients with end-stage renal disease.
Oxycodone accumulation led to severe central nervous system and respiratory depression.

Implications:

Oxycodone should be prescribed with extreme caution in patients with chronic renal failure and those undergoing hemodialysis.
Healthcare providers must be vigilant for signs of opioid toxicity in renally impaired patients.
Alternative analgesics or dose adjustments may be necessary for effective and safe pain management in this population.