Safety and Efficacy of Controlled-Release Oxycodone: A Systematic Literature Review

D. Gary Rischitelli, M.D., J.D., M.P.H., Sean H. Karbowicz, Pharm.D.


Pharmacotherapy. 2002;22(7) 

In This Article

Abstract and Introduction

Prescriptions for controlled-release oxycodone, a narcotic analgesic, recently contributed to a dramatic increase in pharmacy costs for a large private insurance company. To determine whether this agent offered clinical benefits over other available drugs that would justify its significantly greater cost, a systematic review of 16 clinical trials was undertaken. The review suggested that immediate-release and controlled-release preparations of oxycodone have similar efficacy and comparable side effect profiles. Controlled-release oxycodone has the advantage of less frequent dosing than immediate-release oxycodone; however, other agents may be dosed infrequently at much lower costs. For patients requiring a controlled-release opioid treatment, controlled-release morphine and methadone should be considered because they appear to be as effective as oxycodone and cost considerably less. Controlled-release oxycodone may be appropriate for some patients, particularly if they cannot tolerate other controlled-release or long-acting opioid analgesics.

A recent study conducted within a large United States university-based health care system revealed that the greatest cost in caring for patients with low back pain arose from treatment with narcotic analgesics.[1,2] From 1999-2001, a large private workers' compensation insurance company (Liberty Northwest Insurance Co., Portland, OR) experienced a sharp upturn in pharmacy costs that was largely attributable to prescriptions for controlled-release oxycodone for outpatient pain treatment. As a result, the recent literature was reviewed to determine whether controlled-release oxycodone offered clinical benefits over other available drugs that would justify its significantly greater cost.


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