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Key messages1

  • Oxycodone is a strong opioid analgesic that should only be used as a second-line treatment for patients who are not able to tolerate morphine.
  • Oxycodone is approximately twice as potent as morphine and 7.5 – 20 times more potent than codeine, i.e.10 mg of oxycodone is equivalent to 15 – 20 mg of morphine and 75 – 200 mg of codeine
  • Despite a recent decrease in the number of patients receiving oxycodone, there is still a large number of patients prescribed oxycodone each year in New Zealand
  • While most patients are initiated on oxycodone outside general practice, a significant proportion of patients are still being started or continued on oxycodone by general practitioners
  • There is evidence that oxycodone has a higher addictive potential than morphine. Some regular users will experience features of dependence.

Please see BPJ 61 (June, 2014) and 62 (July, 2014) for further information on oxycodone.

Sample Practice Data

Between April 2013 – March 2014

23 patients registered to your practice received oxycodone

34 items of oxycodone were dispensed to these patients

22 patients registered to your practice received morphine

433 items of morphine were dispensed to these patients

Oxycodone is second-line to morphine

Oxycodone does not provide more effective pain relief than morphine, is more expensive, and is associated with increasing levels of misuse. Therefore it should only be used in patients who do not tolerate morphine.

Do you know we have an oxycodone audit for you to review your prescribing? This is available from the audits section

National Trends

There has been an increase in the number of patients receiving either morphine or oxycodone, with an additional 15,501 patients being dispensed these medicines in 2013 compared to 2009. In 2013, 61,824 patients received either morphine or oxycodone. Since the last oxycodone report in 2011 there has been a shift in the dispensing trends of these medicines. Between Q4–2011 and Q1–2014 there was a 19% decrease in the number of patients dispensed oxycodone while the number dispensed morphine increased by 23% (Figure 1).

Figure 1. Number of patients dispensed oxycodone and morphine in each quarter for years 2009–2014

In 2011, 30% of all oxycodone was initiated in general practice. Over the last 12 months (Apr 2013 – Mar 2014) 28% of oxycodone had been initiated in general practice (Figure 2).

Of concern, is the fact that 80% of patients prescribed oxycodone for the first time in 2013 did not have a previous prescription for morphine in the preceeding 12 months.

Figure 2. Source of oxycodone prescriptions for patients initiated in 2013/14

  1. Best Practice Journal, Issue 61 and 62 2014. Available at www.bpac.org.nz (Accessed Jul, 2014).