M-Oxy

Uses

Doctors prescribe M-Oxy to relieve pain.

Other, off label uses for this medicine

The active ingredient in M-Oxy stops a nagging cough.

General Drug Information

M-Oxy contains oxycodone, a potent opioid pain reliever sometimes called a narcotic analgesic.

Administration/Dosage

Patients should never adjust M-Oxy dosages without first consulting a doctor.

Action

The oxycodone in M-Oxy depresses the central nervous system, or CNS, to dull the brain’s perception of pain. This CNS depression also causes sedation, relaxation and a pleasant feeling of euphoria. Oxycodone depresses respiratory centers in the brain to cause slow, shallow and irregular breathing patterns. Oxycodone acts as an antitussive to soothe a nagging cough by making the brain unaware of the need to clear fluid and debris from the lungs.

The oxycodone in M-Oxy acts in systems other than the CNS to produce effects. Oxycodone increases the tone of smooth muscles to make them stiff and less functional. Smooth muscle groups are located in various places in the human body, including those intestinal muscles that push stool through the digestive tract and the ducts that control the flow of bile and other digestive juices into the small intestine.

The opioids in M-Oxy also affect the smooth muscles lining blood vessel walls to widen these blood vessels. This vasodilation can lower blood pressure to the point of dangerous hypotension.

The oxycodone in M-Oxy may produce histamines, which are the compounds responsible for itching or a stuffy, runny nose and other allergy-like reactions.

The consumer can expect the effects of oxycodone to last for three to four hours.

The liver metabolizes the ingredients of M-Oxy into smaller components. The kidneys flush these metabolites from the body through urine. Dysfunction in the liver or kidneys can change how M-Oxy acts in the body.

Warnings

Respiratory Depression

The oxycodone in M-Oxy may depress respiratory centers in the brain to slow breathing patterns. This respiratory depression can prevent the lungs from adequately exchanging spent carbon dioxide for fresh oxygen, causing oxygen starvation and high carbon dioxide levels. Respiratory depression may result in brain damage or death. Symptoms of respiratory depression include slow, shallow or irregular breathing patterns along with a bluish tint around the victim’s eyes, mouth and fingertips.

Respiratory depression occurs more frequently in elderly or debilitated patients, usually after a non-tolerant patient receives large doses of opioids or M-Oxy alongside another drug that depresses breathing.

Patients with the serious breathing condition COPD and those with the heart condition cor pulmonale should exercise extreme caution when taking M-Oxy, as should those with diminished lung capacity, low oxygen or high carbon dioxide levels, or pre-existing respiratory depression. Even therapeutic doses of M-Oxy can cause respiratory problems to the point of stopped breathing. Physicians should consider an alternate form of pain treatment for these patients or prescribe the lowest effective dose while closely monitoring the patient’s condition.

Hypotensive Effect

Oxycodone causes vasodilation and severe hypotension in people who already have trouble maintaining an adequate blood pressure, either because they have lost a lot of blood or because they received a drug that also lowers blood pressure. Healthcare providers should administer M-Oxy with caution to patients in shock, since the vasodilation associated with oxycodone can further reduce the patient’s blood pressure.

M-Oxy may cause orthostatic hypotension, or blood pressure that plummets when the patient stands up quickly.

Head Injury and Increased Intracranial Pressure

M-Oxy can cause respiratory depression that results in low oxygen and high carbon dioxide levels that, in turn, may increase the intracranial fluid pressure surrounding the patient’s brain. Head injuries, brain tumors or pre-existing high intracranial pressure enhance these effects. Furthermore, the effects of M-Oxy can mimic those of a head injury, making it difficult for a physician to diagnose or check on the healing progress of a head injury. Physicians should prescribe M-Oxy to patients with suspected head injuries with caution and only when necessary.

Precautions

M-Oxy can make the consumer feel dizzy or drowsy and impair his physical and mental performance. The consumer should not operate a car or heavy machinery until he knows how M-Oxy affects him.

M-Oxy is only for patients who need opioid therapy to control pain. Physicians should adjust dosage according to the patient’s individual condition and response to opioid therapy. Doctors should prescribe M-Oxy only when the analgesic benefits clearly outweigh the risks for respiratory depression, orthostatic hypotension, altered mood and other opioid side effects.

Physicians should exercise caution when prescribing M-Oxy for patients with certain medical conditions, including Addison’s diseases, seizure disorders, curvature of the spine significant enough to interfere with breathing, and some types of thyroid, prostate, or urinary problems. Patients suffering from severe liver, kidney or lung dysfunction should use M-Oxy with care. Healthcare providers should use caution when prescribing M-Oxy to debilitated patients and to those with pre-existing CNS depression or coma, the serious mental illness known as toxic psychosis, acute alcoholism or delirium tremens, sometimes called “DTs.”

M-Oxy may obscure the presence or healing process of certain abdominal conditions. The oxycodone in M-Oxy may aggravate or cause seizures in some patients.

Tolerance

When a patient begins opioid therapy, he is opioid-naïve and sensitive to the effects of the oxycodone in M-Oxy. With continued use at therapeutic doses, the consumer becomes more tolerant of and less sensitive to the effects of oxycodone. An opioid-tolerant person requires stronger doses of M-Oxy to achieve the same analgesia. Prescribing physicians may have to increase dosages for opioid-tolerant individuals.

Dependence

The human body becomes accustomed to the presence of oxycodone. The body begins to depend on a certain level of oxycodone to feel “normal” after continued use, especially at high doses. An opioid-dependent person feels uncomfortable withdrawal symptoms when he stops using M-Oxy suddenly.

Pancreatic and Biliary Tract Disease

The oxycodone in M-Oxy may cause spasms in the duct controlling the flow of bile and other biliary juices. Oxycodone may affect the levels of certain liver enzymes in the blood. Patients with biliary tract disease, including pancreatitis, should avoid using M-Oxy.

Special Risk Patients

Scientists have not yet established the safety of using M-Oxy in children or if this drug is effective for treating pain in pediatric patients.

Elderly patients may be more sensitive to the effects of M-Oxy; physicians may consider smaller initial doses for patients over the age of 65.

Since the liver metabolizes M-Oxy, those patients with liver dysfunction may clear oxycodone from their bodies slowly. Physicians should start these patients on very low doses of M-Oxy and increase dosages with caution only as necessary to control pain.

The kidneys eliminate M-Oxy metabolites through urine. Patients with end-stage kidney failure may eliminate these metabolites very slowly, potentially causing a dangerous accumulation of oxycodone metabolites in the system. Physicians should prescribe conservative doses to these patients and increase dosages only enough to control pain.

Contraindications

M-Oxy is not appropriate for everyone. Patients with the dangerous bowel problem, paralytic ileus, should not use M-Oxy. This drug is not appropriate for individuals with a known hypersensitivity to oxycodone or other opioids.

Patients with pre-existing respiratory depression should not use M-Oxy outside of monitored locations equipped with resuscitation equipment. Those patients suffering from acute asthma or high carbon dioxide levels should avoid M-Oxy use.

Pregnancy, Labor and Delivery, Breastfeeding

Pregnant women should use M-oxy only when the benefits to the mother’s health clearly outweigh the risks to the mother or the baby.

Medical specialists do not recommend M-Oxy to reduce pain immediately before or during labor and delivery. Doing so may prolong labor by reducing the strength, duration and frequency of contractions.

Regular M-Oxy use by the mother may cause respiratory depression in the newborn; delivery room personnel should be ready to administer the antidote to respiratory depression, naloxone. Babies born to women who take oxycodone products like M-Oxy regularly during pregnancy may suffer withdrawal symptoms in the first weeks of life.

Mothers may excrete oxycodone into breast milk. Babies who nurse from mothers who use M-Oxy regularly may experience withdrawal symptoms when they stop nursing or when the mother discontinues M-Oxy.

Drug Interactions

M-Oxy can interact with other medications to produce unsafe or undesirable results. Patients should supply a list of all prescription and over-the-counter medications to their physicians to reduce the risk for dangerous drug interactions. M-Oxy consumers should not start, stop or change the way they take any prescription or non-prescription drug while on this medication.

Taking M-Oxy with other CNS depressants can have additive effects. Examples of other drugs that depress the central nervous system include sedatives, tranquilizers, general anesthetics, alcohol and other opioids. Combining M-Oxy with another CNS depressant may result in respiratory depression, hypotension, extreme sedation or coma. The oxycodone in M-Oxy can enhance the effects of muscle relaxants to produce respiratory depression. When a patient needs both M-Oxy and other CNS depressant, the prescribing physician should reduce the dosage of one or both medications.

Some medications can interfere with the action of oxycodone to reduce the analgesic effects of M-Oxy and cause withdrawal symptoms in an opioid-dependent patient. Examples of drugs that do this are pentazocine, nalbuphine, butorphanol and buprenorphine.

Many people take MAOIs to treat depression or high blood pressure. Patients should not take M-Oxy if they have used an MAOI within 14 days; doing so may cause anxiety, confusion, respiratory depression or coma.

Side effects

All drugs, including M-Oxy, can cause adverse reactions in some consumers.
Respiratory depression is the most serious adverse reaction associated with oxycodone. Other serious side effects include stopped breathing, depression of the circulatory system, hypotension, shock, and stopped heartbeat.

The most commonly reported non-serious side effects include nausea, constipation, vomiting, headache and the most frequently reported side effect, itching. Patients also report insomnia, dizziness and sleepiness.

Except for constipation, most of the non-serious side effects fade as the consumer becomes opioid-tolerant. The consumer can reduce the frequency of adverse reactions by starting with low doses, increasing dosages slowly and by taking the medication regularly to keep a steady level of oxycodone in the bloodstream.

Overdose

M-Oxy overdose is a serious and sometimes fatal condition. Overdoses from oxycodone and other prescription painkillers claim the lives of nearly 15,000 Americans each year. Deaths from prescription painkiller overdoses are on the rise, more than tripling in the decade between 1999 and 2008.

Symptoms of an acute oxycodone overdose include respiratory depression, sleepiness that worsens to coma, limp muscles, pinpoint pupils and cold, clammy skin. The patient may suffer slow heartbeat, hypotension and death.

M-Oxy overdose requires immediate medical treatment. Emergency department workers will help the patient breathe by sliding a flexible tube into his throat to hold his airway open; workers may attach this tube to a mechanical ventilator to take over breathing responsibilities. Nurses will administer intravenous fluids and medications to control blood pressure and other vital signs.

Nurses may ask the patient to drink ipecac to induce vomiting then pump remaining M-Oxy from the stomach. Nurses may administer activated charcoal into the stomach to absorb and neutralize residual oxycodone.

Doctors may order naloxone to reverse respiratory depression if the patient shows signs of breathing problems. The respiratory depressant effects of oxycodone frequently outlast the therapeutic effects of naloxone so the physician will likely order repeat naloxone doses to treat recurring episode of respiratory depression.

Abuse

According to the DEA, oxycodone became “the most frequently encountered pharmaceutical drug by law enforcement” in 2009. Recreational drug abusers target the oxycodone in M-Oxy because of the way this opioid gets them high.

Abusing M-Oxy increases the risk for adverse reaction, infectious diseases, overdose, addiction and dependence.

Withdrawal

An opioid-dependent person suffers withdrawal symptoms when he stops using M-Oxy. Withdrawal symptoms are the result of the body’s struggle to low oxycodone levels, a process known as detoxification. This detoxification process and the ensuing withdrawal symptoms begin a few hours after the last dose of M-Oxy.

Early opioid withdrawal symptoms include restlessness, watery eyes, stuffy and runny nose, yawning, sweating, chills, body aches and wide pupils. Later, the individual may feel irritable or anxious and experience backache, joint pain, weakness, stomach cramps, trouble sleeping, nausea and vomiting, loss of appetite, and diarrhea. He may exhibit an increase in vital signs such as high blood pressure, respiratory rate and pulse.

Without intervention, these symptoms persist for five or more days before fading. Withdrawal symptoms will not return unless the patient once again becomes dependent on opioids.

The individual may stop withdrawal symptoms at any time by taking more M-Oxy, but this return to opioid use halts the detoxification process, leaving the individual still dependent on opioids.

To avoid withdrawal symptoms, doctors suggest patients wean themselves from M-Oxy by taking smaller doses further apart. This tapering method works well for most people but persistent and overpowering withdrawal symptoms prevent many people from quitting M-Oxy when they no longer need it to control pain.

Detox

The Institute of Addiction Medicine estimates there are almost 2 million opioid-dependent Americans at any given time. Many local healthcare institutions hope to help these individuals through detoxification services. During detoxification, patients receive drugs to counteract the effects of oxycodone along with multiple drugs to soothe withdrawal symptoms. These detoxification procedures provide welcome relief from withdrawal symptoms but do not shorten the duration of the withdrawal experience.

Many informed consumers now recognize rapid detox as the most humane and efficient approach to overcoming withdrawal symptoms. Rapid detox patients receive anesthesia and sedatives prior to the standard detoxification and anti-withdrawal drugs. Consequently, rapid detox patients rest in a comfortable “twilight sleep” for a few hours before awakening renewed and refreshed.

Storage

Consumers and caregivers should store M-Oxy as directed, in a tightly sealed container and out of the reach of children. Patients should never share M-Oxy with another person, even if both share similar symptoms.

Consumers should dispose of M-Oxy when they no longer need it for pain.