Table 25

Oxycodone sublingual

Oxycodone sublingual
What is it?Opioid analgesic
Mechanism of actionMu opioid agonist
Starting dose1.25–2.5 mg given as drops, maximum 1 hourly
Time to effectUncertain (20–30 min with oral route)17
FormulationOxyNorm Concentrate 10 mg/mL oral solution
IndicationPain, breathlessness
Common adverse effects‘Anxiety; bronchospasm; depression; diarrhoea; dyspnoea; gastrointestinal discomfort; hiccups; mood altered; tremor’16
Contraindications‘Acute abdomen; chronic constipation; cor pulmonale; delayed gastric emptying’16
CautionSee for Drug Driving advice
Licencing‘Off label’ route of licensed oral solution
BenefitsA transmucosal alternative to oral or subcutaneous morphine
RisksUnpredictability of bioavailability when sublingual or buccal route used, likely lower than oral due to solution not being lipophilic
Cost£46.63 for 120 mL × 10 mg/mL oral solution