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.
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.