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Prescrire international · Jun 2003
Comparative StudyOral oxycodone: new preparation. No better than oral morphine.
- Prescrire Int. 2003 Jun 1;12(65):83-4.
Abstract(1) For the treatment of cancer pain resistant to WHO step I and II analgesics, several oral morphine preparations are available, in immediate-release and sustained-release formulations. (2) A sustained-release form of oxycodone, an old opiate, was marketed in France in 2002 for oral treatment of cancer pain, in two daily doses. (3) The results of three comparative double-blind trials suggest that 1 mg oxycodone is similarly effective to 1.5 mg of morphine. According to another comparative double-blind trial, 1 mg oxycodone has about the same analgesic efficacy as 0.25 mg of hydromorphone. (4) Oxycodone has the usual opiate side effects including constipation, sedation, nausea and vomiting, and pruritus. (5) Oxycodone has not been tested in comparative trials in patients in whom morphine is ineffective or poorly tolerated. (6) The available product range of sustained-release oxycodone does not allow the dose to be adjusted rapidly at the outset of treatment, and is poorly suited to patients who have difficulty swallowing. (7) In practice, oral morphine remains the reference treatment for cancer pain resistant to WHO step I and II analgesics.
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