Oxycodone: prolonged-release tablets, risks and safe use

The NHS calls oxycodone a medicine in the opioid group, used for pain after an operation or a serious injury, or pain from cancer. It is often reserved for moderate to severe pain when other painkillers such as paracetamol and ibuprofen have not worked. It is not for minor aches, and the prescriber chooses the form and duration.

Oxycodone usually comes as tablets, capsules and a liquid to swallow. Some long-acting (prolonged-release) tablets work differently and are taken less often. Because the products are not interchangeable, take exactly the one you have been prescribed and keep to the schedule on the label.

Swallow tablets or capsules whole with a glass of water, with or without food. Use the syringe or cup supplied with the liquid. How much you take and for how long depends on why you are taking it.

• Standard oxycodone: if a dose is missed, take it when you remember unless the next dose is nearly due, then skip it.

• Long-acting oxycodone: if you remember within 4 hours, take it and take the next dose at the usual time; if it has been more than 4 hours, ask a doctor or pharmacist.

• Never take two doses together to make up for a missed one.

Common effects are constipation, nausea or vomiting, sleepiness or tiredness, dizziness, confusion, headaches and itchy skin or rash. Do not drive, cycle or use machinery if you feel dizzy or sleepy. The NHS says to keep taking the medicine unless advised to stop, but to speak to a pharmacist or doctor if side effects bother you.

Rare serious effects are anaphylaxis, slow, weak or shallow breathing, and low blood pressure with dizziness, confusion, blurred vision and low energy. If you think you are having a serious side effect, seek urgent medical help.

It may be unsuitable if you have had an allergic reaction to oxycodone or another opioid, have a liver or kidney condition, a lung condition such as asthma, a past addiction to alcohol, prescription medicines or recreational drugs, an underactive or overactive thyroid, an enlarged prostate, low blood pressure or a head injury.

Tell your doctor if you are pregnant or planning a pregnancy; it is sometimes used if needed after discussing risks and benefits. It is not usually used while breastfeeding, though a doctor may still recommend it when benefits outweigh risks. Call 111 or speak to a professional if you have concerns about a breastfed baby.

The NHS lists other opioids such as codeine and co-codamol, medicines for mental health conditions such as depression or anxiety, blood pressure medicines, some antihistamines, medicines for seizures such as gabapentin or pregabalin, St John's wort, and recreational drugs such as cannabis, cocaine or heroin.

Do not drink grapefruit juice while taking oxycodone. It is also best to avoid alcohol, since it can make you sleepy and increase serious side effects.

An extra dose can be dangerous. If you take more than prescribed, get medical advice, and if directed to A&E do not drive yourself; take the packaging.

After long use the body gets used to oxycodone, and the NHS says not to stop suddenly because of withdrawal; your doctor reduces the dose gradually over several weeks or months. Addiction is possible and your doctor aims to keep you at the amount you need. Talk to them if you are worried.