Oxycodone IR VS Oxycodone ER: Know the Difference

As seen in The Consultant Connection, January 2017 Issue
Josephine Notter, RN WCC, ICP, Inc.
Medication errors due to look-alike sound-alike drugs are common and a concern for the nurse.  When receiving orders, transcribing orders and administering ordered medications, important steps must be taken to provide a safe environment for patients.   Oxycodone hydrochloride is an opioid painkiller. It is found in some prescription medications such as Percocet, Oxycontin, and Roxicodone.  Oxycodone can be in different doses, strengths, and dosage forms.  These products are look-alike/sound-alike drugs that can cause confusion when ordered and administered.  Here are some important differences that will help you distinguish between the two medications – Oxycodone ER and Oxycodone IR.
Oxycodone ER is an extended- released medication indicated for severe pain. It delivers pain relief over a 12 hours period, and it is recommended for no more than twice a day dosing.   This medication cannot be crushed. The dose for Oxycodone ER may be large but it is released slowly into the blood stream.  Crushing this medication increases the danger of overdose and death to the patient. The brand name is OxyContin. 
Oxycodone IR is an immediate-release medication that starts to works within a few minutes of administration.  It delivers pain relief up to 6 hours. This medication maybe used for acute pain after surgery or as a PRN pain medication. 
When taking orders from the physician, be sure to clarify ambiguous orders.  Oxycodone ER/OxyContin   is indicated for 12 hours usage. Oxycodone IR is indicated for every 4 to 6 hours usage.   When administering the medication, complete your three checks before giving the medication to your patient.  A patient that mistakenly is given the wrong product is a risk for overdoes, and death.  Which med would you give if the order read: Oxycodone 10mg po every 12 hours for pain?  Oxycodone 10 mg po every 6 hours for pain?
Consider clarifying and writing the order  as follows:
  • Oxycodone ER 10 mg po every 12 hours for pain
  • Oxycodone IR 10mg po every 6 hours for pain.
Remember, if something does not look correct, or you are unsure – never guess or assume. Call for clarification before your make a deadly mistake.

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