OxyContin OC 60mg – The Complete Medical Guide

Introduction to OxyContin OC 60mg

OxyContin OC 60mg is a high-potency extended-release oxycodone formulation classified as a Schedule II controlled substance. This pre-reformulation version (lacking modern abuse-deterrent properties) is reserved for severe, around-the-clock pain in highly opioid-tolerant patients. The “OC” designation indicates it can be more easily manipulated for abuse compared to current “OP” formulations.

Oxycontin OC 60mg

Medical Uses & Indications

FDA-Approved Uses

✅ Severe chronic pain requiring continuous opioid therapy
✅ Cancer pain management in opioid-tolerant patients
✅ Pain uncontrolled by lower-dose opioids

Key Clinical Features

• Formulation: Original controlled-release (non-abuse deterrent)
• Onset: 1-2 hours
• Duration: 12-hour controlled release
• Equianalgesic ratio: 60mg q12h ≈ 90mg oral morphine daily
• DEA Classification: Schedule II (Highest abuse potential)

Pharmacology & Mechanism

Neurochemical Action

• Full μ-opioid receptor agonist
• κ-opioid receptor partial agonist
• Potent activation of reward pathways

Metabolic Profile

• Hepatic metabolism: CYP3A4 (major), CYP2D6 (minor)
• Active metabolites: Oxymorphone (via CYP2D6)
• Elimination half-life: 4.5-8 hours (ER formulation)

Dosing & Administration

Strict Eligibility Criteria

• Confirmed opioid tolerance: ≥120mg oral morphine equivalent daily
• Stable pain pattern
• Failed trials of abuse-deterrent formulations

Conversion Protocol

1. Calculate total daily morphine equivalent

2. Reduce by 25-50% (incomplete cross-tolerance)

3. Divide by 2 for q12h dosing

Critical Safety Notes

⚠ Hospital initiation strongly recommended
⚠ Never crush/chew tablets (immediate 60mg release risk)
⚠ Requires dual prescriber verification
⚠ Naloxone rescue kit mandatory

Safety Profile

Common Adverse Effects

• Severe constipation
• Nausea/vomiting
• Profound sedation
• Cognitive impairment

Black Box Warnings

❌ Extreme addiction potential
❌ Life-threatening respiratory depression
❌ Fatal overdose risk if misused
❌ Concomitant CNS depressant danger

Risk Mitigation Strategies

Prescribing Safeguards

1. Specialist pain management consultation

2. Triplicate prescription forms where required

3. Weekly follow-ups initially

4. Random pill counts and UDS

Patient Safety Measures

• Biometric locked storage
• Mandatory caregiver training
• Medication disposal system
• Absolute alcohol prohibition

Clinical Alternatives

For Severe Chronic Pain

• OxyContin OP (abuse-deterrent)
• Methadone (For select patients)
• Fentanyl transdermal

Non-Opioid Options

• Intrathecal pump therapy
• Dorsal column stimulation
• Adjuvant medications

Special Population Considerations