naloxone hydrochloride + oxycodone hydrochloride at a glance
Medicine class
Prolonged-release opioid analgesic combined with a locally acting opioid antagonist.
Licensed use
Severe pain requiring an opioid analgesic in adults.
Administration
Swallow whole with sufficient liquid; it may be taken with or without food.
Important limitation
It is not intended for sudden breakthrough pain or acute postoperative pain.
What is naloxone hydrochloride + oxycodone hydrochloride used for?
The selected product is licensed in adults for:
Severe pain that can only be adequately managed with opioid analgesics.
Pain treatment where naloxone is included to counter opioid-induced constipation through local opioid-receptor blockade in the gut.
How does naloxone hydrochloride + oxycodone hydrochloride work?
Oxycodone activates opioid receptors in the brain and spinal cord, reducing the perception of pain. Oral naloxone undergoes extensive first-pass metabolism, so little normally reaches the systemic circulation; it acts mainly at opioid receptors in the bowel to oppose oxycodone-related bowel dysfunction without normally cancelling its central pain-relieving effect.
naloxone hydrochloride + oxycodone hydrochloride preparations and strengths
Modified-release tablet
Route: Oral
Strengths: 10 mg + 5 mg, 20 mg + 10 mg, 40 mg + 20 mg
How to take naloxone hydrochloride + oxycodone hydrochloride
Follow the prescription and pack leaflet exactly.
Swallow the prolonged-release tablet whole with sufficient liquid.
Do not break, chew or crush it; this can release oxycodone rapidly and may cause a fatal overdose.
It may be taken with or without food.
Avoid alcohol and grapefruit juice.
Do not stop suddenly without an agreed withdrawal plan.
naloxone hydrochloride + oxycodone hydrochloride side effects
Common or expected effects
- Constipation or diarrhoea
- Nausea, vomiting, abdominal discomfort or dry mouth
- Sleepiness, dizziness, headache or vertigo
- Tiredness or weakness
- Reduced appetite
- Itching, sweating or skin reactions
- Difficulty sleeping
Get urgent medical advice
- Slow, weak or shallow breathing, extreme sleepiness or inability to wake
- Severe allergic reaction with swelling or breathing difficulty
- Seizure, fainting or marked confusion
- Severe abdominal swelling, pain or inability to pass stool or wind
- Agitation, high temperature, muscle rigidity or overactive reflexes suggesting serotonin toxicity
- Dependence, loss of control over use or withdrawal symptoms
naloxone hydrochloride + oxycodone hydrochloride in pregnancy
Evidence for the combination in pregnancy is limited. Oxycodone may sometimes be considered when other pain relief is unsuitable, but prolonged exposure can cause neonatal withdrawal and use near delivery can suppress the newborn's breathing. Pregnancy or plans for pregnancy should be discussed promptly with the prescriber; treatment should not be stopped suddenly without advice.
naloxone hydrochloride + oxycodone hydrochloride while breastfeeding
The selected product's SmPC advises discontinuing breastfeeding during treatment because oxycodone enters breast milk and effects on the infant cannot be excluded. UK specialist guidance describes oxycodone, including this combination, as not preferred and requiring careful infant monitoring if specialist assessment supports its use.
naloxone hydrochloride + oxycodone hydrochloride interactions
Tell the prescriber or pharmacist about all medicines, herbal products and recreational substances. Important examples include:
Benzodiazepines, sedatives, gabapentin, pregabalin, other opioids and other CNS depressants
Combined effects can cause profound sleepiness, impaired alertness, respiratory depression, coma or death.
Alcohol
Increases sedation and the risk of serious opioid adverse effects; concomitant use should be avoided.
Common questions about naloxone hydrochloride + oxycodone hydrochloride
Answers are fully visible for fast scanning and source review.
Why are naloxone hydrochloride and oxycodone hydrochloride combined?
Oxycodone provides opioid pain relief, while orally administered naloxone acts mainly in the bowel to oppose opioid-related bowel dysfunction.
Does naloxone hydrochloride + oxycodone hydrochloride prevent all constipation?
No. Naloxone may reduce opioid-related bowel dysfunction, but constipation remains a reported side effect and bowel symptoms should still be monitored.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.