Endone

Generic Name: Oxycodone hydrochloride
Product Name: Endone

Indication of Endone
Action of Endone
Dose advice of Endone
Schedule of Endone
Common side effects of Endone
Uncommon side effects of Endone

Indication of Endone:

Endone is a medicine used to relieve moderate-severe pain. It may be prescribed by a doctor for either short- or long-term use. A doctor will only prescribe Endone for patients who have unsuccessfully tried to relieve pain using other, non-narcotic painkillers.

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Action of Endone:

Endone is one of a group of drugs known as opioid analgesics. Its active ingredient is an opioid called oxycodone hydrochloride. Opioids are also produced naturally by the human body. They affect the way the body responds to pain. Opioids contained in medications like Endone work in the same way as opioids produced by the body.

When opioids are present in the body, opioid receptors in the central and peripheral nervous systems are activated, interfering with the way in which pain signals are transmitted through the nervous system . This reduces the transmission of pain signals through the spinal cord, resulting in a reduced pain sensation.

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Dose advice of Endone:

Dose information

Your doctor will determine the correct dose of Endone for you, depending on the nature (chronic or acute) and extent (moderate or severe) of the pain.

Endone is an oral medication. Each tablet contains 5 mg of oxycodone hydrochloride, the ingredient which works to relieve pain. Tablets should be taken whole. They should not be divided.

The usual dose is one tablet every 4-6 hours, preferably after meals or with milk. Your doctor may adjust the dose depending on the nature and severity of the pain and the effectiveness of the medication. It is important to always take the dose prescribed by your doctor. Never increase or decrease the dose unless advised to do so by your doctor.

Endone takes 10-15 minutes to start working and relieves pain for 3-6 hours. Always try to take Endone at the correct time. If you miss a dose, you can take it 2-3 hours after the scheduled time, but do not take the missed dose within 2-3 hours of the time at which the next Endone dose is due. If you do not realise you have missed a dose until within 2-3 hours of your next dose, skip the missed dose. If you think you will have difficulty remembering to take the medication, ask your doctor or pharmacist for tips to help you remember when you receive your prescription.

Overdose

Taking too much Endone (an overdose) can cause sleepiness and difficulty breathing, and may be life threatening. If you have taken more than the dose of Endone prescribed by your doctor, contact the Poisons Information Hotline or a hospital emergency department immediately. Also contact the Poison's Information Hotline if somebody else takes your Endone tablets, even if they do not show any signs of poisoning or sickness.

Feeling unwell

Contact a doctor if you feel unwell or experience allergic symptoms while taking Endone, even if you don't think your symptoms are caused by the medicine.

Symptoms which may indicate an allergic reaction include unconsciousness, difficulty breathing, severe dizziness, drowsiness or disorientation, and skin reactions including rash or discolouration. These symptoms indicate potentially serious health threats and you should seek medical advice immediately if you experience them.

Addiction

Endone may be addictive and cause physical or psychological dependence. If Endone is abused (i.e. taken in quantities greater than those prescribed by your doctor), it is less effective at reducing pain. It should be taken only to treat the condition for which it was prescribed, according to the dose prescribed. Do not give your Endone to others, even if they have similar symptoms.

Stopping use or changing dosage

Sudden withdrawal or dosage changes of Endone may cause physical withdrawal symptoms. It is therefore important to make sure you always have a sufficient supply of the medication for times when the pharmacy is closed (e.g. weekends or holidays). Do not stop using Endone rapidly or reduce the amount you take. Changes to the dosage should only be made by your doctor, who will monitor your reaction to the new dose to decide whether or not it is appropriate.

Alertness and coordination

Take care when operating machinery and driving a car while taking Endone, as it can affect alertness. This is particularly important when you first start using Endone, as you will be unfamiliar with the way it affects your alertness. Exercise caution when standing up, as rising quickly may cause dizziness.

Alcohol, other medications, and herbal remedies

Your doctor will usually recommend that you do not consume alcohol while taking Endone as, taken together, they may cause dizziness, drowsiness and sleepiness.

Some medications interact with Endone. Always inform other health professionals (e.g. dentists, pharmacists) that you are taking Endone before starting any new medications they prescribe you. Consult your doctor before you begin taking any new medicines, including over-the-counter medicines or herbal remedies from the pharmacy or supermarket.

Expiry and disposal

Endone tablets should not be used if they have passed their expiry date or if the packaging is damaged. In such cases, any unused tablets should be disposed of by returning them to a pharmacy.

If you have any queries about the correct way to use Endone, please ask your doctor.

Contraindications

Endone should not be used under certain conditions. Tell your doctor if you have:

Allergy to oxycodone hydrochloride, other opioids (e.g. morphine), or any other allergies;
Impaired liver function or a liver disease;
Severe breathing problems;
Cor pulmonale (a condition in which the right chamber of the heart is enlarged and weakened);
Arrhythmia (irregular heartbeat);
Asthma;
Inflammation or infection of your brain or spinal cord, or any condition affecting pressure inside your head (e.g. encephalitis);
Epilepsy or another disorder which may cause seizures, including:
- Head injuries;
- Brain tumours;
- Some metabolic disorders;
- Alcohol dependence or withdrawal from alcohol and drug use;
- Central nervous system infection;
Delirium tremens;
Abdominal problems;
Used monoamine oxydase inhibitors (MAOIs) in the part 14 days or are currently using these medications.

Precautions

Special care needs to be taken when using Endone under certain conditions. Tell your doctor if you have:

Other medication use: Using medications together may reduce their effectiveness or present a risk to your health, so doses may need to be altered or alternative medications used. Medications known to interact with Endone include:
- General anaesthetics;
- Anticoagulants or blood-thinning medications;
- Anti-epileptics;
- Sedatives (sleep-inducing medications);
- Antihypertensives (medications which reduce blood pressure);
- Medications used to treat mental conditions such as depression and anxiety;
- Other pain-relieving medications;
- Flu medications;
- Medicines used to relieve stomach cramps and spasms;
Hormone imbalance: Conditions which may cause hormonal imbalance include:
- Adrenocortical insufficiency;
- Hypothyroidism;
- Acute alcoholism;
- Myasthenia gravis (a condition characterised by progressive deterioration and weakness of the muscles);
- Central nervous system depression;
Kidney disease;
Hypotension (low blood pressure);
Shock;
Bile duct disorders, including biliary colic and biliary surgery;
Phaeochromocytoma (tumour of the adrenal gland);
Breathing disorders, including asthma or difficulty breathing;
Depression;
Prostate conditions or difficulty urinating;
Bowel disorder.

Use in pregnancy

Endone is a Pregnancy Category C medication and is not recommended for use by pregnant women. There is an increased risk of breathing difficulties in babies born to women who use opioid analgesics such as Endone. Babies may also experience dependence and withdrawal symptoms if the mother has been using Endone.

Breastfeeding

Endone is not recommended for use by breastfeeding women, as it is passed on to the baby in breastmilk. Rarely, it may be prescribed to a breastfeeding woman if the doctor assesses that the benefits for the mother outweigh the risks for the baby.

If you are breastfeeding and using Endone at the same time, your doctor will probably monitor your baby for signs of being affected by the drug (e.g. sedation). This is especially important if your baby was born prematurely.

Use in children

Endone is not recommended for use by children.

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Schedule of Endone:

Endone is a Schedule 8 medication.¹

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Common side effects of Endone:

All medicines have side effects. Most commonly the side effects are minor; however, some can be more serious. Usually the benefits of taking a medication outweigh the associated side effects. Your doctor would have considered these side effects before starting you on Endone.

Common side effects are those that occur in 1-10% of people given Endone. These include:

Physical dependence: Common with long-term use. Withdrawal symptoms may be experienced if the dose is suddenly withdrawn or another drug that counteracts Endone's effect is taken. Physical withdrawal symptoms include body aches, loss of appetite and tachycardia, and can be avoided if Endone is gradually withdrawn.
Nausea and vomiting: Especially when starting Endone use;
Indigestion;
Drowsiness or unusual tiredness or weakness;
Dizziness, faintness or lightheadedness;
Headache;
Orthostatic hypotension (low blood pressure when standing up);
Confusion;
Itch;
Dry mouth;
Miosis (an eye condition in which the pupils contract when exposed to bright light);
Urinary retention;
Constipation: With long-term use.

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Uncommon side effects of Endone:

Side effects that occur in less than 0.1–1% of people given Endone are considered uncommon. People do not necessarily experience any of these side effects, so do not become alarmed by this list:

Respiratory depression (difficulty breathing): More likely to occur as the dose of Endone increases.
Circulatory depression and coma: With large doses;
Sweating;
Facial flushing;
Nervousness or restlessness;
Bronchospasms (spasms in the smooth muscles of the bronchi or airways, which result in breathing difficulties);
Hallucinations;
Delirium;
Agitation;
Mood changes;
Tremor;
Visual disturbances;
Urticaria;
Hypothermia (reduced body temperature);
Bradycardia (abnormally slow heart rate);
Tachycardia (abnormally fast heart rate);
Hypotension (abnormally low blood pressure): With large doses;
Ureteric or billiary spasm (spasms of the urethra or bile ducts);
Paralytic ileus (obstruction of the intestine and bowel which prevents defecation);
Raised liver enzymes (indicating an abnormality in liver function);
Muscle rigidity;
Myoclonus (muscles spasms).

Rare side effects

Rare side effects are those that occur in less than 0.1% of people given Endone. These include:

Syndrome of inappropriate antidiuretic hormone secretion (SIADH);
Anaphylaxis;
Seizure;
Psychological dependence.

If you experience any of the listed side effects, or any other symptoms that appear abnormal or unusual, please tell your doctor.

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Reference:

Endone [online]. St Leonards, NSW: MIMS Online; 2 July 2009 [cited 5 October 2010]. Available from: URL link
Oxycodone [online]. Adelaide, SA: Australian Medicines Handbook; July 2010 [cited 5 October 2010]. Available from: URL link
Consumer Medical Information: Endone. Croydon, VIC: Sigma Pharmaceuticals Pty Ltd; July 2009.

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