[Efficacy and safety of compound oxycodone injection for cancer pain relief-a multicenter survey of prescriptions].

Oral oxycodone has been available since 2003 in Japan. Oxycodone consumption is increasing along with the decrease in morphine consumption. Although this drug currently has a central role in cancer pain treatment, at this time pure oxycodone injection has not yet been available in Japan. As an alternative, we can subcutaneously administer a compound oxycodone injection (Pavinal) containing a small amount of hydrocotarnine. Since few clinical reports on efficacy and safety of the compound oxycodone injection have been published in Japan, we conducted a retrospective multicenter survey with structured sheets. Monthly survey data regarding the compound prescriptions for cancer pain control have been collected from 3 cancer hospitals. Finally, sixty adult patients were analyzed with the following results. (1) The adverse effects caused by the prior opioids improved in more than half of the patients, and worsened in none. (2) Dose escalation of the drug was achieved through subcutaneous administration(the mean was 1.6 times), and resulted in pain relief with tolerable adverse effects in more than 80% of patients. (3) Adverse effects occurred in 13% of patients, but more than 80% of the episodes were mild in severity. Conversely, we found no adverse effects becoming sequelae, failure and/or fatal in severity. (4) Subcutaneous administrations with the drug were available in long-term(mean 15.4 days, maximum 53 days), including home palliative care use (1.7%). No toxicities due to accumulation were observed. (5) The conversion ratio from oral oxycodone to compound oxycodone injection was 0.82+/-0.20, and the domestic and international reports are basically consistent with our result. So we speculate that the compound can be regarded as a pure oxycodone injection using subcutaneous administration. While further studies are needed, our study indicated that compound oxycodone injection has efficacy and safety in cancer pain treatment. Especially in switching opioids and/or their routes of administration to enhance the analgesic potency along with reducing the adverse effect, we conclude that prescribing this drug can be a convenient alternative.