Oxycodone-related side effects: Impact on degree of bother, adherence, pain relief, satisfaction, and quality of life

OBJECTIVES: Oxycodone immediate-release, alone or in combination (hereafter, oxycodone), is widely used to treat pain and is often associated with bothersome side effects. The objective was to assess side effect frequency, degree of bother, and impact on health-related quality of life (HRQoL). METHODS: An online survey was completed by a nationwide convenience sample of patients currently taking oxycodone for nonmalignant pain. Detailed data on any oxycodone-related side effects were collected. Relationships between side effects, pain relief and HRQoL (Physical Component Summary [PCS] and Mental Component Summary [MCS] of the Short Form 12-Item Health Survey) were explored. RESULTS: Among 601 respondents (average 45 years, 85.0 percent Caucasian, 69.1 percent female, 61.1 percent on oxycodone > 30 days), 84.0 percent were bothered by side effects with 30.8 percent quite a bit or extremely bothered. Over half were bothered by drowsiness (56.2 percent) and constipation (53.1 percent), over two-fifths by lightheadedness (43.6 percent) and dizziness (42.1 percent), approximately one-third by headache (33.1 percent) and nausea (31.3 percent), 27.6 percent itching, and 14.8 percent vomiting, which affected adherence to prescribed dosing regimens and, thus, is inversely associated with the level of pain relief. Patients who experienced less than 50 percent pain relief from oxycodone had worse PCS (33.9 vs 35.7; p = 0.038) and MCS (38.5 vs 42.4; p < 0.001) scores when compared with those who experienced 50 percent or more pain relief CONCLUSIONS: The majority of survey respondents experienced side effects of oxycodone, with a majority being bothered by side effects and impacting their QoL. This raises a question about the unmet need for pain medications with improved side effect profiles.