Xtampza ER (Oxycodone) - Oral

Warning:

Xtampza ER (oxycodone) carries a risk of addiction, abuse, and misuse, which can lead to overdose and death. 

It can also cause serious, life-threatening, or fatal respiratory depression (slow breathing). Accidental ingestion, especially in children, can result in an overdose.

Prolonged use of this medication during pregnancy can result in neonatal withdrawal syndrome. Talk to your healthcare provider if you are pregnant or become pregnant while using Xtampza ER.

Using Xtampza ER with CYP3A4 inhibitors can cause a fatal overdose of oxycodone.

What Is Xtampza?

Xtampza ER (oxycodone), or Xtampza extended release, is an oral prescription medication used to manage severe pain. It is used in people with long-term, around-the-clock pain that can’t be adequately treated with other options.

Xtampza ER is an extended-release, or long-acting, version. This means it releases its contents gradually over several hours instead of immediate-release versions, which often need to be taken more frequently.

Xtampza ER is one of several available formulations of the generic drug oxycodone. Oxycodone is in the opioid class of drugs and is classified as a schedule II controlled substance, meaning it has a high potential for abuse and dependence. Xtampza ER is formulated to make it more difficult to abuse than some other kinds of opioids.

Like many other opioids, Xtampza ER stimulates parts of the brain and nervous system called opioid receptors. These receptors play an important role in the perception of pain. Among other effects, opioids interfere with this process of pain perception and stop pain signals from traveling to the brain.

Drug Facts

Generic Name: Oxycodone

Brand Name: Xtampza ER, Dazidoz, Eth-Oxydose, Oxaydo, OxyCONTIN, OxyCONTIN CR, Oxydose, Oxyfast, Oxy IR, Roxicodone, Roxicodone Intensol, Roxybond

Drug Availability: Prescription

Administration Route: Oral

Therapeutic Classification: Analgesic

Available Generically: No

Controlled Substance: Potential for abuse

Active Ingredient: Oxycodone

Dosage Form: Capsule, Extended Release

What Is Xtampza ER Used For?

The Food and Drug Administration (FDA) approved Xtampza ER as a medication for severe, long-lasting pain that can’t be successfully treated through other means. For example, it might be a good choice for someone with pain from cancer that has spread throughout the body (metastatic cancer).

How to Take Xtampza ER

You should take Xtampza ER exactly as your healthcare provider prescribes (usually once every 12 hours). Your healthcare provider may need to adjust your dose until you find the minimal amount that relieves your symptoms.

Xtampza ER is not meant to be taken every now and then when you need it. Instead, you should take the same dose daily as your healthcare provider prescribes.

Take the drug with food and at the same time each day. If you can’t swallow the pill, your healthcare provider may recommend opening the capsule and sprinkling its contents onto soft foods (e.g., applesauce, pudding, yogurt) to consume.

Storage

Xtampza ER should be stored at room temperature, away from heat and light.

You should also be thoughtful about where you store the drug. It should not be accessible to children or visitors to the household. Ideally, you should keep it out of sight and in a location where it can be locked up.

When traveling, only take a little more than you think you’ll need during your trip. If flying, take your pills in your carry-on baggage in the original bottles. 

If going abroad, check with the embassy of the country you are visiting to see if there are any special requirements for traveling. It may also be helpful to carry your prescription with you and a letter from your healthcare provider.

If you have more Xtampza ER than you need, dispose of it properly. Drop off the extra medication at a local site that takes back unused drugs.

How Long Does Xtampza ER Take to Work?

Ask your healthcare provider when you might expect Xtampza ER to start working. You should notice some relief within a few hours. However, it doesn’t work as quickly as some opioid medications in an immediate-release form.

What Are the Side Effects of Xtampza ER?

This is not a complete list of side effects and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your healthcare provider. You may report side effects to the FDA at fda.gov/medwatch or 1-800-FDA-1088.

Common Side Effects

Xtampza ER can cause some side effects, although you might not have any problems. Some relatively common side effects include:

  • Headache
  • Sleepiness
  • Dizziness
  • Nausea and vomiting
  • Constipation
  • Unusual itching

Do not operate heavy machinery while using the drug until you know how it affects you. You may not be alert enough to do this safely.

Severe Side Effects

In some cases, Xtampza ER can cause severe side effects. It is important to know what signs and symptoms to watch for when taking this medication.

Risk of Dependence, Addiction, and Abuse

Like other opioid drugs, Xtampza ER can lead to physical dependency. That means you’ll experience withdrawal symptoms if you stop taking the medication. These might include:

  • Restlessness
  • Runny nose and watery eyes
  • Sweating
  • Muscle aches
  • Irritability
  • Nausea
  • Increased blood pressure

Symptoms are more likely if you’ve been taking large amounts of the drug or if you stop taking it suddenly.

That’s why it's important to work closely with your healthcare provider if you need to stop taking it. Your healthcare provider will slowly reduce your dose to help your body adapt. 

A certain amount of physical dependency happens in most people who take the drug for more than a few days. But in some people, this issue becomes much more severe. Some people develop psychological dependence and addiction to opioid drugs.

Risk of Slowed Breathing, Coma, and Death

Like other opioid drugs, Xtampza ER may cause your breathing to slow or even stop. This risk is much higher if you take a larger-than-normal dose of the drug. 

Taking certain drugs along with Xtampza ER will also significantly increase this risk. These include alcohol, sleep medicines, muscle relaxants, and some medications used for anxiety.

Call 911 if someone taking Xtampza ER is breathing more slowly than usual or if they seem to be unresponsive.

Report Side Effects

Xtampza ER may cause other side effects. Call your healthcare provider if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your provider may send a report to the FDA's MedWatch Adverse Event Reporting Program or by phone (1-800-332-1088).

Dosage: How Much Xtampza ER Should I Take?

Drug Content Provided and Reviewed by IBM Micromedex®

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For oral dosage form (extended-release capsules):
    • For severe pain:
      • Patients who are not taking narcotic medicines or are not opioid tolerant:
        • Adults—At first, 9 milligrams (mg) every 12 hours with food. Your doctor may adjust your dose as needed. However, the dose is usually not more than 288 mg per day.
        • Children—Use and dose must be determined by your doctor.
      • Patients switching from other narcotic medicines:
        • Adults—The total amount of milligrams (mg) per day will be determined by your doctor and depends on which narcotic you were using. Your doctor may adjust your dose as needed.
        • Children—Use and dose must be determined by your doctor.
  • For oral dosage form (capsules):
    • For moderate to severe pain:
      • Patients who are not taking narcotic medicines:
        • Adults—At first, 5 to 15 milligrams (mg) every 4 to 6 hours as needed. Your doctor may adjust your dose as needed.
        • Children—Use and dose must be determined by your doctor.
      • Patients switching from other narcotic medicines:
        • Adults—The total amount of milligrams (mg) per day will be determined by your doctor and depends on which narcotic you were using. Your doctor may adjust your dose as needed.
        • Children—Use and dose must be determined by your doctor.
  • For oral dosage form (extended-release tablets):
    • For moderate to severe pain:
      • Patients switching from regular oxycodone forms:
        • Adults—One tablet every 12 hours. The total amount of milligrams (mg) per day is the same as the total amount of regular oxycodone that is taken per day. The total amount per day will be given as 2 divided doses during the day. Your doctor may adjust your dose as needed.
        • Children 11 years of age and older—Dose must be determined by your doctor. The patient must already be receiving and tolerating opioids for at least 5 days in a row with a minimum of 20 mg per day of oxycodone or its equivalent for at least 2 days before taking OxyContin®.
        • Children younger than 11 years of age—Use and dose must be determined by your doctor.
      • Patients switching from other narcotic medicines:
        • Adults—One tablet every 12 hours. The total amount of milligrams (mg) per day will be determined by your doctor and depends on which narcotic you were using. The total amount per day will be given as 2 divided doses during the day. Your doctor may adjust your dose as needed.
        • Children 11 years of age and older—Dose must be determined by your doctor. The patient must already be receiving and tolerating opioids for at least 5 days in a row with a minimum of 20 mg per day of oxycodone or its equivalent for at least 2 days before taking OxyContin®.
        • Children younger than 11 years of age—Use and dose must be determined by your doctor.
      • Patients who are not taking narcotic medicines:
        • Adults—At first, 10 milligrams (mg) every 12 hours. Your doctor may adjust your dose as needed.
        • Older adults—At first, 3 to 5 milligrams (mg) every 12 hours. Your doctor may adjust your dose as needed.
        • Children—Use and dose must be determined by your doctor.
  • For oral dosage form (immediate-release tablets):
    • For moderate to severe pain:
      • Patients who are not taking narcotic medicines:
        • Adults—At first, 5 to 15 milligrams (mg) every 4 to 6 hours as needed. Your doctor may adjust your dose as needed.
        • Children—Use and dose must be determined by your doctor.
      • Patients switching from other narcotic medicines:
        • Adults—The total amount of milligrams (mg) per day will be determined by your doctor and depends on which narcotic you were using. Your doctor may adjust your dose as needed.
        • Children—Use and dose must be determined by your doctor.
  • For oral dosage forms (liquid concentrate or solution):
    • For moderate to severe pain:
      • Adults—10 to 30 milligrams (mg) every 4 hours as needed. Your doctor may adjust your dose as needed.
      • Children—Use and dose must be determined by your doctor.
  • For oral dosage forms (solution):
    • For moderate to severe pain:
      • Adults—5 to15 milligrams (mg) every 4 hours as needed. Your doctor may adjust your dose as needed.
      • Children—Use and dose must be determined by your doctor.
  • For oral dosage form (tablets):
    • For moderate to severe pain:
      • Adults—At first, 5 to 15 milligrams (mg) every 4 to 6 hours as needed. Your doctor may adjust your dose as needed and tolerated.
      • Children—Use and dose must be determined by your doctor.

Modifications

You can safely take Xtampza ER by opening the capsule and sprinkling the tiny spheres on a small amount of soft food, like applesauce. Swallow the total amount immediately. Do not attempt to crush the tiny spheres found inside the capsule. This method might be helpful for someone who has difficulty swallowing pills. It will not affect how the drug breaks down in your body. Unlike some other kinds of oxycodone (and some other types of opioids), Xtampza ER is designed so that it can be taken this way.

You should never crush or otherwise tamper with opioid medications unless you’ve specifically discussed potential modifications with a healthcare professional. Xtampza ER should never be taken through an injection or through your nose. 

Xtampza ER can also be given to people who use feeding tubes, including gastronomy tubes (G-tubes) inserted into the stomach. It is also OK for nasogastric feeding tubes (NG-tubes) inserted down through the nose into the stomach. 

The tiny spheres inside the capsule should be poured directly into the tube. Then, flush the tiny spheres through the tube with a small amount of water a few times.

Missed Dose

If you miss a dose, take it as soon as you can, with food. However, if you are close to your next dose, do not double up your doses. 

Do your best to take the medication exactly as prescribed at the same time each day. It might help to set a daily timer to remind you. 

If you skip a dose, you might notice pain or withdrawal symptoms within a few hours.

Overdose: What Happens If I Take Too Much Xtampza ER?

Like other forms of oxycodone (and other opioids), overdosing on Xtampza ER can be life-threatening. Many people who overdose on opioids do so accidentally. This is particularly likely if you combine the drug with other medications that decrease your breathing rate. For example, someone who took a sleeping pill and had some alcohol might accidentally overdose, even if they didn’t take more Xtampza ER than usual.

Overdose is also much more likely if you tamper with the drug in some way or don’t take it as prescribed. 

It’s not a bad idea to ask your healthcare provider about having naloxone on hand. Naloxone, also known by its brand name Narcan, can rapidly reduce life-threatening symptoms in someone who has overdosed on Xtampza ER or another opioid. 

Overdose symptoms might include: 

  • Pinpoint pupils
  • Shallow breathing
  • Severe constipation
  • Poor coordination
  • Seizures

What Happens If I Overdose on Xtampza ER?

If you think you or someone else may have overdosed on Xtampza ER, call a healthcare provider or the Poison Control Center (1-800-222-1222).

If someone collapses or isn't breathing after taking Xtampza ER, call 911 immediately.

Precautions

Drug Content Provided and Reviewed by IBM Micromedex®

It is very important that your doctor check your progress while you are using this medicine, especially within the first 24 to 72 hours of treatment. This will allow your doctor to see if the medicine is working properly and to decide if you should continue to take it. Blood and urine tests may be needed to check for unwanted effects.

Do not use this medicine if you are using or have used an MAO inhibitor (MAOI) (eg, isocarboxazid [Marplan®], linezolid [Zyvox®], phenelzine [Nardil®], selegiline [Eldepryl®], tranylcypromine [Parnate®]) within the past 14 days.

This medicine may cause a serious type of allergic reaction called anaphylaxis, which can be life-threatening and requires immediate medical attention. Call your doctor right away if you have a rash, itching, hoarseness, trouble breathing or swallowing, or any swelling of your hands, face, or mouth while you are using this medicine.

It is against the law and dangerous for anyone else to use your medicine. Keep your unused medicine in a safe and secure place. People who are addicted to drugs might want to steal this medicine.

If you think you or someone else may have taken an overdose of this medicine, get emergency help at once. Your doctor may also give naloxone to treat an overdose. Signs of an overdose include: change or loss of consciousness, cold, clammy skin, coughing that sometimes produces a pink frothy sputum, decreased awareness or responsiveness, extreme dizziness or weakness, increased sweating, irregular, fast, or slow, or shallow breathing, pale or blue lips, fingernails, or skin, sleepiness or unusual drowsiness, slow heartbeat, seizures, swelling in legs and ankles, or trouble breathing. Call your doctor right away if you notice these symptoms.

This medicine may cause sleep-related breathing problems (eg, sleep apnea, sleep-related hypoxemia). Your doctor may decrease your dose if you have sleep apnea (stop breathing for short periods during sleep) while using this medicine.

This medicine will add to the effects of alcohol and other CNS depressants. Some examples of CNS depressants are antihistamines or medicine for allergies or colds, sedatives, tranquilizers, or sleeping medicine, other prescription pain medicine or narcotics, medicine for seizures or barbiturates, muscle relaxants, or anesthetics (numbing medicines), including some dental anesthetics. This effect may last for a few days after you stop using this medicine. Check with your doctor before taking any of these medicines while you are using this medicine.

This medicine may be habit-forming. If you feel that the medicine is not working as well, do not use more than your prescribed dose. Call your doctor for instructions.

Dizziness, lightheadedness, or fainting may occur when you get up suddenly from a lying or sitting position. Getting up slowly may help lessen this problem. Also, lying down for a while may relieve dizziness or lightheadedness.

This medicine may make you dizzy, drowsy, or lightheaded. Do not drive or do anything else that could be dangerous until you know how this medicine affects you.

Using narcotics for a long time can cause severe constipation. To prevent this, your doctor may direct you to take laxatives, drink a lot of fluids, or increase the amount of fiber in your diet. Be sure to follow the directions carefully, because continuing constipation can lead to more serious problems.

If you have been using this medicine regularly for several weeks or longer, do not change your dose or suddenly stop using it without checking with your doctor. Your doctor may want you to gradually reduce the amount you are using before stopping it completely. This may help prevent worsening of your condition and reduce the possibility of withdrawal symptoms, such as stomach cramps, anxiety, fever, nausea, restlessness, runny nose, sweating, tremors, or trouble sleeping.

Using this medicine while you are pregnant may cause serious unwanted effects, including neonatal withdrawal syndrome in your newborn baby. Tell your doctor right away if you think you are pregnant or if you plan to become pregnant while using this medicine.

For nursing mothers taking this medicine:

  • Talk to your doctor if you have any questions about taking oxycodone or about how this medicine may affect your baby.
  • Call your doctor if you become extremely tired and have difficulty caring for your baby.
  • Your baby should generally nurse every 2 to 3 hours and should not sleep for more than 4 hours at a time.
  • Check with your doctor or hospital emergency room immediately if your baby shows signs of increased sleepiness (more than usual), difficulty breastfeeding, difficulty breathing, or limpness. These may be symptoms of an overdose and need immediate medical attention.

Using too much of this medicine may cause infertility (unable to have children). Talk with your doctor before using this medicine if you plan to have children.

This medicine may cause adrenal gland problems. Check with your doctor right away if you have darkening of the skin, diarrhea, dizziness, fainting, loss of appetite, mental depression, nausea, skin rash, unusual tiredness or weakness, or vomiting.

Check with your doctor right away if you have anxiety, restlessness, a fast heartbeat, fever, sweating, muscle spasms, twitching, nausea, vomiting, diarrhea, or see or hear things that are not there. These may be symptoms of a serious condition called serotonin syndrome. Your risk may be higher if you also take certain other medicines that affect serotonin levels in your body.

Make sure any doctor or dentist who treats you knows that you are using this medicine. This medicine may affect the results of certain medical tests.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

What Are Reasons I Shouldn’t Take Xtampza ER?

Taking Xtampza ER may not be a smart choice for people with certain medical conditions. For example, it probably isn’t a good idea for people with the following problems:

  • Severe asthma
  • Chronic lung disease 
  • Obstruction in their bowels
  • Adrenal gland insufficiency
  • Extremely low blood pressure
  • Brain tumor
  • Head injury
  • Impaired consciousness

People who have experienced problems with addiction might not want to take Xtampza ER. You may also want to be cautious if addiction runs in your family.

Healthcare professionals recommend that people who are pregnant or nursing do not take oxycodone. If the drug is taken during pregnancy, the baby can be born with symptoms of withdrawal. These can be fatal if not recognized and treated quickly. 

Older adults (65 years and older) should use drug cautiously. For various reasons, they may be more prone to dangerous decreases in their rate of breathing. 

People who have an allergy to Xtampza ER should not take it.

What Other Medications Interact With Xtampza ER?

Taking certain drugs along with Xtampza ER can greatly increase the risk of severe symptoms, like coma or even death. 

While you are taking Xtampza ER, it’s very important to avoid certain drugs that affect your central nervous system, including:

  • Additional opioid medications, unless specifically prescribed by your healthcare provider
  • Alcohol
  • Valium (diazepam), Xanax (alprazolam), or other benzodiazepine drugs
  • Soma (carisoprodol), Flexeril (cyclobenzaprine), or other muscle relaxants
  • Ambien (zolpidem), Lunesta (eszopiclone), or other sleep medicines

Other drugs should be avoided as well. For example, many drugs taken for depression should not be taken with Xtampza ER due to the risk of serotonin syndrome, a rare but life-threatening condition.

Examples of drugs used to treat depression include:

  • Selective serotonin reuptake inhibitors, like Prozac (fluoxetine)
  • Tricyclic antidepressants, like amitriptyline
  • Monoamine oxidase inhibitors, like Nardil (phenelzine)

Other drugs might make Xtampza ER more or less potent in your body. Taking some of these additional drugs might put you into withdrawal.

On the other hand, taking others might make you more prone to overdose. Some examples are:

Your healthcare provider may need to adjust your dose if you take one of these drugs.

Make sure your healthcare provider knows all the medications you are taking, including prescription medications, over-the-counter (OTC) products, and herbal supplements.

What Medications Are Similar?

Oxycodone, the active ingredient in Xtampza ER, is available in a variety of formulations. 

Oxycodone formulations include:

  • OxIR (immediate-release oxycodone tablet)
  • OxyContin (a different extended-release oxycodone tablet)
  • Percodan (immediate-release tablet with oxycodone and aspirin)
  • Percocet (immediate-release tablet with oxycodone and Tylenol)

These are other alternatives that might work for you. Unless specifically directed by your healthcare provider, do not take them at the same time as Xtampza ER.

Extended-release products, such as Xtampza ER, have certain advantages for people with round-the-clock pain. You don’t need to dose yourself as frequently compared with immediate-release products. You’ll also get more consistent pain relief and perhaps less frequent waking due to pain.

One disadvantage of extended-release products is that they are more prone to abuse. By cutting, crushing, or dissolving the capsule, a person can get a very high dose of the drug all at once. However, Xtampza ER is more difficult to tamper with than some other formulations. It is specifically designed so that if it is crushed or cut, it should still deliver its dose over the course of the day.

If you take another pain reliever drug along with your oxycodone (e.g., Percocet), you might be able to use a lower dose of the opioid. Other opioid drugs may also be an option. For example, hydrocodone is a very similar drug.

Other drugs commonly used for pain include:

Discuss all your options with your healthcare provider.

Frequently Asked Questions

  • What are opioids?

    Opioids are a type of pain-relieving drugs that have been used for hundreds of years. Although they are very effective at relieving immediate pain, they also carry serious risks, like addiction and overdose. 

    Prescription opioids include:

    • Xtampza ER and other forms of oxycodone (like OxyContin)
    • Hydrocodone
    • Morphine
    • Methadone
    • Fentanyl

    Heroin is an illegal opioid. Many people now addicted to heroin initially took prescription opioids.

  • Will I develop dependence if I take Xtampza ER?

    Most people will develop some signs of physical dependence if they take the drug for a while. Physical dependence can cause uncomfortable symptoms of withdrawal if you stop taking the medication abruptly. 

    However, you probably won’t experience any issues if you continue to take the drug exactly as prescribed. In someone with severe chronic pain, Xtampza ER can help them function normally.

  • Will I develop a serious addiction if I take Xtampza ER?

    Some people do develop more severe problems with addiction after they start drugs like Xtampza ER. 

    Healthcare providers generally try to avoid prescribing opioid drugs like Xtampza ER unless there are no other options to bring relief. Before starting Xtampza ER, your healthcare provider will carefully discuss the risks and potential benefits with you.

  • Can I open the capsule and sprinkle it on food?

    Yes. This is one way to take Xtampza ER safely. Sprinkle the entire capsule contents on a small amount of soft food, like applesauce. Then swallow the whole amount.

    You cannot safely do this with all opioid drugs or with all kinds of oxycodone. For most of these, cutting or crushing the drug is unsafe. It can lead you to get more of the drug in your system all at once. This can increase your risk of addiction and/or eventual overdose.

  • What is naloxone?

    Naloxone is a life-saving medication used to treat opioid overdose. In some states, you need a prescription to get it, but in others, you do not.

    You may want to talk about it with your healthcare provider if you are prescribed an opioid drug like Xtampza ER. Naloxone is not a replacement for medical evaluation and treatment.

How Can I Stay Healthy While Taking Xtampza ER?

One of the most important things you can do is take the drug exactly as prescribed, neither skipping or doubling up on doses. This will help you greatly reduce your risk of overdose or withdrawal symptoms.

Carefully study the drugs that you must avoid while taking the medication. Some of these include over-the-counter products like sleeping aids and alcohol. Unfortunately, taking these drugs with Xtampza ER can lead to accidental overdose and death. 

Xtampza ER is a powerful drug that should be used cautiously. Only start taking the medication after you’ve carefully considered the pros and cons with your healthcare provider. For many people, opioids like oxycodone can provide life-changing pain relief when used correctly.

Medical Disclaimer

Verywell Health's drug information is meant for educational purposes only and is not intended to replace medical advice, diagnosis, or treatment from a healthcare provider. Consult your healthcare provider before taking any new medication(s). IBM Watson Micromedex provides some drug content, as indicated on the page.

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7 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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