OxyNeo: Innovation In Pain Management or Patent Extender of OxyContin?

The premise is great; OxyNeo is a fairly innovative oral tablet (Concerta [methylphenidate controlled release] also utilizes this formulation) to possibly help curb abuse of one of the most highly abused prescription medications - OxyContin.

OxyNeo is not clear of problems, however, and is actually NOT desirable in a variety of patient populations.

OxyNeo tablets are formulated to make them harder to break or crush, making it difficult for people to chew OxyNeo to release all of the drug at once or crush it into a powder to snort. If one attempts to dissolve the tablets in water or alcohol, the result is a gummy gel that cannot be drawn up in a syringe.

OxyNeo and OxyContin are bioequivalent but there are slight differences:

• OxyNeo takes slightly longer to reach peak levels, which may be perceived as being less effective.
• have a slightly higher peak, which may ptentially lead to more side effects.

Of course, OxyNeo will not curb all abuse. Patients can still take larger amounts orally. As well, creative people are already trying to figure out how to get oxycodone more readily out of the new tablets.  Crushing the tablets followed by dissolution can release over 75% of the dose, depending on the solvent utilized.  There is no proof that OxyNeo is less subject to abuse or diversion.


Patients have to be cautioned NOT to wet or lick OxyNeo tablets prior to putting them in their mouth. There are reports of patients choking because the tablet forms a gummy gel when it is wet. Patients are to be told to swallow each tablet one at a time if they have to take multiple tablets per dose.

This poses a major risk to cancer patients, especially those in head and neck tumour groupings who have fiddiculties swallowing as it is.
One is left to ponder if this is simply a case of altering the controlled release formulation to allow a pharmaceutical company to extend the patent (although I admittely am not certain of what that date would be and company did not disclose when asked).

 
Reference:
Pharmacist Letter