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Key takeaways
Xtampza ER and Oxycontin are both extended-release formulations of oxycodone, used for treating moderate to severe pain, with the main difference being Xtampza ER’s abuse-deterrent formulation.
Both medications are effective for pain management, but Xtampza ER has a lower risk of abuse due to its formulation, making it potentially a safer option for some patients.
Xtampza ER must be taken with food for optimal absorption, unlike Oxycontin, which can be taken with or without food.
Insurance coverage and cost differences exist between the two, with Xtampza ER generally being more expensive but potentially preferred by insurance plans due to its abuse-deterrent properties.
Drug overview & main differences | Conditions treated | Efficacy | Insurance coverage and cost comparison | Side effects | Drug interactions | Warnings | FAQ
Xtampza ER and Oxycontin are brand-name drugs used to treat severe pain that is not relieved by non-opioid treatment options. Both drugs are extended-release formulations of the opioid analgesic, oxycodone. Opioid analgesics work by binding to opioid receptors in the central nervous system to block the sensation of pain.
Xtampza ER and Oxycontin are Schedule II controlled substances that carry a risk of abuse and dependence. They should only be used as prescribed by a healthcare provider.
Continue reading to learn about the similarities and differences between Xtampza ER and Oxycontin.
What are the main differences between Xtampza ER vs. Oxycontin
Xtampza ER and Oxycontin both contain extended-release oxycodone. However, they differ in how they are formulated.
Xtampza ER is manufactured by Collegium Pharmaceutical, Inc. and comes in an abuse-deterrent formulation. Xtampza extended-release capsules contain microspheres with inactive ingredients to prevent abuse, misuse, and tampering of the drug.
Xtampza ER is approved for use in adults. It is usually prescribed to be taken every 12 hours with food. The drug is best absorbed into the body when taken with food.
Oxycontin is manufactured by Purdue Pharma L.P. It is available as an extended-release tablet that is usually prescribed to be taken every 12 hours with or without food. The absorption of the drug is not affected by food.
Oxycontin is approved for use in adults and children aged 11 years and older who have already been taking a minimum daily opioid dose of 20 mg of oxycodone.
| Main differences between Xtampza ER vs. Oxycontin | ||
|---|---|---|
| Xtampza ER | Oxycontin | |
| Drug class | Opioid analgesic | Opioid analgesic |
| Brand/generic status | Only available as a brand-name medication | Brand and generic version available |
| What is the generic name? | Oxycodone base, extended-release | Oxycodone hydrochloride, extended-release |
| What form(s) does the drug come in? | Extended-release oral capsule | Extended-release oral tablet |
| What is the standard dosage? | One 9 mg oral capsule every 12 hours with food Dosage may be adjusted based on response to treatment. The lowest effective dose should be used. |
One 10 mg oral tablet every 12 hours Dosage may be adjusted based on response to treatment. The lowest effective dose should be used. |
| How long is the typical treatment? | Short-term | Short-term |
| Who typically uses the medication? | Adults | Adults and children aged 11 years or older |
Conditions treated by Xtampza ER and Oxycontin
Xtampza ER and Oxycontin are FDA-approved opioid medications that treat moderate to severe pain. They are generally reserved for treating chronic pain that is not relieved by non-opioid analgesics. Xtampza ER or Oxycontin may be prescribed after non-opioid analgesics like acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs) have failed to provide adequate pain relief. Extended-release opioids, like Xtampza ER and Oxycontin, may also be prescribed after an immediate-release opioid has been tried.
| Condition | Xtampza ER | Oxycontin |
| Management of pain severe enough to require an opioid analgesic and for which alternative treatments are inadequate | Yes | Yes |
Is Xtampza ER or Oxycontin more effective?
Xtampza ER and Oxycontin both contain extended-release oxycodone and are similarly effective for pain management. Their primary difference lies in their potential to be abused.
People who are susceptible to drug abuse may crush and snort opioid prescription drugs like Oxycontin. Crushing extended-release oxycodone tablets can impair the drug’s pharmacokinetics, or the delivery and absorption of the drug into the body. Crushed Oxycontin tablets are rapidly absorbed into the body, increasing the risk of overdose and abuse.
Randomized clinical trials have shown that crushing Xtampza ER capsules does not affect its extended-release properties. Compared to crushed Oxycontin tablets, crushed Xtampza ER capsules result in lower plasma concentrations of the opioid. Xtampza ER capsules have been shown to be similarly effective to other opioids, and they are associated with lower rates of abuse.
The most effective opioid prescription drug will depend on a person’s overall condition. Consult with a healthcare provider for the most effective treatment option.
Coverage and cost comparison of Xtampza ER vs. Oxycontin
Xtampza ER capsules may be covered by some Medicare and insurance plans. Many insurance plans may prefer to provide coverage for Xtampza ER over Oxycontin due to its abuse-deterrent properties. Xtampza ER, however, may be more expensive than Oxycontin with an average cash price of $424.31 versus $118.13 with Oxycontin.
A SingleCare discount card may help reduce the cash price of Xtampza ER or Oxycontin. Consult with an insurance provider or pharmacist to determine the exact costs and to compare savings options.
| Xtampza ER | Oxycontin | |
| Typically covered by insurance? | Maybe | Maybe |
| Typically covered by Medicare Part D? | Maybe | No |
| Quantity | 60, 9 mg oral capsules | 60, 10 mg oral tablets |
| Typical Medicare copay | Varies | Varies |
| SingleCare cost | $300+ | $81+ |
Common side effects of Xtampza ER vs. Oxycontin
In clinical trials, the most common side effects of Xtampza ER were nausea, headache, constipation, drowsiness, itching, vomiting, and dizziness.
In clinical trials, the most common side effects of Oxycontin were constipation, nausea, drowsiness, dizziness, vomiting, itching, headache, dry mouth, weakness, and sweating.
| Xtampza ER | Oxycontin | |||
| Side Effect | Applicable? | Frequency | Applicable? | Frequency |
| Nausea | Yes | 17% | Yes | 23% |
| Headache | Yes | 14% | Yes | 7% |
| Constipation | Yes | 13% | Yes | 23% |
| Drowsiness | Yes | 9% | Yes | 23% |
| Itching | Yes | 7% | Yes | 13% |
| Vomiting | Yes | 6% | Yes | 12% |
| Dizziness | Yes | 6% | Yes | 13% |
| Weakness | No | – | Yes | 5% |
| Sweating | Yes | 1–5% | Yes | 5% |
| Diarrhea | Yes | 1–5% | Yes | 1–5% |
| Decreased appetite | Yes | 1–5% | Yes | 1–5% |
| Insomnia | Yes | 1–5% | Yes | 1–5% |
| Abdominal pain | Yes | 1–5% | Yes | 1–5% |
Frequency is not based on data from a head-to-head trial. This may not be a complete list of adverse effects that can occur. Please refer to your doctor or healthcare provider to learn more.
Source: DailyMed (Xtampza ER), DailyMed (Oxycontin)
Drug interactions of Xtampza ER vs. Oxycontin
Oxycodone is primarily processed in the liver by certain enzymes called CYP3A4 and CYP2D6. Drugs that block these enzymes are called inhibitors while drugs that increase the activity of these enzymes are called inducers.
Combining Xtampza ER or Oxycontin with CYP3A4 or CYP2D6 inhibitors can lead to increased blood levels of oxycodone, which can lead to increased side effects of oxycodone. Examples of CYP inhibitors include macrolide antibiotics, azole antifungal agents, and protease inhibitors.
CYP3A4 inducers can speed up the metabolism of oxycodone, decreasing the pain-relieving effects of the opioid. Drugs that act as CYP3A4 inducers include carbamazepine and phenytoin.
The use of benzodiazepines, muscle relaxants, and other CNS depressants should be avoided or monitored while taking an opioid medication. Combining these drugs may lead to an increased risk of respiratory depression, sedation, coma, or death.
Combining an opioid medication with drugs that increase serotonin levels can increase the risk of serotonin syndrome. The use of Xtampza ER or Oxycontin should be monitored while taking drugs like SSRIs, SNRIs, tricyclic antidepressants, triptans, and MAOIs. The use of Xtampza ER and Oxycontin is not recommended for people taking MAOIs or within 14 days of stopping an MAOI.
Opioids may reduce the effectiveness of diuretics. Blood pressure may need to be monitored in people taking an opioid and a diuretic.
Other drug interactions are listed below.
| Drug | Drug Class | Xtampza ER | Oxycontin |
| Erythrocin (erythromycin Biaxin (clarithromycin) |
Macrolide antibiotics | Yes | Yes |
| Diflucan (fluconazole) Nizoral (ketoconazole) |
Azole antifungal agents | Yes | Yes |
| Norvir (ritonavir) | Protease inhibitors | Yes | Yes |
| Tegretol (carbamazepine) Dilantin (phenytoin) |
Anticonvulsants | Yes | Yes |
| Xanax (alprazolam) Valium (diazepam) Ativan (lorazepam) Klonopin (clonazepam) |
Benzodiazepines | Yes | Yes |
| Risperdal (risperidone) Seroquel (quetiapine) Zyprexa (olanzapine) |
Antipsychotics | Yes | Yes |
| Methadone Codeine Duragesic (fentanyl) Morphine |
Opioids | Yes | Yes |
| Alcohol | Alcohol | Yes | Yes |
| Prozac (fluoxetine) Paxil (paroxetine) Zoloft (sertraline) Celexa (citalopram) Lexapro (escitalopram) |
Selective serotonin reuptake inhibitors (SSRIs) | Yes | Yes |
| Cymbalta (duloxetine) Effexor (venlafaxine) Pristiq (desvenlafaxine) |
Serotonin and norepinephrine reuptake inhibitors (SNRIs) | Yes | Yes |
| Pamelor (nortriptyline) Elavil (amitriptyline) |
Tricyclic antidepressants (TCAs) | Yes | Yes |
| Imitrex (sumatriptan) Maxalt (rizatriptan) |
Triptans | Yes | Yes |
| Flexeril (cyclobenzaprine) Skelaxin (metaxalone) |
Muscle relaxants | Yes | Yes |
| Azilect (rasagiline) Eldepryl (selegiline) Parnate (tranylcypromine) |
Monoamine oxidase inhibitors (MAOIs) | Yes | Yes |
| Hydrochlorothiazide Lasix (furosemide) |
Diuretics | Yes | Yes |
| Cogentin (benztropine) Benadryl (diphenhydramine) Ditropan (oxybutynin) Detrol (tolterodine) |
Anticholinergic drugs | Yes | Yes |
This may not be a complete list of all possible drug interactions. Consult a healthcare provider with all medications you may be taking.
Warnings of Xtampza ER and Oxycontin
Medications containing an opioid, like oxycodone, carry a risk of abuse, misuse, and addiction, which can lead to overdose and death. An overdose of these medications may cause fatal respiratory depression and sedation. The risk of serious adverse events may be increased when combining opioids with benzodiazepines or other CNS depressants. Opioid medications should only be used as prescribed by a healthcare provider.
Opioid medications should not be discontinued abruptly. The abrupt discontinuation of an opioid medication in people who are dependent on the drug may lead to severe withdrawal symptoms, uncontrolled pain, or suicide. Withdrawal symptoms may include muscle pain, insomnia, irritability, increased blood pressure, and nausea.
The ingestion of opiates in women who are pregnant can cause harm to an unborn baby. Breastfeeding while taking an opioid medication can cause harm to a breastfed infant. Xtampza ER and Oxycontin should be avoided in women who are pregnant or breastfeeding.
Consult with a healthcare provider or the prescribing information for other possible warnings and precautions associated with Xtampza ER or Oxycontin.
Frequently asked questions about Xtampza ER vs. Oxycontin
What is Xtampza ER?
Xtampza ER is a prescription opioid analgesic used to treat pain. It is available as an extended-release capsule that is formulated to prevent drug abuse and misuse. Xtampza ER capsules come in strengths of 9 mg, 13.5 mg, 18 mg, 27 mg, and 36 mg. It is usually prescribed to be taken every 12 hours.
What is Oxycontin?
Oxycontin is a prescription opioid medication used to treat pain. It is available as an extended-release tablet that can be taken every 12 hours to relieve pain. Oxycontin extended-release tablets are available in strengths of 10 mg, 15 mg, 20 mg, 30 mg, 40 mg, 60 mg, and 80 mg.
Are Xtampza ER and Oxycontin the same?
Xtampza ER and Oxycontin are two extended-release oxycodone formulations. Xtampza ER comes as an extended-release capsule while Oxycontin comes as an extended-release tablet. Both drugs are usually prescribed to be taken every 12 hours for chronic pain relief. They are typically only recommended after non-opioid alternatives have been tried without adequate pain relief.
Is Xtampza ER or Oxycontin better?
Xtampza ER and Oxycontin are similarly effective opioid pain medications that contain oxycodone. They both provide pain relief in people experiencing moderate to severe pain associated with chronic back pain or other conditions. However, Xtampza ER is resistant to tampering and has a lower risk of abuse and misuse than Oxycontin. One possible downside to Xtampza ER is that it needs to be taken with food for maximum effects.
Can I use Xtampza ER or Oxycontin while pregnant?
Opioid prescription drugs should not be taken while pregnant. Taking an opioid medication while pregnant may cause harm to an unborn baby. The use of Xtampza ER or Oxycontin while pregnant can cause neonatal opioid withdrawal syndrome, which may be life-threatening.
Can I use Xtampza ER or Oxycontin with alcohol?
It is recommended to avoid alcohol with opioid use. Both alcohol and opioid medications have CNS depressant effects. Drinking alcohol with opioids can increase the risk of profound sedation, respiratory depression, coma, and death.
Does Xtampza ER work for pain?
Xtampza ER is an effective extended-release opioid for pain relief. It may be prescribed if other non-opioid analgesics are unable to provide adequate pain relief. Clinical trials have shown that Xtampza ER is an effective medication to relieve pain in people with chronic lower back pain. It may also be prescribed for pain associated with other medical conditions, including cancer.
How long does it take Xtampza ER to get into your system?
Xtampza ER can take around 4.5 hours to reach peak levels in the blood. Compared to immediate-release oxycodone, Xtampza ER takes about three hours longer to reach peak levels in the blood. Xtampza ER must be taken with food for maximum absorption.
