***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: To compare the effectiveness and safety of controlled-release ( CR ) oxycodone tablets with immediate-release ( IR ) oxycodone in patients with chronic cancer pain , a multicenter , r and omized , double-blind , parallel-group study was performed in 111 patients with cancer pain . Patients were treated with 6 to 12 tablets or capsules of fixed-combination opioid/nonopioid analgesics per day at study entry . Patients received 30 mg of CR oxycodone tablets every 12 hr or 15 mg of IR oxycodone four times daily for 5 days . No titration or supplemental analgesic medications were permitted . The mean ( + /- SE ) baseline pain intensity ( 0 = none , 1 = slight , 2 = moderate , 3 = severe ) was 1.5 + /- 0.1 for the CR oxycodone-treated group and 1.3 + /- 0.1 for the group given IR oxycodone ( P > 0.05 ) . The 5-day mean pain intensity was 1.4 + /- 0.1 and 1.1 + /- 0.1 for the CR and IR groups , respectively ( P > 0.05 ) . Discontinuation rates were equivalent ( 33 % ) . There was no significant difference between treatment groups in the incidence of adverse events . This study demonstrates that cancer pain patients given 6 to 12 tablets or capsules of fixed-dose combination analgesics can be equally well treated with CR oxycodone administered every 12 hr or IR oxycodone four times daily at the same total daily dose . CR oxycodone offers the benefits of twice daily dosing Morphine and oxycodone were administered to ten patients suffering from severe cancer pain in a double-blind cross-over study . The patients titrated themselves pain-free , first intravenously , using a patient-controlled analgesia device , and then orally . Each titration phase lasted for 48 hours . Blood sample s were drawn after 36 hr of each administration phase . The plasma levels of morphine , morphine-6- and morphine-3 glucoronides were determined with high performance liquid chromatography ( HPLC ) , whereas the oxycodone sample s were assayed with gas chromatography ( GC ) . Twin sample s were analyzed for plasma opioid activity with a radioreceptor assay ( RRA ) using 3H-dihydromorphine and 3H-naloxone as radiolig and s. Adequate analgesia was achieved with both morphine and oxycodone . About 30 % more oxycodone was needed intravenously , whereas 25 % less oxycodone than morphine was consumed orally . There was a good linear correlation between the morphine concentrations measured with HPLC and RRA . The mean morphine-6-glucuronide to morphine concentration ratio was 2.3 after intravenous and 4.6 after oral administration . Results from RRA indicate that oxycodone in vivo is a potent mu-agonist and that at least part of its analgesic action is mediated by active metabolites . In vitro morphine glucuronides enhanced morphine in displacing radiolig and s from the opioid receptors , thus suggesting their complex interactions in vivo The antinociceptive effect of morphine and oxycodone is mediated preferentially at μ and κ receptors , respectively . The aim of this study was to evaluate the analgesic profile of the combination of morphine and oxycodone in cancer pain , compared to the st and ard administration of morphine alone . Controlled-release formulations of oxycodone ( CRO ) and morphine ( CRM ) were compared in 26 patients . The study started with an open-label , r and omised titration phase to achieve stable pain control for 7 days , followed by a double-blind , r and omised crossover phase in two periods , 14 days each . At any point , patients were allowed to use oral immediate-release morphine ( IRM ) as needed , in order to keep visual analogue scale ⩽4 . Pain , satisfaction , adverse effects and number of daily rescue morphine tablets were assessed . A total of 22 patients were evaluated .  The weekly upload consumption ratio in morphine/oxycodone was 1 : 1.8 ( 1.80 , 1.83 , 1.76 , 1.84 ) . The weekly IRM consumption was higher in patients having CRM compared to patients having CRO ( ratio morphine/oxycodone : 1.6 , 1.6 , 1.6 , 1.7 ) ( P<0.05 ) . Patients receiving oxycodone complained of less nausea and vomiting . The rescue morphine analgesic consumption was 38 % higher in patients receiving only morphine , compared to patients receiving both morphine and oxycodone . The results suggest that the combination of morphine/oxycodone ( opioids with differential preferential sites of action ) can be a useful alternative to morphine alone , result ing in a better analgesia profile and less emesis Abstract Background and objective : Oxycodone is a semisynthetic opioid analgesic drug classed as a strong opioid . The controlled-release oxycodone tablet formulation ( OCRT ) was approved in China in 2004 for management of moderate to severe cancer pain . Few data about the efficacy of OCRT and clinical outcomes in Chinese patients taking this drug are available . The purpose of this study was to evaluate the efficacy and tolerability of this drug for relief of moderate to severe cancer pain in Chinese patients . Methods : This was a prospect i ve , open-label , multicentre clinical trial carried out in ten hospitals in Zhejiang Province , China . Patients with cancer pain with a score ≥4 ( numerical rating scale ) were enrolled . They received oral OCRT at an initial dosage of 5 mg every 12 hours for patients scoring 4–6 and 10 mg every 12 hours for patients scoring ≥7 . Doses were then titrated on an individual basis . Onset of analgesic action , pain score and quality -of-life ( QOL ) scores —including items measuring family underst and ing and support , sleep , mental state , appetite , fatigue , and activities of daily life —were evaluated . Adverse effects were also documented . Results : 216 patients ( 126 males and 90 females ) aged 22–84 years were enrolled . The total mean OCRT dosage was 445.2 ± 361.6 mg ( range 130–2320 mg ) . The daily dosages of the vast majority of cases ( 89 % ) were between 10 mg and 30 mg . Onset of analgesic action occurred within 1 hour in 198 cases ( 91.7 % ) following administration of OCRT . 82.4 % of cases were titrated to a steady dosage level within 2 days following administration of the first dose of medication . Pain score decreased significantly ( p < 0.01 ) from 7.1 ± 1.2 at baseline to 2.3 ± 1.2 one week after starting medication and 1.8 ± 0.9 four weeks after starting medication . Scores on all six QOL items increased significantly ( p < 0.01 ) compared with baseline but showed varying rates of improvement . Adverse events included constipation , nausea , vomiting , drowsiness and dysuria . These were noted most frequently in the first week ( 25.5 % of patients ) and lessened over time . No severe adverse events were noted . Conclusion : We conclude that OCRT is well tolerated and effective in controlling moderate to severe cancer pain in Chinese patients Oxycodone is an opioid analgesic that closely resembles morphine . Oxymorphone , the active metabolite of oxycodone , is formed in a reaction catalyzed by CYP2D6 , which is under polymorphic genetic control . The role of oxymorphone in the analgesic effect of oxycodone is not yet clear . In this study , controlled-release ( CR ) oxycodone and morphine were examined in cancer pain . CR oxycodone and morphine were administered to 45 adult patients with stable pain for 3 - 6 days after open-label titration in a r and omized , double-blind , cross-over trial . Twenty patients were evaluable . Both opioids provided adequate analgesia . The variation in plasma morphine concentrations was higher than that of oxycodone , consistent with the lower bioavailability of morphine . Liver dysfunction affected selectively either oxycodone or morphine metabolism . Three patients with markedly aberrant plasma opioid concentrations are presented . Significant individual variation in morphine and oxycodone metabolism may account for abnormal responses during treatment of chronic cancer pain The single-dose pharmacokinetics and pharmacodynamics of oxycodone administered by the intravenous and rectal routes were determined in 12 adult cancer patients with moderate to severe cancer pain ( visual analog scale [ VAS ] score , approximately 5 ) .  Oxycodone was administered by the intravenous and rectal routes with open drug administration and a cross-over design . After single-dose intravenous administration ( 7.9 + /- 1.5 mg , mean + /- SD ) , the mean ( + /- SD ) terminal half-life was 3.4 h ( + /- 1.1 ) , the mean ( + /- SD ) plasma clearance was 45.4 L/h ( + /- 10.1 ) , and the mean ( + /- SD ) volume of distribution in the terminal phase was 3.0 L/kg ( + /- 1.1 ) . After rectal oxycodone ( 30 mg ) , the mean ( + /- SD ) absorption lag time was 0.52 h ( + /- 0.29 ) and the mean ( + /- SD ) absolute bioavailability was 61.6 % ( + /- 30.2 % ) . Intravenous oxycodone was associated with a rapid onset of pain relief ( 5 - 8 min ) in contrast to the 0.5- to 1.0-h delay observed after rectal administration . However , rectal oxycodone provided analgesia of much longer duration ( approximate equals 8 - 12 h ) than did intravenous oxycodone ( approximate equals 4 h ) . There were no significant differences ( P > 0.05 ) in the incidence and severity of side effects between intravenous and rectal oxycodone . The marked interindividual variation observed in the pharmacokinetics and pharmacodynamics of oxycodone in this study emphasizes the need for individualized dosing regimens . ( Anesth Analg 1995;80:296 - 302 Thirty patients with cancer pain completed a double-blind crossover study comparing controlled-release ( CR ) and immediate-release ( IR ) oxycodone . In open-label titration ( 2 to 21 days ) , these patients were stabilized on IR oxycodone qid . They were then r and omized to double-blind treatment with CR oxycodone q12h or IR oxycodone qid for 3 to 7 days followed by crossover at the same daily dose . Mean ( + /- SD ) pain intensity ( 0 = none to 10 = severe ) decreased from a baseline of 6.0 + /- 2.2 to 2.7 + /- 1.1 after titration with IR oxycodone dosed qid . Pain intensity remained stable throughout double-blind treatment : 2.7 + /- 1.9 with CR oxycodone and 2.8 + /- 1.9 with IR oxycodone .  Acceptability of therapy and pain scores correlated with plasma oxycodone concentrations for each interval and were similar for both medications ( IR and CR oxycodone ) . Adverse events were similar for both formulations . Following repeat dosing under double-blind conditions , oral CR oxycodone administered q12h provided analgesia comparable to IR oxycodone given qid PURPOSE AND METHODS We assessed the analgesic efficacy and safety of single-entity oxycodone solution at doses greater than 10 mg orally every 4 hours in 24 patients with chronic cancer pain not controlled by weaker analgesics . RESULTS Twenty of 24 patients completed the study .  Pain relief was obtained with doses up to 60 mg every 4 hours . When oxycodone was taken for long periods , further dose increments could be made safely . The side effects of oxycodone are mild , and common to all opioids , with sedation and constipation most frequent . Nausea was more common in females in all age groups and in patients of either sex less than 50 years of age . Episodes of serious toxicity were rare , and responded to dose reduction . Patients older than 65 years required lower doses , suggesting pharmacokinetic similarities between oxycodone and morphine . Patients changed from oral oxycodone to morphine remained pain-free when relative milligram potency ratios of 1:1 to oral morphine and 3:1 to intravenous morphine were used . CONCLUSION Oxycodone has been shown for the first time to be as versatile and flexible as oral morphine in the management of chronic pain in patients with advanced cancer Background and objectives : Cancer pain affects patients at all stages of the disease and there are clear guidelines for its management . Morphine is considered the first-choice strong opioid in the treatment of moderate-to-severe pain ; however , numerous studies have shown that oxycodone controlled-release ( CR ) has a similar efficacy and safety profile . The purpose of this study was to evaluate the efficacy and tolerability of oxycodone CR as a first-line strong opioid for the treatment of moderate-to-severe pain in Italian cancer patients . Methods : This was a prospect i ve , open-label , multicentre , observational trial carried out at 15 locations across Italy . Patients with a referral for cancer-related pain of ≥5 on a 10-point numerical rating scale were enrolled . Patients were treated with oral oxycodone CR and 
    Output:
    
Conclusions : There is no evidence from the included trials of a significant difference in analgesia or adverse effects between oxycodone and morphine or hydromorphone .
The research was conducted using participants relevant to cancer and palliative care population s.  Oxycodone can be recommended as an alternative to morphine or hydromorphone for cancer-related pain