Precipitated Withdrawal Following Injection of Oxycodone/Naloxone Combination Tablets – Targin

Information for People who Inject Drugs (PWID)
Precipitated Withdrawal Following Injection of Targin®

Targin® is officially marketed for the “treatment of severe pain, which can be adequately managed only with opioid analgesics”.  Naloxone is added to counteract opioid-induced constipation – it blocks the action of oxycodone at opioid receptors located in the gut. Naloxone also acts as a deterrent by causing precipitated withdrawal if injected or snorted.

AIVL has recently received several reports from PWID and practitioners about the emergence of Targin® on to the market in Australia. AIVL recommends that PWID who are likely to come into contact with this medication be informed about the difference between Targin® (the combination product) and Oxycodone (in its mono form).

Reports have included PWID experiencing severe precipitated withdrawals when the slow-release mechanism of Targin® is bypassed and the resulting content is injected or snorted.

Precipitated withdrawal is caused by the Naloxone binding tightly and rapidly to the opioid receptors and removing any opioids which were previously occupying these sites.

AIVL believes that anyone who may be accessing this medication and intending to bypass the slow-release mechanism to achieve a  rapid onset of the effects of Oxycodone speak to their local drug user organisation or NSP for appropriate harm reduction information and advice.

The ratio of Oxycodone/Naloxone is 2/1 and comes in the following doses:

Targin® prolonged-release tablet

  • Targin 5 mg/2.5 mg prolonged-release tablets are oblong, blue film-coated tablets, marked “OXN” on one side and “5” on the other side.
  • Targin 10 mg/5 mg prolonged-release tablets are oblong, white film-coated tablets, marked “OXN” on one side and “10” on the other side.
  • Targin 20 mg/10 mg prolonged-release tablets are oblong, pink film-coated tablets, marked “OXN” on one side and “20” on the other side.
  • Targin 40 mg/20 mg prolonged-release tablets are oblong, yellow film-coated tablets, marked “OXN” on one side and “40” on the other side.

 
Please take note of the above descriptions and doses available so that identification of Targin® is able to be made quickly to prevent any further cases of precipitated withdrawal.

If someone is experiencing precipitated withdrawals and reports recently injecting or snorting Targin®, it is important to monitor the person for any severe withdrawal symptoms, and if warranted seek immediate medical attention.

To download a copy of this warning click here (PDF, 50 KB)

To download a copy of the Product Infomration (PI) click here

For further information from the National Prescribing Service (NPS)  click here