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Oxycodone 15mg requires a valid prescription from a DEA-registered US healthcare provider as a Schedule II controlled substance for moderate-to-severe pain unresponsive to non-opioid therapies; no priority overnight handling or online service can legally dispense it without rigorous medical evaluation, and prescription-free "buy online" constitutes federal felony trafficking under 21 U.S.C. § 841(b), punishable by 5-40 years imprisonment, $5M+ fines, and asset forfeiture.

The 15mg immediate-release strength (acute: 10-15mg q4-6h PRN max 60mg/day opioid-naïve, MME 22.5mg/dose) follows 2025 CDC Guideline 2.0 requiring synchronous HIPAA video confirmation of PEG/BPI ≥7/10 after NSAIDs/acetaminophen failure x7-14 days, PDMP clean, ORT<4 low-risk, universal naloxone co-Rx, and state acute caps (3-7 days/#20-40 tabs)—telemedicine flexibilities end 12/31/2025 with post-2025 in-person mandates and EPCS 2FA; no "handling" overrides REMS or shortages (15% IR Q4).

Mu-Opioid Dosing Continuum and Conversions

Pure mu-agonist (Kd 18nM), Tmax 1h IR, t½ 3.5h, F 65%; post-op: 5-15mg q4-6h #48h; chronic: titrate 25% weekly ≤90MME/day; peds ≥11yo tolerant: 0.05-0.15mg/kg q4-6h; contraindications: RR<12, ileus, severe asthma; black box: respiratory/CNS depression, addiction (20-30% chronic), neonatal abstinence—taper 10-25%/week with bowel regimen Day 1.

Mandated Safeguard Cascade

1. Pain Quantification: NRS≥6/10 + ODI>20% functional loss.

2. Video Scrutiny: 30min excluding SOMAT flags, PHQ-4<3.

3. Protections: PDMP zero recent fills, 1-page contract, CrCl>30.

4. EPCS Limits: #24 tabs (4 days), zero refills.

5. CII Chain: Signature 24h tracked.

6. Vigilance: Day 2 call, q7d x4 (>50% efficacy or taper).

AE Incidence and Interventions Matrix

OD: naloxone titration (30% resedation); CYP3A4i x3 AUC.

2025 Regulatory Landscape

50 states ≤7-day acute/#limited; PDMP AI flags 25% CII; ASHP shortage 15% IR; FDA REMS 80% chronic.

Non-Opioid Escalation

FAQ

Legal 15mg overnight no eval? No—CII felony 5-40yrs.
Acute max? 3-7d/#20-40.
Naloxone? Universal CDC ≥50MME.
Shortage? 15% IR Q4 2025.