Oxycodone, a mu-opioid receptor (MOR) agonist, is a widely used analgesic. Its mechanism of action involves binding to the MOR, inhibiting cAMP production, and modulating ion channels. Oxycodone is metabolized primarily by CYP2D6 and CYP3A4/5, producing metabolites with varying potency. Genetic polymorphisms in CYP2D6 can influence oxycodone metabolism and response. While studies have shown potential associations between CYP2D6 genotypes and analgesic effects, the clinical significance remains uncertain. Oxycodone is indicated for chronic and acute pain management. It is available in immediate-release and extended-release formulations. Dosage adjustments may be necessary based on individual factors and pain severity. Common side effects include constipation, nausea, vomiting, and drowsiness. Oxycodone is metabolized primarily in the liver and can be problematic in patients with significant liver disease. Serious adverse effects, such as respiratory depression and addiction, are also potential risks. Healthcare providers should carefully consider patient factors, concomitant medications, and possible interactions when prescribing oxycodone. Ongoing research and monitoring are important to ensure its safe and effective use.