Oxycontin is a extended release formulation of oxycodone that is an effective analgesic for patients with severe pain. The appropriate oral dose can be estimated based on the dose of other agents required to control pain.
mg per day of oral oxycontin =
= (mg per day prior opioid) * (conversion factor)
dosage of Oxycontin q12h =
= (mg per day) / 2
|
Opioid |
Factor |
|
oxycodone, oral |
1 |
|
codeine, oral |
0.15 |
|
hydrocodone, oral |
0.9 |
|
hydromorphone, oral |
4 |
|
hydromorphone, parenteral |
20 |
|
levorphanol, oral |
7.5 |
|
levorphanol, parenteral |
15 |
|
meperedine, oral |
0.1 |
|
meperidine, parenteral |
0.4 |
|
methadone, oral |
1.5 |
|
methadone, parenteral |
3 |
|
morphine, oral |
0.5 |
|
morphine, parenteral, low dose |
3 |
|
morphine, parenteral, high dose |
1.5 |
where:
• The point at which parenteral morphine is considered high dose is not defined. The starting dose is 10 mg every 3-4 hours (60-80 mg per day). Fairly high doses may be given, with doses up to 1,000 mg/h (Nelson KA, et al. J Pain Symptom Management. 1997; 13: 262-267). I will use > 240 mg per day as high dose in the spreadsheet, but this may be too low a level.
Additional instructions:
(1) A supplemental agent should be available for breakthrough pain. Ideally no more than 2 rescue doses should be required per day.
(2) If pain control is inadequate, the q12h dose may be increased by 25-50% every 1-2 days, with monitoring for adverse effects.
Specialty: Pharmacology, clinical
ICD-10: ,
