Sometimes a physician may change the prescription of a narcotic analgesic. Ideally this is done for a good reason as the process is not without risks in patients requiring high doses of narcotics.
Rotation is a switch from one opioid to another. This is done with some goal in mind.
Indications for opioid rotation:
(1) to reduce cost or for change in coverage
(2) convenience or compliance
(3) safety of administration
(4) bothersome adverse drug effects
(5) pain persists despite dose escalation
(6) improved kinetics (better absorption, less accumulation, slower clearance)
(7) drug interactions
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